Competence areas for registered nurses and podiatrists in chronic wound care, and their role in wound care practice

2019 ◽  
Vol 28 (21-22) ◽  
pp. 4021-4034 ◽  
Author(s):  
Emilia Kielo ◽  
Riitta Suhonen ◽  
Leena Salminen ◽  
Minna Stolt
Keyword(s):  
Registered Nurses ◽  
Chronic Wound ◽  
Wound Care ◽  
Care Practice

scholarly journals Principles of Best Diagnostic Practice in Tissue Repair and Wound Healing: An Expert Consensus

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 50
Author(s):  
David G. Armstrong ◽  
Karen Bauer ◽  
Greg Bohn ◽  
Marissa Carter ◽  
Robert Snyder ◽  
...  
Keyword(s):  
Protease Activity ◽  
Pathogenic Bacteria ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Signs ◽  
Care Practice ◽  
Invasive Infection ◽  
Consensus Panel ◽  
Advanced Therapies

Chronic wound treatment currently relies heavily on visual assessment by clinicians; however, the clinical signs and symptoms of infection and inflammation are unreliable in chronic wounds. The specialty of wound care has witnessed the advent of advanced interventions, such as cellular and/or tissue based products (CTP). The success of advanced therapies relies on preparing the wound bed by reducing bacterial burden and inflammation. The lack of diagnostics in chronic wound care leads to uncertainty in the adequacy of wound bed preparation. Recent research suggests that two novel point-of-care diagnostic tests can assist in the detection of chronic inflammation known as elevated neutrophil derived protease activity (EPA) and bacterial pathogenesis known as bacterial protease activity(BPA) in chronic wounds. Despite the evidence, however, clinicians report that incorporating diagnostics into every day practice is challenging and across the globe, they have requested guidance on their use. Methods and Recommendations: A panel of wound care experts, experienced with these tests, met to develop guidelines on their use in wound care practice. The consensus panel concluded that the clinician should test for BPA first. The panel maintained that the risk of invasive infection resulting from the presence of pathogenic bacteria was the greatest threat to the patient’s health. If the BPA test is negative, the panel recommended testing for EPA. In addition, it was suggested that if the wound failed to progress after the elevated BPA was treated and subsequent testing was negative for BPA, the clinician should consider testing for EPA. Conclusions: In this manuscript, the consensus panel suggests pathways for testing, treating, and retesting for EPA and BPA. The panel expects that following the algorithm has the potential to improve healing outcomes, result in more cost-effective use of advanced therapies, and improve antimicrobial stewardship by guiding antimicrobial use.

scholarly journals Interpretation of Near-Infrared Imaging in Acute and Chronic Wound Care

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 778
Author(s):  
Jonathan Arnold ◽  
Valerie L. Marmolejo
Keyword(s):  
Near Infrared ◽  
Clinical Decision Making ◽  
Infrared Imaging ◽  
Chronic Wound ◽  
Wound Care ◽  
Imaging Modality ◽  
Point Of Care ◽  
Care Practice ◽  
Correct Interpretation ◽  
Near Infrared Imaging

Vascular assessment is a critical component of wound care. Current routine noninvasive vascular studies have limitations which can give a false sense of security of the presence of adequate perfusion for healing. Near-infrared imaging modalities can serve as an additional diagnostic assessment of wounds in which adequate perfusion is a concern. Correct interpretation of near-infrared images obtained is critical as subtleties that exist in the acute and chronic wound population goes beyond the interpretation that increased signal is consistent with adequate perfusion for healing. The objective of this paper is to educate providers on the correct interpretation of this point-of-care imaging modality in day-to-day wound-care practice to guide clinical decision-making for rapid wound resolution.

The Analysis of Nurses’ Positive Deviance Behaviours as a Measure in Preventing the Transmission of Healthcare-Associated Infections (HAIs) at M. Djamil Hospital, Padang, West Sumatera

2018 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Esthika Ariany Maisa ◽  
Yulastri Arif ◽  
Wawan Wahyudi
Keyword(s):  
Grounded Theory ◽  
Wound Care ◽  
Positive Deviance ◽  
Care Practice ◽  
Theory Approach ◽  
Nursing Managers ◽  
Theoretical Sampling ◽  
Develop Theory ◽  
Healthcare Associated ◽  
Grounded Theory Approach

Purpose: To explore the nurses’ positive deviance behaviors as an effort to provide solutions in preventing and controlling infections in the hospital. Method: This is a qualitative research using grounded theory approach. Thirteen nurses from Dr.M.Djamil hospital were selected based on theoretical sampling in order to develop theory as it appears. Nurses were interviewed from June to September 2014. Interviews were thematically analyzed using techniques of grounded theory to then generate a theory from themes formed. Findings: The modes of positive deviance behavior identified were practicing hand hygiene beyond the standards (bringing handsanitizer from home), applying nursing art in wound care practice, placing patients with MRSA infections at the corner side, giving a red mark on a MRSA patient’s bed for easy identification by nurses, changing clothes and shoes in hospital, reducing hooks on the wall, and cleaning the ward on scheduled days. Conclusion: The study shows that nurses have a number of positive deviance behaviors to prevent infection transmission in the wards. It is sugested that the hospital management and nursing managers adopt some of the uncommon solution highlighted by the nurses to solve the HAIs problems in the hospital.

