GENERAL PURPOSE To synthesize the evidence regarding nonhealable and maintenance wound management and propose an interprofessional referral pathway for wound management. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES After participating in this continuing professional development activity, the participant will apply knowledge gained to: 1. Identify the ideas from the authors’ systematic review that could prove useful in understanding nonhealable and maintenance wound management. 2. Select evidence-based management strategies for nonhealable and maintenance wound management. OBJECTIVE This systematic integrative review aims to identify, appraise, analyze, and synthesize evidence regarding nonhealable and maintenance wound management to guide clinical practice. An interprofessional referral pathway for wound management is proposed. DATA SOURCES An electronic search of Scopus, Web of Science, PubMed, Academic Search Ultimate, Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature database with Full Text, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition, and MEDLINE was conducted for publications from 2011 to 2019. Search terms included (nonhealable/nonhealing, chronic, stalled, recurring, delayed healing, hard-to-heal) and wound types most associated with nonhealable or maintenance wounds. Published studies were hand searched by the authors. STUDY SELECTION Studies were appraised using two quality appraisal tools. Thirteen reviews, six best-practice guidelines, three consensus studies, and six original nonexperimental studies were selected. DATA EXTRACTION Data were extracted using a coding framework including treatment of underlying causes, patient-centered concerns, local wound care, alternative outcomes, health dialogue needs, challenges within resource restricted contexts, and prevention. DATA SYNTHESIS Data were clustered by five wound types and local wound bed factors; further, commonalities were identified and reported as themes and subthemes. CONCLUSIONS Strong evidence on the clinical management of nonhealable wounds is limited. Few studies describe outcomes specific to maintenance care. Patient-centered care, timely intervention by skilled healthcare providers, and involvement of the interprofessional team emerged as the central themes of effective management of maintenance and nonhealable wounds.
Background Infection is more frequent, and serious in people aged > 65 as they experience non-specific signs and symptoms delaying diagnosis and prompt treatment. Monitoring signs and symptoms using decision support tools (DST) is one approach that could help improve early detection ensuring timely treatment and effective care. Objective To identify and analyse decision support tools available to support detection of infection in older people (> 65 years). Methods A scoping review of the literature 2010–2021 following Arksey and O’Malley (2005) framework and PRISMA-ScR guidelines. A search of MEDLINE, Cochrane, EMBASE, PubMed, CINAHL, Scopus and PsycINFO using terms to identify decision support tools for detection of infection in people > 65 years was conducted, supplemented with manual searches. Results Seventeen papers, reporting varying stages of development of different DSTs were analysed. DSTs largely focussed on specific types of infection i.e. urine, respiratory, sepsis and were frequently hospital based (n = 9) for use by physicians. Four DSTs had been developed in nursing homes and one a care home, two of which explored detection of non- specific infection. Conclusions DSTs provide an opportunity to ensure a consistent approach to early detection of infection supporting prompt action and treatment, thus avoiding emergency hospital admissions. A lack of consideration regarding their implementation in practice means that any attempt to create an optimal validated and tested DST for infection detection will be impeded. This absence may ultimately affect the ability of the workforce to provide more effective and timely care, particularly during the current covid-19 pandemic.
Aim To adapt the Youth‐Friendly Health Services‐World Health Organization+ questionnaire to suit the health needs of youth in the South African context, and estimate its psychometric properties. Background Youth‐friendly health services promote health‐seeking behaviour amongst young people. The perceptions of youth and adolescents are thus important whilst assessing the youth‐friendliness of health services. Methods We conducted six focus group interviews to evaluate the clarity and relevance of the questionnaire items and adapted the questionnaire which was was administered to 101 youth who visited primary healthcare clinics. We reduced the number of items through quantitative analysis of responses and item analysis. Cronbach's alpha was used to optimize internal consistency reliability. Experts established a baseline of youth‐friendliness. We ranked the responses from the youth against the baseline of youth‐friendliness and used independent two sample t‐test to test for construct validity of the final adapted version, titled Youth‐Friendly Health Services‐ South Africa. Results or Findings After the focus group interviews, we rephrased 27 items, removed four items and added eight items. We reduced the questionnaire to 57 items whilst optimizing internal consistency reliability. The statistical analysis supported construct validity. Conclusion The Youth‐Friendly Health Services‐South Africa is the first English validated version and demonstrates good psychometric properties. Implication for nursing practice and health policy The Youth‐Friendly Health Services‐South Africa can be useful to evaluate the youths' satisfaction with the health care and nursing service they receive. This study's findings indicate that the original questionnaire can be adapted for use in different contexts to shape local and global nursing practice and policies.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.