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1.
Nursing ; 49(10): 32-39, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31568079

RESUMO

The clinical nurse may be the first caregiver to assess changes in a patient's skin and initiate wound care. This article provides practical guidelines that any nurse can implement.


Assuntos
Guias de Prática Clínica como Assunto , Higiene da Pele/enfermagem , Ferimentos e Lesões/enfermagem , Administração Tópica , Humanos , Avaliação em Enfermagem , Ferimentos e Lesões/etiologia
2.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1219-1225, out.-dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022336

RESUMO

Objetivo: Avaliar os efeitos da irradiação ultrassônica de baixa frequência no tratamento de úlcera venosa. Método: Estudo de aplicação de tecnologia em saúde, realizado com indivíduos com lesões venosas, no ano de 2017 entre os meses de abril a agosto, utilizado formulário estruturado para coleta, analisados no programa Excel e representados em tabela e estatística descritiva. Resultados: Participaram cinco pacientes, três mulheres entre 65 e 88 anos de idade. Os participantes apresentaram cinco úlceras venosas, maioria localizada na porção inferior da perna. Houve redução mínima de 2,5% e máxima de 35,8% sobre a área das lesões. Um participante apresentou 100,0% de epitelização e os demais apresentaram tecido de granulação maior ou igual a 70,0%. Encontrou-se redução máxima de 10 pontos na PUSH, redução mínima de 2 pontos. Conclusão: A terapia ultrassônica traz aspectos positivos para o processo de reparação tecidual


Objective: The study's purpose has been to assess the effects of low-frequency ultrasound irradiation in the treatment of venous ulcer. Methods: It is a health technology application study, which was performed with individuals bearing venous lesions. The research was carried out over 2017 from April to August, using a structured form for data collection, where such data was analyzed in the Excel program and represented through tables and descriptive statistics. Results: Five patients have participated, being three women within the age group from 65 to 88 years old. The participants had five venous ulcers, predominantly located in the leg's lower portion. There was a reduction in the lesion area ranging from 2.5% (minimum) to 35.8% (maximum). One participant achieved 100% epithelization, and the others showed granulation tissue greater or equal to 70.0%. There was a maximum reduction of 10 points in the Pressure Ulcer Scale for Healing (PUSH), and a minimum reduction of 2 points. Conclusion: The low-frequency ultrasound therapy produces positive aspects to the tissue healing process


Objetivo: Evaluar los efectos de la irradiación ultrasónica de baja frecuencia en el tratamiento de úlcera venosa. Método: Estudio de aplicación de tecnología en salud, realizado con individuos con lesiones venosas, en el año 2017 entre los meses abril a agosto, utilizado formulario estructurado para recolección, analizados en el programa Excel y representados en tabla y estadística descriptiva. Resultados: Participaron cinco pacientes, tres mujeres entre 65 y 88 años de edad. Presentaron cinco úlceras venosas, mayoría localizada en la porción inferior de la pierna. Se observó una reducción mínima del 2,5% y una máxima del 35,8% sobre el área de las lesiones. Un participante presentó 100,0% de epitelización y los demás presentaron tejido de granulación mayor o igual al 70,0%. Se encontró reducción máxima de 10 puntos en la PUSH, reducción mínima de 2 puntos. Conclusión: La terapia ultrasónica trae aspectos positivos para el proceso de reparación del tejido


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Terapia por Ultrassom/enfermagem , Úlcera Varicosa/terapia , Cicatrização , Ferimentos e Lesões/enfermagem , Ferimentos e Lesões/terapia , Tecnologia Biomédica/métodos
3.
Rech Soins Infirm ; 137(2): 49-61, 2019 06.
Artigo em Francês | MEDLINE | ID: mdl-31453671

RESUMO

Introduction and objective : In the activity of wound and scar nurses (Infirmières spécialisées en plaies et cicatrisation ; ISPC), the "second-line" nursing consultation is also an opportunity to offer applicants the opportunity for training. This study is part of an exploratory perspective, with the objective of questioning the didactic dimension of this type of consultation. To address the issue, attention is focused on the analysis of the ISPC's activity.Material and method : Two simple self-confrontation interviews of an ISPC are analyzed on the basis of video consultations.Results and discussion : Although the results identified remain incomplete since the interviews were based on a single individual, this article shows how the ISPC, after the interviews, is able to formulate future adjustments to their practice. The first avenue is to highlight a necessary transformation of the discourse of the ISPC during consultations. The second is to question the modality of the post-consultation follow-up.


