The experience of infection prevention and control nurse (IPCN) in conducting post-discharge surveillance (PDS) of surgical site infections (SSI): A qualitative study.

BACKGROUND: Surgical Site infections (SSI) are healthcare-associated infections (HAI) resulting from surgical procedures, which can increase morbidity, mortality, and economic burden. SSI surveillance is useful for detecting the magnitude of SSI cases and evaluating the impact of SSI prevention implementation. Post-discharge surveillance (PDS) of SSIs may identify more significant cases. To the best of our knowledge, there is no research exploring the experiences of Infection Prevention and Control Nurse (IPCN) in conducting PDS of SSI. METHODS: To explore the experience of IPCN in conducting PDS of SSI. A qualitative transcendent phenomenological (descriptive) research, using a purposive sampling technique with 15 informants from 9 hospitals in Indonesia. Data were collected through in-depth direct and semi-structured interviews and analyzed using thematic analysis through Nvivo 12 plus software. RESULTS: Five themes were generated, including the stages of PDS of SSI, the collaborative role of PDS of SSI officers, inhibiting factors of PDS of SSI, supporting factors of PDS of SSI, and optimization of PDS of SSI. CONCLUSION: This study provides a deep understanding of the implementation PDS of SSI through an exploration of IPCN experiences, offering insights into the execution and various challenges faced by hospitals in conducting PDS of SSI.

Matrix Metalloproteinase-9 Testing of Golden Rice Cookies With Piper Crocatum Active Extract for Preventing Foot Ulcers in Patients With Diabetes: Protocol for a Randomized Controlled Trial.

BACKGROUND: Diabetic foot ulcers (DFUs) present a formidable challenge to both patients and health care systems. DFUs significantly reduce the quality of life for patients, prolong hospital stays, and are the cause of approximately 70,000 lower limb amputations across the globe annually. Prevention of DFUs primarily involves the optimization of blood sugar levels and the effective management of complications, particularly peripheral neuropathy. Golden Rice has been proven to lower blood sugar levels due to its beta-carotene content, and Piper crocatum (P. crocatum) has been found to be effective in reducing the risk factors of DFUs through biomolecular regulation because of its polyphenol content. OBJECTIVE: The principal objective of this study is to identify the efficacy of P. crocatum-enriched cookies, with Golden Rice as their primary ingredient, in preventing DFUs. The evaluation will center on their impact on the expression of matrix metalloproteinase-9 (MMP-9), a pivotal factor in the development of DFUs. METHODS: This study is an experimental clinical research that follows the randomized controlled trial method and uses a single-blind design. The participants in the study are outpatients from primary health centers in Makassar, Indonesia, who have been diagnosed with diabetes mellitus. The sample for the study will be randomly selected and subsequently categorized into 2 groups: the intervention group and the control group. The intervention group consumes P. crocatum-enriched Golden Rice cookies, while the control group receives cookies without these additives. The participants from both groups will consume their respective cookies (packaged identically) twice a day for 14 days. The cookies will be prepared according to a modified recipe with an emphasis on low glucose content, resulting in 51 calories per cookie, comprising 1% carbohydrates, 6% fat, 4% cholesterol, and 4% fiber, excluding gluten, sugar, and salt. They will be baked at 158°C for 20 minutes. The process involves the addition of 20% Golden Rice and 10% P. crocatum ethanol extract, both prepared via maceration with 96% ethanol. The dependent variable in this study is the expression of gelatinases matrix metalloproteinase, to be assessed at 2 distinct time points-preintervention (pretest) and postintervention (posttest)-with the evaluation conducted through the western blotting method. RESULTS: The recruitment and testing phase started in January 2024. The study is scheduled to be completed by the end of March 2024. Data analysis will commence in April 2024, and the publication of the results is anticipated in the same year (2024). The study will report on the changes in primary data, encompassing gelatinases matrix metalloproteinase, as well as secondary data, including the ankle-brachial index, neuropathy score, and random blood glucose level. CONCLUSIONS: The findings of this trial are expected to significantly impact the selection of strategies by health care practitioners to enhance diabetes self-management, particularly in the domain of therapeutic snacking, for patients diagnosed with diabetes mellitus. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20230502001; https://www.thaiclinicaltrials.org/show/TCTR20230502001. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/49940.

