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In 2010, a three-year research programme was launched to study the occurrence and significance of certain risk factors for pressure ulcers (PUs) in a mixed intensive care unit (ICU), and to find previously unidentified risk factors. A modified Jackson/Cubbin (mJ/C) risk scale was used to formalise PU risk assessment. Adult patients needing intensive or high dependency care were included. The first results of a whole cohort (n=1,629 patients) treated in 2010 are reported. In this cohort, 72% of the patients had a surgical condition and 31% needed treatment for three or more days. The prevalence of PUs was 11.8% and the incidence was 11.1% (181/1,629) or the incidence rate was 3.0/100 ICU days. The most common sites of PUs were the sacrum, heels and nose. Nasal PUs were associated with masks used for noninvasive ventilation. Demographic variables did not differ between patients with or without PUs. Medical patients had the highest incidence of PUs (18.2%). In this group, 46.6% of patients without PU had a mJ/C-score ≤29 and 55.8% of the patients with PUs had a similar score. Patients with longer treatment times (three days or more) and medical patients had increased risk for PU development. The results indicate that the previously published J/C cut-off score of 29 may not be optimal for the identification of high/extremely high-risk patients. Further analysis of the patient populations, their PU risk factors and the significance of individual components of the J/C risk scale are ongoing.

The purpose of this study was to describe the level of chronic wound‐care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.

Background Ventilating critically ill patients with acute respiratory distress syndrome in the prone position is a life-saving strategy, but it is associated with adverse consequences such as skin damage. Aim To identify, review and evaluate international proning and skin care guidelines and make an inventory of commonly used equipment and training resources. Design A gap analysis methodology was applied. Methods 1) Comprehensive search and evaluation of proning and skin care guidelines, 2) extensive search and listing equipment and educational resources, and 3) international consultation with 11 experts (8 countries). Data sources A variety of sources researched through July 2021 were used to identify relevant literature: (1) scientific literature databases and clinical trials registries, (2) intensive care and wound care associations, (3) healthcare organisations, (4) guideline development organisations, and (5) the Google search engine. Eleven international experts reviewed the literature and provided insights in two, 2-h online sessions. Findings The search yielded 24 guidelines. One clinical practice guideline had high methodological quality. Twenty-five devices/equipment and sixteen teaching materials were identified and discussed with the expert panel. The gap analysis identified a lack of concise, accessible, evidence-based guidelines and educational materials of short duration. Conclusion This analysis forms the basis for designing a competency-based education and training intervention for an interdisciplinary team caring for the skin of critically ill patients in the prone position. Impact The results can assist the multidisciplinary team to review their current protocol for prone positioning. This is a first step in developing a training package for clinicians.

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