Assuntos
Cicatriz/enfermagem , Encaminhamento e Consulta , Ferimentos e Lesões/enfermagem , Humanos
4.
Metas enferm ; 22(6): 66-72, jul. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-184048

RESUMO

Se presenta un caso clínico de un paciente con elefantiasis y úlceras sobreinfectadas en ambas extremidades inferiores, incluyendo una valoración enfermera, diagnósticos prioritarios, plan de cuidados, justificación del tratamiento elegido y la evolución posterior. La evidencia de infección de las úlceras planteó la necesidad de instaurar una terapia con cadexómero yodado para tratar localmente la infección, e hidrogel para evitar la formación de biopelículas. Transcurrido un mes del alta del paciente se realizó un seguimiento en el que se observó una evolución favorable con aumento de tejido de granulación y tejido epitelial en varias de las lesiones presentes, por lo que se valoró de forma favorable el procedimiento de cura en ambiente húmedo; la mejora en los hábitos higiénico-dietéticos se completó por parte del paciente


We present the clinical case of a patient with elephantiasis and superinfected ulcers in both lower limbs, including the Nursing assessment, primary diagnosis, plan of care, justification for the treatment selected, and subsequent evolution. The evidence of ulcer infection required to initiate therapy with cadexomer iodine in order to treat the infection locally, and hydrogel to prevent the formation of biofilms. Follow-up was conducted one month after the patient was discharged, and favourable evolution was observed, with an increase in granulation tissue and epithelial tissue in many of the lesions; therefore, the procedure of healing in a moist environment was assessed as favourable, and the improvement in hygienic-dietary habits was completed by the patient


Assuntos
Humanos , Masculino , Idoso , Infecção dos Ferimentos/complicações , Infecção dos Ferimentos/enfermagem , Ferimentos e Lesões/enfermagem , Elefantíase/complicações , Cuidados de Enfermagem , Linfedema/enfermagem , Cicatrização , Tecido de Granulação/lesões , Epitélio/lesões , Avaliação em Enfermagem
5.
Rech Soins Infirm ; (136): 54-65, 2019 03.
Artigo em Francês | MEDLINE | ID: mdl-31210500

RESUMO

INTRODUCTION: Managing chronic wounds is a large part of a nurse's role. However, this complex mission requires nursing professionals to have a wide knowledge base. OBJECTIVE OF THE STUDY: The objective is to undertake a comparative review of pedagogical practices used to teach nursing students about chronic wounds in French nursing training institutes (compared to nursing training institutes in Lorraine). METHOD: A survey was carried out using a self-administered online questionnaire disseminated via the national nursing training network Cefiec, between February and April 2018. It contained 21 questions. MAIN RESULTS: 34.8% of nursing training institutes have a teacher with a university diploma in wounds and healing. Only 30.4% offer hospital-based clinical teaching on this topic. In Lorraine, 40% of nursing training institutes cover the preparation of the wound bed using the TIME model, and 20% cover debridement, compared to 40% and 7.5% nationally. DISCUSSION: Teaching content varies greatly depending on the training institute, and shows that there is a theoretical and practical deficiency in teaching on topics including preparing the wound bed, debridement, and venous compression. Collaboration with expert nurses and referral hospitals is common. Teachers still do not have sufficient access to continuing training and scientific journals.


Assuntos
Educação em Enfermagem , Ensino , Ferimentos e Lesões/enfermagem , França , Humanos , Inquéritos e Questionários
6.
Crit Care Nurse ; 39(3): e9-e17, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154338

RESUMO

BACKGROUND: Free water protocols allow patients who aspirate thin liquids and meet eligibility criteria to have access to water or ice according to specific guidelines. Limited research is available concerning free water protocols in acute care settings. OBJECTIVES: To compare rates of positive clinical outcomes and negative clinical indicators of a free water protocol in the acute care setting and to continue monitoring participants discharged into the hospital system's rehabilitation setting. Positive clinical outcomes were diet upgrade, fewer days to diet upgrade, and fewer days in the study. Negative clinical indicators were pneumonia, intubation, and diet downgrade. METHODS: A multidisciplinary team developed and implemented a free water protocol. All eligible stroke and trauma patients (n = 104) treated over a 3-year period were randomly assigned to an experimental group with access to water and ice or a control group without such access. Trained study staff recorded data on positive outcomes and negative indicators; statistical analyses were conducted with blinding. RESULTS: No significant group differences in positive outcomes were found (all P values were > .40). Negative clinical indicators were too infrequent to allow for statistical comparison of the 2 groups. Statistical analyses could not be conducted on the small number (n = 15) of patients followed into rehabilitation, but no negative clinical indicators occurred in these patients. CONCLUSIONS: Larger-scale studies are needed to reach decisive conclusions on the positive outcomes and negative indicators of a free water protocol in the acute care setting.