Exploring herbal remedy utilization for wound healing: Patterns, patient preferences, and implications for nursing practice.

PURPOSE: The utilization of herbal remedies for wound healing is a notable aspect of traditional medicine practices. Understanding herbal use among patients yields insights for nursing care enhancement. This study aimed to investigate the utilization of herbal remedies for wound healing among diabetic patients. METHODS: A total of 453 participants were enrolled, with demographic data, including age, sex, occupation, education level, residence, ethnic group, distance from health service, herbal use duration, and wound duration presented. Descriptive statistics were used to analyze the data, including means, standard deviations, ranges, and percentages. FINDINGS: The average participant age was 55.39 years, with most being non-civil servant workers (60.3%) and having a low education level (67.1%). Indian almond wood (9.7%) and green betel (6.8%) were the most commonly used herbs for wound healing. Family members were the primary source of information (29.1%), and 43.7% obtained herbs from personal gardens. Although 94.2% of participants did not disclose herbal use to health liaisons, 53.4% used herbs specifically for wound healing. Users reported both positive and negative effects on wounds from various herbs, indicating variability in experiences. However, the consistency of herb usage by individual patients was uncertain. CONCLUSIONS: The study identified diverse herbal remedies used for wound healing among patients, driven by familial recommendations. Usage pattern diversity and effects signal necessity for researching herb safety and efficacy. Clarifying the impact of consistent herb usage on wound healing is essential for understanding patients' preferences and practices. IMPLICATIONS FOR CLINICAL PRACTICE: These findings emphasize the importance of open communication between patients and healthcare providers regarding herbal remedy use. Nurses should acknowledge patients' preferences for traditional healing practices while ensuring they receive evidence-based care. Patient-centered herbal strategies enhance nursing practice, fostering holistic wound care. Further research can guide nursing interventions, facilitate informed decision-making, and improve patient outcomes.

TUJUAN: Penggunaan terapi herbal untuk penyembuhan luka merupakan hal yang perlu diperhatian pada praktek pengobatan tradisional. Kualitas asuhan keperawatan pada pasien dengan luka diabetik dapat ditingkatkan dengan memahami pola penggunaan terapi herbal oleh pasien. Penelitian ini bertujuan untuk mengidentifikasi karakteristik penggunaan terapi herbal untuk menyembuhkan luka oleh individu dengan diabetes. METODE: Penelitian ini merupakan penelitian deskriptif dengan jumlah responden berjumlah 453 orang. Data demografis yang diidentifikasi mencakup usia, jenis kelamin, pekerjaan, tingkat pendidikan, tempat tinggal, suku bangsa, jarak rumah dari pelayanan kesehatan, durasi penggunaan terapi herbal, dan lama mengalami luka. Analisa data dengan menggunakan statiktik deskriptif yang terdiri dari rerata, standar deviasi, dan persentase. HASIL: Rata-rata usia responden adalah 55,39 tahun, dengan sebagian besar merupakan pekerja non-pegawai negeri sipil (60,3%) dan memiliki tingkat pendidikan rendah (67,1%). Kemiri (9,7%) dan sirih hijau (6,8%) adalah herbal yang paling umum digunakan untuk penyembuhan luka. Anggota keluarga menjadi sumber informasi utama (29,1%) dan mayoritas responden mendapatkan herbal dari kebun pribadi (43,7%). Meskipun 94,2% peserta tidak melaporkan penggunaan herbal kepada tenaga kesehatan, 53,4% menggunakan herbal dengan tujuan untuk menyembuhkan luka. Adanya efek baik positif maupun negatif dari penggunaan terapi herbal yang dilaporkan responden menunjukkan pengalaman penggunaan herbal yang masih bervariasi. Konsistensi penggunaan herbal yang mencakup dosis, cara konsumsi dan cara pengolahan oleh responden secara individu belum dapat disimpulkan. KESIMPULAN: Terapi herbal yang digunakan untuk penyembuhan luka oleh responden pada umumnya merupakan rekomendasi dari keluarga. Keragaman pola penggunaan dan efek menunjukkan perlunya penelitian tentang keamanan dan efektivitas herbal lebih. Teridentifikasinya efek terapi herbal yang konsisten pada penyembuhan luka dapat digunakan untuk pertimbangan mengintegrasikan preferensi pasien pada praktik kesehatan. IMPLIKASI UNTUK PRAKTIK KEPERAWATAN: Hasil penelitian ini menekankan pentingnya komunikasi terbuka antara pasien dan penyedia layanan kesehatan mengenai penggunaan terapi herbal. Perawat penting untuk menghargai preferensi pasien terhadap praktik penyembuhan tradisional dan memastikan bahwa pasien menerima perawatan yang tepat dan efektif. Strategi terapi herbal yang berorientasi pada pasien dapat meningkatkan kualitas praktik keperawatan dan mendukung perawatan luka dilaksanakan secara holistik. Penelitian selanjutnya diharapkan dapat dijadikan pedoman intervensi keperawatan, dapat memfasilitasi pengambilan keputusan yang terinformasi, dan meningkatkan kualitas hasil perawatan.

