Open-label randomized controlled trial to compare wound dressings for patients undergoing hip and knee arthroplasty: study protocol for a randomized controlled trial.

BACKGROUND: Surgical wounds are covered to prevent bleeding, absorb the exudates, and provide a barrier against external contamination. Currently, in our hospital, after orthopedic surgery, traditional occlusive dressing of sterile gauze and non-woven hypoallergenic adhesive tape is placed. Some of the newest dressings have been shown to reduce the incidence of blisters compared with traditional dressing or colloid adhesive dressings. However, there are no comparative evaluations between the different types of dressings and their contribution to the overall results of the healing process. METHODS/DESIGN: This is a randomized, controlled, open-label trial to compare five types of dressings used in total knee and hip arthroplasty surgical wounds. A total of 550 patients will be randomly allocated to one of the following dressings: (1) traditional occlusive dressing, (2) Aquacel Surgical®, (3) Mepilex® Border Post-Op, (4) OpSite Post-Op Visible, or (5) UrgoTul® Absorb Border. The dressing assigned is placed right after surgery. Patients will be followed up to 14 days after surgery when the dressing is definitively removed and will be tracked up to 3 months to record any late complications. During the immediate postoperative period and patient hospitalization and at the ambulatory visits after discharge, every time that the dressing is changed, nurses perform the study assessments. The main study outcome will be the percentage of patients with skin integrity at all times when the dressing has been changed. Skin integrity is a composite of the absence of blisters, erosion, erythema, maceration, swelling, wound dehiscence, and purulent exudates. Secondary outcomes include time to first change of dressing; percentage of patients with presence/absence of blisters, erosion, erythema, maceration, swelling, wound dehiscence, and purulent exudates; number of dressing changes needed; days of hospital stay; and nurse and patient satisfaction. Differences in the main variable between each treatment group and group 1 will be tested by means of a chi-squared test or Fisher's exact test. Subgroup analyses of diabetic and non-diabetic patients, patients with a body mass index of more than 30 or not more than 30, and type of surgery (hip or knee) are planned. DISCUSSION: The results of this study will be useful for clinical decision making by giving information on the contribution of the dressings studied to the outcome of the wound and may also show which dressing offers better results depending on the characteristics of patients. TRIAL REGISTRATION: This trial has been registered at ClinicalTrials.gov ( NCT03190447 ). Retrospectively registered on 16 June 2017.

Modelos teóricos y estudiantes de enfermería: aspectos motivacionales para su elección durante las prácticas clínicas / Theoretical models and nursing students: motivational aspects for election in clinical practice

Introducción. El cuerpo teórico y filosófico de enfermería es complejo; existen un gran número de teorías enfermeras, algunas de difícil comprensión, por lo que habitualmente su aplicación práctica se ve restringida. Objetivo. Identificar el modelo teórico de enfermería que los estudiantes dicen utilizar durante las prácticas clínicas, la motivación para su elección, y la escuela universitaria donde estaban cursando sus estudios. Sujetos y métodos. Estudio descriptivo en el que participaron 105 estudiantes (de una población total de 108) que realizaban prácticas de enfermería en el hospital durante el curso 2006-2007. La variables de estudio fueron los modelos teóricos enfermeros, las razones de la elección y variables sociodemográficas. La recogida de datos se llevo a cabo mediante un cuestionario cumplimentado durante su experiencia clínica. El análisis de los datos se realizó mediante un análisis temático de texto, categorizando para crear finalmente un marco explicativo. Resultados y conclusiones. El modelo elegido es principalmente el de Virginia Henderson. Las motivaciones para la elección, según los estudiantes, son su uso en la enseñanza universitaria y la facilidad de ejecución del modelo. Se evidenció confusión entre los términos ‘modelo conceptual y/o teórico’ y ‘metodología enfermera’ (AU)

Introduction. The theoretical and philosophical nursing is complex, there are a large number of nursing theories, some difficult to understand, because this usually its practical application is restricted. Aim. To identify the theoretical model of nursing students say they use in clinical practice, the motivation for their choice, and school where they were pursuing their studies. Subjects and methods. Descriptive study. Participants were 105 students doing school practice during the academic year 2006-2007 (of a total population of 108 students). The study variables were the nursing models and theories, the reasons for the choice and demographic variables. Data collection was conducted through a questionnaire completed during their clinical experience. The analysis of data using a thematic analysis of text, categorizing to finally create an explanatory framework. Results and conclusions. The model chosen is mainly that of Virginia Henderson. The motivations for the election as students are used in university education and ease of implementation of the model. It was evident confusion between the terms related to nursing model and methodology (AU)

Los modelos en la práctica asistencial: visión de los profesionales y estudiantes de Enfermería / Models in healthcare practice: the perspective of professionals and Nursing students

