Decision support-tools for early detection of infection in older people (aged> 65 years): a scoping review.

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.

Practical view of the topical treatment of peripheral venous catheter-related phlebitis: A scoping review.

OBJECTIVE: To identify and analyse topical treatments for peripheral venous catheter (PVC)-related phlebitis. DESIGN: The methodological framework used to make this scoping review was developed by Arksey and O'Malley (2005; (International Journal of Social Research Methodology, 8, 2005 and 19)). DATA SOURCES: A literature search was performed in various databases such as PubMed, Scopus, CINAHL, Cochrane, Cuiden, Web of Science, WorldWideScience and Joanna Briggs. Additionally, articles from informal sources were incorporated. REVIEW METHODS: A search and selection were made of experimental, quasi-experimental and pre-experimental studies published between January 2015 and September 2020 that consider the use of topical products for the treatment of hospital in-patients with PVC-related phlebitis. Appraisal of the methodological quality of the study was performed independently by pairs of reviewers on the basis of the Cochrane Collaboration tool. The review was based on the guidelines in the PRISMA-ScR statement. RESULTS: Twenty-two articles were selected (8 randomised controlled trials (RCTs), 12 quasi-RCTs and 2 pre-experimental studies) which considered treatments applied to a total of 2042 adult patients. The topical treatments described were classified into physical measures and phytotherapeutic and pharmacological treatments. The physical measures are easy to apply, but their effectiveness is limited. The main limitation of the phytotherapeutic treatments is their marketing and use in eastern culture. The best performing pharmacological treatment is the application of magnesium sulphate either with or without glycerine. These products can be presented in different pharmaceutical formulas: ointment, solution and oil. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: The evidence currently available on this issue is limited and often of dubious methodological rigour. Further studies are required on the treatment and follow-up of intravenous therapy-related phlebitis in different national and international contexts.

The perception of training and professional development according to nursing students as health workers during COVID-19: A qualitative study.

AIM: To explore the perception of education and professional development of final-year nursing students who carried out health relief tasks during the COVID-19 pandemic. BACKGROUND: The COVID-19 pandemic has led to a global health emergency. This situation has exacerbated the need for additional healthcare employees, forcing the Spanish government to incorporate volunteer nursing students as auxiliary health staff. DESIGN: A qualitative study framed in the constructivist paradigm. METHODS: Twenty-two students of nursing were recruited. A purposeful sampling was implemented until reaching saturation. A semi-structured interview as a conversational technique was used to collect information based on three dimensions: academic curriculum, disciplinary professional development, and patient care. Subsequently, a content analysis of the information was carried out. Three phases were followed in the data analysis process: theoretical, descriptive-analytical, and interpretive. The COREQ checklist was used to evaluate the study. RESULTS: The most important results are linked to the students' professional and academic preparation, how the nurses handled the pandemic situation and the characteristics of the COVID-19 patients. CONCLUSIONS: Students require training in order to offer holistic care to patients, adapted to the context. Participants highlight the importance of professional values and recognise a high level of competence and autonomy in nurses.