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  • 1
    In: Journal of Wound Care, Mark Allen Group, Vol. 30, No. 3 ( 2021-03-02), p. 162-170
    Abstract: The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries (PI) among frontline healthcare workers wearing personal protective equipment (PPE) during the COVID-19 pandemic. The primary outcome of interest was the incidence of facial PIs. The secondary outcomes of interest were facial pain while wearing PPE and ease of use of the care bundle. Methods: This study used a voluntary survey by questionnaire, supplemented by a qualitative analysis of interviews from a small purposive sample that took place in one large Irish hospital over a two-month period in 2020. The hospital was a city-based public university teaching hospital with 800 inpatient beds. The intervention was a care bundle consisting of skin protection, face mask selection, material use, skin inspection, cleansing and hydration developed in line with international best practice guidelines. All staff working in COVID-19 wards, intensive care units and the emergency department in the hospital were given a kitbag containing the elements of the care bundle plus an information pamphlet. Data were collected via a survey and interviews. Results: A total of 114 staff provided feedback on the use of the care bundle. Before using the care bundle 29% (n=33) of the respondents reported developing a facial PI, whereas after using the care bundle only 8% (n=9) of the respondents reported developing a facial PI. The odds ratio (OR) of skin injury development was 4.75 (95% confidence interval (CI): 2.15–10.49; p=0.0001), suggesting that after the care bundle was issued, those who responded to the survey were almost five times less likely to develop a skin injury. Interviews with 14 staff determined that the bundle was easy to use and safe. Conclusion: Among those who responded to the survey, the use of the bundle was associated with a reduction in the incidence of skin injury from 29% to 8%, and respondents found the bundle easy to use, safe and effective. As with evidence from the international literature, this study has identified that when skincare is prioritised, and a systematic preventative care bundle approach is adopted, there are clear benefits for the individuals involved.
    Type of Medium: Online Resource
    ISSN: 0969-0700 , 2052-2916
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Mark Allen Group ; 2022
    In:  British Journal of Nursing Vol. 31, No. 15 ( 2022-08-11), p. S4-S6
    In: British Journal of Nursing, Mark Allen Group, Vol. 31, No. 15 ( 2022-08-11), p. S4-S6
    Type of Medium: Online Resource
    ISSN: 0966-0461 , 2052-2819
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2022
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  • 3
    In: Australian Critical Care, Elsevier BV, Vol. 35, No. 6 ( 2022-11), p. 714-722
    Type of Medium: Online Resource
    ISSN: 1036-7314
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2276137-8
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  • 4
    In: Journal of Neonatal Nursing, Elsevier BV, Vol. 29, No. 2 ( 2023-04), p. 253-259
    Type of Medium: Online Resource
    ISSN: 1355-1841
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2007287-9
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  • 5
    In: Worldviews on Evidence-Based Nursing, Wiley, Vol. 19, No. 2 ( 2022-04), p. 112-120
    Abstract: A pressure ulcer (PU) is a localized injury to the skin or underlying tissue usually over a bony prominence. The prevention PU per patient per day is costly; therefore, the detection of a PU at its earliest stage is imperative to afford timely interventions. Currently, there are very few clinically useful tools to assist with early PU detection and prevention. Aim There were two primary aims of this study: (1) to investigate the relationship between activity, mobility, and PU development; and (2) to ascertain the next steps for delineating an algorithm based on activity and mobility for detecting PU risk among older adult residents in long‐term care. Method This quantitative, prospective, descriptive, non‐experimental study was conducted between July 2019 and March 2020 among 53 older adult residents who were followed for 4 consecutive days. Participants’ Braden score, Elderly Mobility Scale (EMS) score, Movement Level, and 6‐item Cognitive Impairment Test score were assessed. Further, the sacrum and heels were assessed daily using a non‐invasive subepidermal moisture (SEM) scanner and visual skin assessment (VSA). SEM values 〉 0.5 were considered as indicative of the presence of an SEM‐PU. Results The incidence rate of VSA‐PU was 15.1% ( N  = 8). There was an incidence of 87.5% ( N  = 42) of SEM‐PU damage. According to the Braden subscale, Mobility Braden, most of the participants (62.2%, N  = 33) were assessed as having no limitations/slightly limited mobility, while the EMS indicated that most of the participants (67.9%, N  = 36) were classed in an independent category. From the 42 SEM‐PUs observed, 62% ( N  = 26) occurred among the low movers, and 38% ( N  = 16) occurred among the high movers. Linking Evidence to Action Using traditional methods for the assessment of movement does not provide insight into the protective nature of the movement. Given that both low‐ and high‐moving patients can develop tissue damage, it is important to focus on the assessment of movement using more objective measures and algorithms, which enable real‐time assessment of the protective nature of the movement. This would enable development of person‐centered PU prevention strategies to reduce the burden of this significant healthcare problem.