Objetivo: indagar la percepción de los profesionales y de los estudiantesde Enfermería en relación al uso en la práctica de los modelos y teoríasde Enfermería.Material y método: estudio descriptivo transversal. La muestra estuvo formadapor los profesionales asistenciales y estudiantes matriculados en lasescuelas que realizan prácticas clínicas en la Corporación Sanitaria delParc Taulí durante 2006/2007.Resultados: el modelo aprendido durante la formación es Henderson enambos grupos. En cuanto al uso del modelo en la práctica asistencial,los estudiantes usaban modelos en un 62% mientras lo hacían el 23%de los profesionales. Referente a si se identificaban con el modelo conel que atendían a las personas, los estudiantes dijeron sí en un 88% y losprofesionales en un 83%.Conclusiones: ambos grupos muestran una gran variabilidad y confusiónen algunos conceptos. El uso de un modelo o teoría en la formaciónno condiciona a identificarse con los conceptos de la autora estudiada.El metaparadigma enfermero no se nutre de un sólo modelo (AU)

Objective: to gain deeper knowledge on the perception that professionalsand nursing students have regarding the practical use of Nursingmodels and theories.Material and method: cross-sectional, descriptive study. The sample wascomprised of healthcare professionals and students enrolled in the schoolsthat carried out clinical practice sessions in the Parc Taulí Health Corporationduring 2006/2007.Results: The model learned during the training period was the Hendersonmodel in both groups. In regards to the use of the model in healthcarepractice, 62% of students and 23% of professionals claimed that theyused the models. In terms of whether they identified with the care modelused, 88% of students and 83% of professionals responded affirmatively.Conclusions: both groups showed high variability and confusion in certainconcepts. The use of a certain model or theory during training doesnot necessarily lead to identification with the studied author’s concepts.The nursing meta-paradigm is not shaped by one exclusive model (AU)

Perspectiva sobre modelos y teorías de enfermería en el ámbito de nefrología / Nursing model and theory prospects in nephrology

Enfermería depende de la existencia de un conocimiento teórico para todas las áreas. Usar un modelo Conceptual o Teoría de Enfermería en la atención, garantiza que los profesionales compartan igual concepción del metaparadigma y lenguaje en la orientación de los cuidados. Los objetivos del estudio son: 1.Conocer el posicionamiento de los profesionales de enfermería de la unidad nefrológica sobre modelos conceptuales y teorías de enfermería. 2. Conocer el nivel de aplicabilidad sobre los mismos. Estudio descriptivo observacional a todos los profesionales de enfermería de nuestra unidad. Se recogieron los datos mediante un cuestionario de elaboración propia, realizando un estudio descriptivo de todas las variables, expresando los resultados de las variables cuantitativas en forma de media y desviación estándar. Las variables categóricas se expresaron en forma de frecuencia y porcentajes. Se analizaron 27 cuestionarios. Índice de respuesta del 77,1%. Los datos sociodemográficos son: edad media de 32,26±7,92 años, y el 81,5% son mujeres. El 88,9% utilizó el modelo de Henderson en la escuela universitaria. Respecto al metaparadigma enfermero: en el concepto de Enfermería el 88,9% se identificó con V Henderson; en el concepto de salud el 81,5% escogió la definición de Erickson; en el concepto de entorno el 63% se decantó por Henderson; y en el concepto de persona: el 70,4% señaló a Roy. Se evidencia una gran variabilidad en cuanto al posicionamiento teórico de los profesionales. Además es necesario una mayor formación y reflexión del tema en nuestro ámbito (AU)

Nursing depends on existence of a theoretic knowledge for everything areas. To use a conceptual model or nursing theory in the attention, guarantees that everybody nurses share equal metaparadigm conception and the same language in the cares guidance. Objectives are: 1. To investigate the nurses position of nephrology unit on conceptual models and nursing theories. 2. To investigate the application level on the same nursing models and theories. It is a descriptive and observational study on all nurses of our unit. Data were capture by a questionnaire elaborate by us. Achieving a descriptive study of all variables, quantitative variables results were expressed as average and plus minus standard deviation. Categorical variables were expressed as frequency and percentages. Twenty seven questionnaires were analysed. Response rate was 77.1%.The demographic data are: average age 32.27± 7.92 years, and 81.5% are women. 88.9% used Henderson’s model in the university school. Results nursing’s metaparadigm: In the Nursing concept, 88,9% selected to V. Henderson; in the Health concept, 81.5% chose to Erickson; in the environment concept, 63% opted for Henderson; and in the person concept, 70.4% selected to Roy. A wide variability of the about theoretic position of nurses was found. Also a robust training and analysis of the issue is necessary (AU)