Management of established pressure ulcer infections in spinal cord injury patients

Dinh, Aurélien; Bouchand, Frédérique; Duran, Clara; Denys, Pierre; Lortat-Jacob, A; Rottman, Martin; Salomon, J; Bernard, Louis

doi:10.1016/j.medmal.2018.05.004

Cited by 19 publications

(22 citation statements)

References 63 publications

(66 reference statements)

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“…However, a study by Alhassan et al [12] found contrary results when lower cadre of nurses were found to follow policy protocols for nasogastric tube feedings than higher professional ranks. The authors suggested, neglect of professional duties and over delegation of these professional tasks to lower rank nurses who turn to master the skill and acquire better dexterity on the job over time since the nursing professional is also an art beyond being a science [33][34][35]. In this current study, the authors did not go further to explore reasons for these revelations and would recommend future researchers consider exploring, perhaps employing a blended qualitative and quantitative approach, to unearth reasons for these findings.…”

Section: Discussionmentioning

confidence: 99%

Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

Alhassan

Karley

Ackah

et al. 2020

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Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relations to septic and surgical wounds has been largely attributed to poor adherence to standard policy protocols on wound management by clinical staff especially nurses. Objective Explore the extent to which nursing staff adhere to the policy protocol on management of septic and surgical wounds in selected public health facilities in Ghana. Methodology An analytic cross-sectional study among nursing staff (n=140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to standard policy protocols on septic and surgical wound care. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound healing (Coef.= -0.49, CI=-0.93 -0.05, p=0.036). Conversely, being a senior nursing officer relative to other professional ranks increases staff likelihood of complying with standard policy protocol for wound care (Coef. 5.27, CI=0.59 9.95, p=0.027) relative to lower rank of nurses. Conclusion There is the need for accelerated in-service training for staff on standard protocols for wound are coupled with supportive supervisions. Staff adherence to standard quality care should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.

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Section: Discussionmentioning

confidence: 99%

Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

Alhassan

Karley

Ackah

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Previous studies have made similar conclusions on the association between higher professional ranks and compliance with standard clinical guidelines for nursing care [33]. However, a study by Alhassan et al [12] found contrary results when lower cadre of nurses were found to follow policy protocols for nasogastric tube feedings than higher professional ranks with the rebuttable argument perhaps, unregulated task-shifting and delegation of duties to lower rank nurses promotes mastery of the nursing skills and dexterity on the job over time by these lower ranks given that the nursing profession is also an art beyond being a science [33][34][35]. Additionally, staff with higher ranks are more likely to demonstrate higher likelihood of adherence than those with lower ranks, perhaps because the former might have been exposed to higher educational training and had better opportunities for in-service trainings and workshops on current policy protocols on wound management.…”

Section: Plos Onementioning

confidence: 99%

Implementation of the policy protocol for management of surgical and non-surgical wounds in selected public health facilities in Ghana: An analytic case study

et al. 2020

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Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relation to non-surgical (also called contaminated wounds) and surgical wounds (also called sterile wounds) is largely attributed to poor adherence to policy protocols for wound management by frontline clinical staff especially nurses. Objective Investigate the extent to which nursing staff adhere to the policy protocol for management of non-surgical and surgical wounds in selected public health facilities in Ghana. Methodology This is an analytic case study among nursing staff (n = 140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to policy protocols on non-surgical and surgical wound management. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound management (Coef. =-0.49, CI =-0.93-0.05, p = 0.036). Being a senior nursing officer relative to lower nursing ranks increased staff likelihood of complying particularly with standard policy protocol for management of non-surgical wounds (Coef. 5.27, CI = 0.59 9.95, p = 0.027).

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“…Por lo tanto, en etapa 2, las LP presentaron un costo de tratamiento promedio de R$ 67,69 a 172,32, en etapa 3, entre R$ 29,02 y R$ 96,38, en etapa 4 entre R$ 20,04 y R$ 225,34; y las no clasificables cuestan entre R$ 16,41 y R$ 260,18 (9) . Las lesiones por presión todavía se pueden clasificar como no infectadas o infectadas, en cuyo caso, a menudo se asocian con osteomielitis, que puede ocurrir en 17 a 32% de LP y aumentar el costo del tratamiento (10) .…”

Section: Introductionunclassified

Caracterização das lesões por pressão em adultos portadores de germes multirresistentes

et al. 2020

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Objetivo: Describir las características de las lesiones por presión en pacientes adultos con gérmenes multirresistentes.Método: Este es un estudio transversal realizado con pacientes hospitalizados en la unidad de pacientes hospitalizados por gérmenes resistentes a múltiples fármacos de un hospital público en el sur de Brasil. Se seleccionaron pacientes con lesión por presión del estadio II. Los datos se recopilaron en 2017 de una muestra de 110 lesiones en 36 pacientes utilizando la Herramienta de evaluación de heridas Bates-Jensen (BWAT). Los datos se analizaron mediante estadísticas descriptivas y analíticas. Resultados: La edad promedio de los individuos fue de 45.4 (± 21.3) años y el 89.1% había sido hospitalizado con una lesión por presión, que ocurrió en el hogar o en otras instituciones de salud. El valor medio de BWAT fue de 35.5 ± 8.9 puntos y hubo una correlación positiva débil (r = 0.228 p = 0.017) con el tamaño de la lesión, correlación positiva moderada con el estadio de la lesión (r = 540 p <0.001). y con el resultado de la escala de Braden (r = 0.44 p = 0.651).Conclusión: Los resultados muestran la enfermedad de pacientes jóvenes. Los pacientes con gérmenes multirresistentes presentaron lesiones por presión con una mayor participación de las estructuras, lo que sugiere la necesidad de apoyo en el hogar. Objective: To describe the characteristics of the pressure lesions in adult patients with multiresistant germs.Method: This is a cross-sectional study conducted with patients admitted to the inpatient unit for multidrug resistant germs in a public hospital in Brazil. Patients with pressure lesions from stage II were selected. Data collection took place in 2017, in a sample of 110 injuries, in patients, through the Pressure Ulcer State Assessment Instrument (Bates-Jensen Wound Assessment Tool - BWAT). Results: The average age of the individuals was 45.4 (± 21.3) years old and 89.1% had already suffered pressure lesions, such as those that occurred at home or in other health institutions. The mean BWAT value was 35.5 ± 8.9 points and there was a weak positive correlation (r = 0.228 p = 0.017) with lesion size, moderate positive correlation with lesion stage (r = 540 p <0.001), and with the result of the Braden scale (r = 0.44 p = 0.651).Conclusion: The results indicated the illness of young patients. Patients with multiresistant germs suffered pressure lesions with greater involvement of structures, which suggests the need for home support.

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Management of established pressure ulcer infections in spinal cord injury patients

Cited by 19 publications

References 63 publications

Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

Implementation of the policy protocol for management of surgical and non-surgical wounds in selected public health facilities in Ghana: An analytic case study

Caracterização das lesões por pressão em adultos portadores de germes multirresistentes

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