Assuntos
Transtornos de Deglutição/prevenção & controle , Ingestão de Líquidos , Acidente Vascular Cerebral/terapia , Ferimentos e Lesões/terapia , Idoso , Enfermagem de Cuidados Críticos/métodos , Estado Terminal/enfermagem , Estado Terminal/terapia , Feminino , Guias como Assunto , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Equipe de Assistência ao Paciente/organização & administração , Segurança do Paciente , Valores de Referência , Método Simples-Cego , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/enfermagem , Resultado do Tratamento , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/enfermagem
8.
9.
Gerokomos (Madr., Ed. impr.) ; 30(2): 87-92, jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183947

RESUMO

Introducción: Las heridas crónicas suponen un problema de salud en todos los ámbitos, desde la calidad de vida de los pacientes que las sufren hasta el gasto sanitario que generan. Las intervenciones formativas sobre profesionales han demostrado ser beneficiosas, y la evidencia existente sobre el abordaje de heridas crónicas precisa de acrónimos que ayuden o guíen a profesionales sanitarios en su labor. Objetivos: evaluar el impacto de una intervención formativa en preparación del lecho de la herida (PLH) de las heridas de difícil cicatrización mediante los acrónimos TIME y DOMINATE en estudiantes de enfermería. Metodología: estudio cuasi experimental con diseño pre-postest mediante una intervención formativa y test ad hoc realizados sobre 427 estudiantes y análisis de datos con SPSS22.0 mediante prueba de McNemar. Resultados: en 11 de las preguntas se superó en más del 50% la varianza entre respuestas pre- y postest. En el 83,6% de los casos, DOMINATE fue el acrónimo elegido para realizar un abordaje integral de la lesión. Conclusiones: la formación en herida crónica en los planes de estudio de las universidades es uno de los aspectos que queda al descubierto o segmentado en asignaturas en la formación académica. El conocimiento y uso de acrónimos sirve como mecanismo sencillo, aplicable y lógico para desarrollar el concepto de PLH fundamental en un proceso cicatricial correcto y ordenado como objetivo final del plan de cuidados de enfermería


Background: chronic wounds represent a health problem in all areas, from the quality of life of patients who suffer them to the health care they generate. Training interventions on professionals have proven to be beneficial and the existing evidence on the approach to chronic wounds requires acronyms that help or guide health professionals in their work. Objectives: to evaluate the impact of a training intervention in preparation of the wound bed (PLH) of wounds difficult to heal by the acronyms TIME and DOMINATE in nursing students. Methodology: quasi-experimental study with pre-test design through a training intervention and ad hoc test performed on 427 students and data analysis with SPSS22.0 using the McNemar test. Results: in 11 of the questions, more than 50% of variance between pre and post test responses was exceeded. In 83.6% of the cases, DOMINATE was the acronym chosen to perform an integral approach to the lesion. Conclusions: the formation in chronic wound in the curricula of the universities is one of the aspects that remains uncovered or segmented in subjects in the academic formation. The knowledge and use of acronyms serves as a simple, applicable and logical mechanism to develop the concept of fundamental PLH in a correct and ordered cicatricial process as the final objective of the nursing care plan


Assuntos
Humanos , Ferimentos e Lesões/complicações , Ferimentos e Lesões/enfermagem , Educação em Enfermagem/normas , Abreviaturas como Assunto , Doença Crônica/enfermagem , Estudantes de Enfermagem/estatística & dados numéricos , Cicatrização
12.
Enferm. clín. (Ed. impr.) ; 29(2): 74-82, mar.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182596

RESUMO

Objetivo: Determinar el impacto de las enfermeras de práctica avanzada en heridas crónicas complejas (EPA-HCC) en la adecuación de los tratamientos de los pacientes con heridas crónicas y el consumo de apósitos en los distritos donde están implantadas. Método: Estudio de tipo cuasiexperimental de tipo pre-post sin grupo control con 3mediciones: preimplantación en 2015, al año de implantación en 2016 y a los 2 años postimplantación en 2017, en los distritos sanitarios donde se estaba pilotando la EPA-HCC en Andalucía. Las variables principales son: número de profesionales formados, número de consultorías, prevalencia de heridas crónicas, adecuación de los tratamientos y coste económico en materiales para cura de los DS participantes. Resultados: Se ha conseguido la formación de un total de 2.717 profesionales sanitarios con un total de 95.095 h lectivas; además, se han realizado un total de 3.871 consultorías y asesorías. La prevalencia de pacientes con lesiones en programa de atención domiciliaria y en residencias ha disminuido a la mitad. La adecuación de los tratamientos ha aumentado hasta el 90% y se ha conseguido un ahorro de más de 250.000 Euros en apósitos, en un período de 2años. Conclusión: La prevalencia de heridas crónicas durante los 2 años de implantación ha disminuido a la mitad, se ha conseguido una correcta adecuación del plan de formación y consultoría, consiguiendo racionalizar el gasto sanitario y una eficiente atención a las personas con heridas crónicas