Enhancing knowledge of Diabetes self-management and quality of life in people with Diabetes Mellitus by using Guru Diabetes Apps-based health coaching.

Introduction: Virtual diabetes coaching through applications has the potential to improve self-management in people with Type 2 Diabetes Mellitus. However, applications designed for Asian's diabetic have never been studied. Therefore, our study aimed to identify the effect of Guru Diabetes Apps-Based Health Coaching on the level of glycemic hemoglobin, knowledge, and quality of life in Indonesians, as one of Asian ethnicities. Materials and methods: This study used an experimental design. Participants with T2DM were recruited from three primary care health centers. The intervention included 3 months of virtual health coaching through the Guru Diabetes application. The daily monitoring of glycemic blood glucose, blood pressure, body weight, nutrition intake, and activity provided were used as baseline to conduct virtual in-person coaching. The glycemic hemoglobin level, knowledge level, and quality of life were assessed at baseline and post-enrollment. A multilevel modeling approach was used for statistical analysis. Results: A total of 66 respondents were enrolled, and 62 respondents (93.93%) remained in the study at 3 months. After completing the intervention, the HbA1c level decreased in all groups, however it did not differ among the groups. On the other hand, the results indicate significant improvement in the average diabetes self-management knowledge score (pre = 14.97 vs post = 19.07, p < 0.05) and quality of life score (pre = 54.34 vs post = 60.28, p < 0.05), with significant difference among the groups (p < 0.05). Conclusion: Participants in the Android Application-Based Health Coaching experienced a significant improvement in diabetes self-management knowledge and quality of life scores at 3 months. In conclusion, the Guru Diabetes Apps-Based Health Coaching has the potential to support people with T2DM in performing diabetes self-management at home.

Exploring the coach-client interaction of virtual health coaching conducted in patients with type 2 diabetes mellitus: A scoping review.

