The correlation between sub-epidermal moisture measurement and other early indicators of pressure ulcer development-A prospective cohort observational study. Part 1. The correlation between sub-epidermal moisture measurement and ultrasound.

The correlation between sub-epidermal moisture (SEM) and other early indicators of pressure ulcer (PU) development is yet to be determined. This three-part series aims to bridge this knowledge gap, through investigating SEM and its correlation with evidence-based technologies and assessments. This article focuses on the correlation between SEM and ultrasound. A prospective cohort observational study was undertaken between February and November 2021. Patients undergoing three surgery types were consecutively enrolled to the study following informed consent. Assessments were performed prior to and following surgery for 3 days at the sacrum, both heels and a control site, using a SEM scanner and high-frequency ultrasound scanner (5-15 MHz). Spearman's rank (rs ) explored the correlation between SEM and ultrasound. A total of 60 participants were included; 50% were male with a mean age of 58 years (±13.46). A statistically significant low to moderately positive correlation was observed between SEM and ultrasound across all anatomical sites (rs range = 0.39-0.54, p < 0.05). The only exception was a correlation between SEM and ultrasound on day 0 at the right heel (rs = 0.23, p = 0.09). These results indicate that SEM and ultrasound agreed in the presence of injury; however, SEM was able to identify abnormalities before ultrasound.

Skin hydration measurement and the prediction of the early development of pressure ulcers among at risk adults: A systematic review.

This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion criteria. Data were extracted using a pre-designed extraction tool and a narrative synthesis of the data was undertaken. The methodological quality of the included articles was assessed using the evidence-based librarianship checklist. Included studies were published between 1997 and 2021, with most using a prospective cohort design (88.9%, n = 8). The mean sample size was 74 participants (SD = 38.6; median 71). All studies measured skin hydration objectively, with 55.6% (n = 5) using the Corneometer® CM825 and 33.3% (n = 3) of studies reported a statistically significant association between skin hydration and pressure ulcer development. The mean evidence-based librarianship percentage was 66.6% (SD: 20.7%), however, only 33.3% (n = 3) of studies scored ≥75%, indicating validity. The quality of included studies, methodology variation, and reported results has reduced the homogeneity of outcomes. This review highlights the requirement for future research evidence to ascertain the role of skin hydration in pressure ulcer development.

Sub-epidermal moisture measurement: an evidence-based approach to the assessment for early evidence of pressure ulcer presence.

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.

A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills.

BACKGROUND: The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate. OBJECTIVES: This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students. DESIGN: This study used an experimental three-group pre- and post-test design. SETTINGS: The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran. PARTICIPANTS: A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34). METHODS: To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL). RESULTS: Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006). CONCLUSIONS: Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.