Aim: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. Method: A quasi-experimental pre-poststudy without a control group with 3 measurements: pre-implementation in 2015, one year after implementation in 2016, and 2 years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. Results: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000 Euros in dressings were achieved in just 2 years. Conclusion: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds


Assuntos
Humanos , Prática Avançada de Enfermagem/métodos , Ferimentos e Lesões/enfermagem , Doença Crônica , Prevalência
17.
Enferm Clin ; 29(2): 74-82, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30837191

RESUMO

AIM: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. METHOD: A quasi-experimental pre-poststudy without a control group with 3measurements: pre-implementation in 2015, one year after implementation in 2016, and 2years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. RESULTS: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000€ in dressings were achieved in just 2years. CONCLUSION: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds.


Assuntos
Prática Avançada de Enfermagem , Bandagens/estatística & dados numéricos , Ferimentos e Lesões/enfermagem , Doença Crônica , Humanos , Projetos Piloto , Espanha
19.
J Trauma Nurs ; 26(2): 67-70, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845000

RESUMO

In January 2017, the Emergency Trauma Advocate (ETA) program was piloted at our Level 1 trauma center to promote patient advocacy, particularly in pediatric patients. The goal was to empower emergency department nurses by improving their knowledge base through interactive didactic sessions. This study reviews the preliminary findings of the program. Surveys were administered after each teaching session to participating ETA nurses to determine their personal academic interests and how to improve the program. We then performed a retrospective review of pediatric trauma admissions from January 2017 through April 2017 to delineate the most common injury patterns. Survey responses demonstrated the greatest nursing interest in learning critical care (n = 11), orthopedic management (n = 11), and neurosurgical trauma education (n = 9). During this study period, 113 pediatric patients arrived and had a mean age of 7.8 ± 5.2 years. The most common injury patterns were orthopedic (n = 38) and neurosurgical (n = 28), and 35 patients required critical care management. Bivariate analysis revealed a significant and positive relationship between injury frequency and educational interests (R = 98.8%, p = .0057). A nurse's interest in educational topics directly correlates with recent pediatric trauma injury patterns. Future work should focus on determining what impact the ETA program has had on pediatric outcomes.


Assuntos
Competência Clínica , Capacitação em Serviço , Recursos Humanos de Enfermagem no Hospital/educação , Ferimentos e Lesões/enfermagem , Adolescente , Criança , Serviços de Saúde da Criança/normas , Pré-Escolar , Enfermagem em Emergência , Feminino , Georgia , Humanos , Lactente , Masculino , Melhoria de Qualidade , Estudos Retrospectivos
20.
J Trauma Nurs ; 26(2): 71-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845002

RESUMO

: The Trauma Survivors Network (TSN) was developed as a program of the American Trauma Society (ATS) to support recovery for adult trauma patients. However, the children of adult trauma patients, families of pediatric trauma patients, and pediatric trauma patients previously had scarce resources. Our institution, in collaboration with the ATS, sought to expand the TSN to support pediatric trauma patients, caregivers, and family members. We aimed to determine whether the TSN could be transferred to the pediatric population. Focus groups identified psychosocial needs of younger survivors, children of adult survivors, and caregivers. A Pediatric TSN Coordinator was hired, Pediatric TSN Peer Visitors were recruited and trained, and Pediatric TSN Activity Hour was implemented for pediatric patients and families. Since implementation 1 year ago, 26 peer visitors have been trained and have conducted approximately 200 visitations. In total, 93 patients and family members have attended Pediatric TSN Activity Hour. TSN services can be adapted to address psychosocial needs of pediatric trauma survivors, families, and children of trauma survivors. When possible, sharing resources between an existing adult TSN program and a pediatric program is valuable to facilitate expansion. TSN complements and strengthens the care offered at our institution by providing patient-centered and family-centered care services for the entire family at various stages of development. The implementation of this program might be different at sites without an existing adult TSN with established resources and support. This article describes the development and implementation of the program; we did not assess outcomes.


Assuntos
Família , Grupos de Autoajuda , Sobreviventes/psicologia , Ferimentos e Lesões/psicologia , Criança , Serviços de Saúde da Criança/organização & administração , Feminino , Grupos Focais , Implementação de Plano de Saúde , Humanos , Masculino , North Carolina , Enfermagem Pediátrica , Virginia , Ferimentos e Lesões/enfermagem
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