Aims and objectives This study aims to explore nurses' perceptions and experiences regarding pressure injuries caused by medical devices and to understand the perceived challenges and barriers nurses face in preventing medical device‐related pressure injuries. Background Nurses have a responsibility to prevent pressure injuries and play a major role in their prevention. As there has been a lack of research on medical device‐related pressure injuries, not much is known about nurses’ perceptions and experiences. This therefore hinders the establishment of effective and efficient interventions in nurses’ education and in the practical environment. Design A descriptive qualitative design was adopted, and the COREQ checklist was employed to report on the current study. Methods The study was conducted at an acute care hospital in Singapore. Purposive sampling was used, and a total of 21 enrolled and registered nurses who had recent experiences with medical device‐related pressure injuries were recruited between August and December 2018. Face‐to‐face interviews were conducted using a semi‐structured interview guide. A thematic analysis was performed to analyse the qualitative data. Results Five themes emerged regarding pressure injuries: (1) preventable yet unavoidable, (2) everyone's responsibility, (3) harmonising theory with practice reality, (4) pre‐existing conditions may limit injury prevention and management; and (5) nurses expressed a need for experiential training. Conclusions The study's findings could be used to develop improvements in nursing practice and policy at acute care hospitals, as well as to improve awareness of medical device‐related pressure injuries among healthcare professionals. Moreover, the findings can also inform future research studies to develop effective evidence‐based practices and improve patient outcomes. Relevance to the clinical practice This study reveals the unique challenges and dilemmas that nurses face and will help to inform healthcare institutions and management in developing programmes and improving protocols to reduce the incidence rate of pressure injuries caused by medical device.
Aims: To describe a systematic process for the development of a nurse-led smartphone-based self-management programme for type 2 diabetes patients with poor glycaemic control in Singapore. Methods: A three-step process involving the application of a theoretical framework, evidence from literature, content validity, and pilot tests were conducted for the content and technical development of the programme. Content experts and lay patients evaluated the appropriateness, relevance, and comprehensibility of the newly developed Care4Diabetes application. A pilot randomized controlled trial was conducted with 40 patients recruited in Singapore. Twenty patients each were randomly allocated to the control and intervention groups. The study outcomes were collected at baseline and at 3 months thereafter. Results: The nurse-led smartphone-based self-management programme was developed with integration of the Care4Diabetes application and the web-portal system. The pilot results indicated that the effects of this smartphone-based programme on patient's health-related outcomes were comparable with those of the currently available nurse-led diabetes service. Conclusion: The smartphone-based self-management intervention was deemed effective, yet full-scale randomized controlled trials are still ongoing and the results of these may provide strong evidence of the effectiveness of such an approach in improving patient care. Impact: The uniqueness of this study lies in the integrated system used, which offers a clinical platform for diabetes nurses to provide personalized coaching and care to patients remotely, while monitoring patients' progress closely. By adopting such an approach, it would free up more time for nurses to cater to patients who are more critically in need of their direct attention.
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