    Type of Medium: Online Resource
    ISSN: 1545-102X , 1741-6787
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2140041-6
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  • 6
    In: International Wound Journal, Wiley, Vol. 17, No. 6 ( 2020-12), p. 1615-1623
    Abstract: This paper aims to discuss the literature pertaining to early pressure‐shear induced tissue damage detection, with emphasis on sub‐epidermal moisture measurement (SEM). The current method for pressure detection is visual skin assessment (VSA); however, this method is fraught with challenges. Advances in early detection of pressure ulcers are reported in the literature and mainly involve measuring inflammation markers on weight‐bearing anatomical areas in order to capture the first signs of tissue damage. One novel technique currently in use is SEM measurement. This biophysical marker is the product of plasma that leaks as a response to local inflammation arising due to pressure‐shear induced damage over bony prominences. The early detection of tissue damage is beneficial in two different ways. First, it enables early intervention when the damage is still microscopic and reversible and, therefore, has the potential to prevent further aggravation of healthy surrounding tissue. This arises by avoiding the causation of the problem and stopping the knock‐on effect of inflammation, especially when the rapid pressure ulceration pathway of deformation is in place. Second, when the slow ischaemic‐reperfusion related mechanism is undergoing, cell death can be avoided when the problem is identified before the cell reaches the “death threshold,” completely averting a pressure ulcer.
    Type of Medium: Online Resource
    ISSN: 1742-4801 , 1742-481X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2152163-3
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  • 7
    In: International Wound Journal, Wiley, Vol. 20, No. 6 ( 2023-08), p. 1987-1999
    Abstract: This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149 at risk acute hospital patients took part, 78 treatment, and 71 control. SEM deltas were recorded daily for a maximum of 5 days using the SEM Scanner (Bruin Biometrics LLC, Los Angeles, California), on three sites: the sacrum, the right heel, and the left heel, with enhanced and targeted PU prevention interventions occurring in those with an elevated SEM delta scores in the treatment group. Intention to treat analysis was used to guide the final composition of results. SEM PU represents PU development as identified by 2 days of sustained abnormal SEM delta scores, ≥0.5, after day one. The mean number of days completed by participants was just under 4 days, participants had many different comorbidities, with the most common being: hypertension, cancer, and chronic obstructive pulmonary disease. Results showed that following the introduction of SEM guided targeted treatments, participants in the treatment group yielded a statistically significant reduction in mean SEM delta scores (MD: 0.49; 95% CI: 0.59, 0.39; P   〈  .0001), and in the odds of developing a SEM PU (OR: 0.59, 95% CI: 0.24 to 1.00; P  = .05). In the treatment group, none of the participants developed a visual PU, whereas, in the control group, 1.41% (n = 1/71) developed a visual PU. Based on all the results, the following is concluded, (1). There was a greater reduction in mean SEM delta scores among those cared for using SEM measurement and targeted PU prevention, versus those cared for using visual skin assessment and usual care, and (2). the mean SEM delta scores was statistically significantly lower at the study end for those who received targeted treatments based on abnormal SEM scores. More research is now needed in other and larger at‐risk groups to further validate what was found in this study.
    Type of Medium: Online Resource
    ISSN: 1742-4801 , 1742-481X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2152163-3
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  • 8
    In: International Wound Journal, Wiley, Vol. 20, No. 2 ( 2023-02), p. 430-447
    Abstract: This meta‐review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR‐2 tool was used for quality appraisal and the certainty of the evidence was appraised using GRADEpro. Data analysis was undertaken using RevMan. We identified 12 systematic reviews published between 1997 and 2021. AMSTAR‐2 assessment identified three as high quality, five as moderate quality, and four as low quality. Seven comparisons were reported, with a meta‐analysis undertaken for five of these comparisons: compression vs no compression (risk ratio [RR]: 1.55; 95% confidence interval [CI] 1.34‐1.78; P   〈  .00001; moderate‐certainty evidence); elastic compression vs inelastic compression (RR: 1.02; 95% CI: 0.96‐1.08; P   〈  .61 moderate‐certainty evidence); four layer vs 〈 four‐layer bandage systems (RR: 1.07; 95% CI: 0.82‐1.40; P   〈  .63; moderate‐certainty evidence); comparison between different four‐layer bandage systems (RR: 1.08; 95% CI: 0.93‐1.25; P  = .34; moderate‐certainty evidence); compression bandage vs compression stocking (RR 0.95; 95% CI 0.87‐1.03; P  = .18; moderate‐certainty evidence). The main conclusion from this review is that there is a statistically significant difference in healing rates when compression is used compared with no compression, with moderate‐certainty evidence. Otherwise, there is no statistically different difference in healing rates using elastic compression vs inelastic compression, four layer vs 〈 four‐layer bandage systems, different four‐layer bandage systems, or compression bandages vs compression stockings.