BACKGROUND AND AIMS: Recent studies reported that virtual health coaching (VHCs) had greater benefits on glycemic control compared to traditional diabetes care. However, VHCs are reported to lack real-time evaluations and personalized patient feedback. To support the intention of developing high quality VHC programs, this review aimed to describe characteristics of the coach-client interaction within VHC that had beneficial impacts on patients with type 2 diabetes mellitus (T2DM) patients. METHODS: We conducted a comprehensive scoping review following the six steps of the framework developed by Arksey and O'Malley. Twelve articles that met the eligibility criteria were retrieved from Medline, ProQuest, Science Direct and Scopus. RESULTS: We found five key concepts regarding the characteristics of coach-client interactions. First, the discussion through smartphones involved individualized feedback and insights, goals setting, barrier identification, facilitation to change behavior, and also clients' clinical, mental, and social conditions. Second, the interactions were supported by in-app features including in-app messaging, email, in-app live video consultation and in-app discussion forums. Third, the most used time of evaluation was 12 months. Fourth, the most commonly delivered topic was lifestyle changes which were predominantly focused on dietary patterns. Fifth, most of health coaches were health liaisons. CONCLUSIONS: The findings highlight the discussion points within interaction through well-planned devices combining an appropriate in-app features contribute to an effective coach-client interactions of VHC. It is expected that future studies can apply these findings as the basis to develop a single set of standards for VHCs which refer to specific patterns of patient-oriented interaction.

Virgin Coconut Oil: A Dietary Intervention for Dyslipidaemia in Patients with Diabetes Mellitus.

Hyperlipidaemia is causally related to coronary artery diseases (CAD) and peripheral artery diseases (PAD) in people with Diabetes Mellitus (DM). An in vivo study confirmed that virgin coconut oil (VCO) could maintain levels of lipids in the blood as effectively as conventional therapy. Therefore, this study aimed to determine the effect of VCO on the lipid profiles and ankle-brachial index (ABI) of patients with DM. In this experimental study with pre- and post-test design and a control group, the participants were selected purposively. The ABI was evaluated on the first visit. Baseline lipid profile readings were taken. Each participant took 1.2 mL/kgBW of VCO daily and divided it into three doses. After 30 days of taking VCO, laboratory examinations and ABI were repeated, and adverse events were evaluated. The dependent t-test and Wilcoxon sign rank test with a significance level of α ≤ 0.05 showed a significant decrease in low-density lipoprotein (LDL) (p = 0.002), a significant increase in high-density lipoprotein (HDL) levels (p = 0.031), a significant decrease in energy intake (p = 0.046) and cholesterol intake (p = 0.023) at the endpoint in the VCO group. In conclusion, this therapy is beneficial for maintaining lipid profile when combined with dietary therapy. Future studies should investigate the duration and dosage of VCO on patients to maintain lipid-linked protein.

Piper crocatum Ruiz & Pav. ameliorates wound healing through p53, E-cadherin and SOD1 pathways on wounded hyperglycemia fibroblasts.

INTRODUCTION: Piper crocatum Ruiz & Pav (P. crocatum) has been reported to accelerate the diabetic wound healing process empirically. Some studies showed the benefits of P. crocatum in treating various diseases but its mechanisms in diabetic wound healing have never been reported. In the present study we investigated the diabetic wound healing activity of the active fraction of P. crocatum on wounded hyperglycemia fibroblasts (wHFs). METHODS: Bioassay-guided fractionation was performed to get the most active fraction. The selected active fraction was applied to wHFs within 72 h incubation. Mimicking a diabetic condition was done using basal glucose media containing an additional 17 mMol/L D-glucose. A wound was simulated via the scratch assay. The collagen deposition was measured using Picro-Sirius Red and wound closure was measured using scratch wound assay. Underlying mechanisms through p53, αSMA, SOD1 and E-cadherin were measured using western blotting. RESULTS: We reported that FIV is the most active fraction of P. crocatum. We confirmed that FIV \(7.81 µg/ml, 15.62 µg/ml, 31.25 µg/ml, 62.5 µg/ml, and 125 µg/ml) induced the collagen deposition and wound closure of wHFs. Furthermore, FIV treatment (7.81 µg/ml, 15.62 µg/ml, 31.25 µg/ml) down-regulated the protein expression level of p53 and up-regulated the protein expression levels of αSMA, E-cadherin, and SOD1. DISCUSSION/CONCLUSIONS: Our findings suggest that ameliorating collagen deposition and wound closure through protein regulation of p53, αSMA, E-cadherin, and SOD1 are some of the mechanisms by which FIV of P. crocatum is involved in diabetic wound healing therapy.