Considerations for Translating Medical Devices Under Development From the Clinic to the Home: A Case Study in Providing Chronic Wound Care

2021 ◽  
Vol 10 (1) ◽  
pp. 238-242
Author(s):  
Ellen J. Bass ◽  
Justine S. Sefcik ◽  
Elease McLaurin ◽  
Rose Ann DiMaria-Ghalili
Keyword(s):  
Medical Devices ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Protocol ◽  
Structured Interviews ◽  
Home Setting ◽  
Ultrasound Application ◽  
Research Assistants ◽  
Current Device

A prototype medical device and protocol that work well in a clinic would not necessarily work reliably in the home setting. The goal of this work is to identify factors to consider when translating a device evaluated in a clinic for use by home caregivers providing chronic wound care for persons living with dementia. One must consider the current device, the associated bundle, the protocol and how they may need to be modified. Semi-structured interviews with the research assistants who have applied a prototype device were conducted to generate a list of known issues with the current clinical protocol in terms of ultrasound application The researchers performed a set of specified tasks by following the current device protocol and explaining any difficulties with use\execution. They embellished the descriptions with details about what had happened with actual patients in the clinic. Using thematic analysis, analysts identified themes and subthemes. Issues potentially relevant to translating medical devices to the home are discussed.

Optimising chronic wound care: a human and financial necessity

2021 ◽  
Vol 27 (11) ◽  
pp. 269-271
Author(s):  
Julie Penfold
Keyword(s):  
Chronic Wound ◽  
Evidence Based Practice ◽  
Wound Care ◽  
Healthcare Services ◽  
Evidence Based

Julie Penfold highlights the importance of evidence-based practice in wound care to reduce the burden on patients and healthcare services.

Placing the patient at the centre of chronic wound care: A qualitative evidence synthesis

2017 ◽  
Vol 26 (4) ◽  
pp. 254-259 ◽  
Author(s):  
Naomi Fearns ◽  
Stephen Heller-Murphy ◽  
Joanna Kelly ◽  
Jenny Harbour
Keyword(s):  
Chronic Wound ◽  
Wound Care ◽  
Evidence Synthesis ◽  
Qualitative Evidence Synthesis ◽  
Qualitative Evidence

Wound infections: an overview

2021 ◽  
Vol 26 (Sup6) ◽  
pp. S22-S25
Author(s):  
Martha Williams
Keyword(s):  
Wound Infection ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Economic Factors ◽  
Ageing Population ◽  
Wound Infections ◽  
The Many ◽  
Systemic Therapies ◽  
Socio Economic Factors

In the ever-changing world of wound care and nursing, it remains apparent that chronic wounds are a growing challenge. Evidence shows that age increases the likelihood of developing a chronic wound, which supports the notion that the burden of these wounds on the NHS is likely to further intensify with the ageing population. There are many reasons why a wound may fail to progress, including wound aetiology, comorbidities and environmental and socio-economic factors. One of the most significant reasons why wounds may fail to progress and become chronic is untreated wound infection. In order for clinicians to be able to treat and manage wound infections, it is vital that they understand how infection develops, the many ways in which infections may present themselves and how and when to initiate appropriate topical and systemic therapies to treat wound bed infections. The present article provides an overview of wound bed infections and their management.

Effect of Topical Oxygen Therapy on Chronic Wounds

2021 ◽  
Vol 39 ◽  
Author(s):  
Crystal James ◽  
◽  
So Park ◽  
Denise Alabi ◽  
John Lantis ◽  
...  
Keyword(s):  
Personal Experience ◽  
Oxygen Therapy ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Treatment Modalities ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence ◽  
The Past ◽  
Ischemic Ulcers

Over the past three decades, there has been a growing interest in the use of oxygen therapy to promote wound healing. Although the most commonly recognized oxygen therapy for the treatment of chronic wounds is hyperbaric oxygen therapy, topical oxygen therapy has a greater level of evidence supporting its use in chronic wound care. Still, it is imperative that these two treatment modalities be recognized not merely as competitors, but as distinct therapeutic entities. Through personal experience and a thorough literature review, we investigated the use of topical oxygen therapy in the management of chronic wounds. The benefits of using topical oxygen therapy have been demonstrated in patients with diabetic foot ulcers, ischemic ulcers, post-revascularization ulcers, and pressure ulcers. There are several topical oxygen devices currently on the market that are versatile, relatively low-risk, and generally well-tolerated by patients. While these devices have been used in the treatment of chronic wounds at different locations and of different etiologies, other uses of these devices are still being investigated. Topical oxygen therapy is yet another tool in our arsenal to be used in treating difficult to heal chronic wounds and could potentially be used more readily.

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