    Type of Medium: Online Resource
    ISSN: 1742-4801 , 1742-481X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2152163-3
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  • 9
    In: Worldviews on Evidence-Based Nursing, Wiley, Vol. 18, No. 4 ( 2021-08), p. 299-307
    Abstract: Pressure ulcer (PU) development begins with an inflammatory response, arising due to pressure and shear forces causing changes to the cytoskeletal structure of cells. Thus, pain, synonymous with inflammation, may be an indicator of PU development. Aim To explore the role of pain as an indicator of PU development and to determine how this pain was measured. Method We searched PUBMED, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 879 records were returned, with eight satisfying the inclusion criteria. Narrative data synthesis was undertaken. The quality of studies was assessed using the evidence‐based librarianship (EBL) checklist. Results The studies were conducted between 2000 and 2019, and 75% ( n  = 6) employed a cross‐sectional design. The mean sample size was 760 participants (SD = 703). Of the included studies, 87.5% ( n  = 7) identified that pain was associated with PU development. The most frequent pain assessment tool was the numeric rating scale (37.5%; n  = 3). Using the EBL checklist, 62.5% ( n  = 5) of the studies scored ≥75%, reflecting validity. Linking Evidence to Action Pain is associated with PU development; however, further research is required to validate these findings and assess the characteristics associated with pain as a symptom preceding PU development.
    Type of Medium: Online Resource
    ISSN: 1545-102X , 1741-6787
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2140041-6
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  • 10
    Online Resource
    Online Resource
    Mark Allen Group ; 2020
    In:  Journal of Wound Care Vol. 29, No. 9 ( 2020-09-02), p. 496-508
    In: Journal of Wound Care, Mark Allen Group, Vol. 29, No. 9 ( 2020-09-02), p. 496-508
    Abstract: The aim of this systematic review was to assess the effects of different repositioning regimens on pressure ulcer (PU) incidence in at-risk adult individuals without existing PUs. Method: Using systematic review methodology, randomised controlled trials (RCTs), including cluster-RCTs, prospective non-RCTs, pre–post-studies and interrupted-time-series studies were considered. Specifically explored was the impact of the frequency of repositioning, use of repositioning systems and use of turning teams. The search was conducted in January 2019, using PubMed, CINAHL, SCOPUS, Cochrane and EMBASE databases. Data were extracted using a pre-designed extraction tool and analysis was undertaken using RevMan. Results: A total of 530 records were returned, of which 16 met the inclusion criteria. Half of studies were conducted in intensive care units (50%). The mean sample size was 629±604 participants. Frequency of repositioning was explored in nine studies. PU incidence was 8% (n=221/2834) for repositioning every 2–3 hours, versus 13% (n=398/3050) for repositioning every 4–6 hours. The odds ratio (OR) was 0.75 (95% confidence interval (CI): 0.61–0.90, p=0.03), suggesting that there is a 25% reduction in the odds of PU development in favour of more frequent repositioning. Use of a repositioning system was explored in three studies. PU incidence was 2% (17/865) for the repositioning system, versus 5.5% (51/926) for care without using the repositioning system. The OR was 0.26 (95% CI: 0.05–1.29, p=0.10); this finding was not statistically significant. Use of a turning team was explored in two studies. PU incidence was 11% (n=22/200) with use of a turning team versus 20% (n=40/200) for usual care. The OR was 0.49 (95% CI: 0.27–0.86, p=0.01) suggesting that there is a 51% reduction in the odds of PU development in favour of use of a turning team. Using GRADE appraisal, the certainty of the evidence was assessed as low. Conclusion: The results of this systematic review indicate that more frequent repositioning and use of a turning team reduce PU incidence. However, given the low certainty of evidence, results should be interpreted with caution.
    Type of Medium: Online Resource
    ISSN: 0969-0700 , 2052-2916
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2020
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