Development and validation of the pressure ulcer management self-efficacy scale for nurses.

BACKGROUND: Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self-efficacy in managing PUs could predict patients' outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task-specific self-efficacy has not yet been developed. OBJECTIVES: To develop a valid and reliable scale to assess nurses' self-efficacy in managing PUs, that is, the pressure ulcer management self-efficacy scale for nurses (PUM-SES). METHODS: This study had a multi-method and multi-phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items' generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three-step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM-SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM-SES and an established general self-efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency. RESULTS: PUM-SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM-SES had four domains, labelled as follows: assessment, planning, supervision and decision-making. These domains were predicted by the same second-order factor, labelled as PU management self-efficacy. CONCLUSION: PUM-SES is a 10-item scale to measure nurses' self-efficacy in PU management. A standardised 0-100 scoring is suggested for computing each domain and the overall scale. PUM-SES might be used in clinical and educational research. RELEVANCE TO CLINICAL PRACTICE: Optimising nurses' self-efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.

Treating a non-healing postoperative sternal wound in a woman with type 2 diabetes mellitus: A case report.

One of the leading causes of impaired chronic wound healing is diabetes mellitus because it involves many factors that influence the physiopathology of tissue healing. Therefore, it is strategic to analyse clinical cases of this population. We presented a clinical case report of a 51-year-old female with type 2 diabetes mellitus, presenting a non-healing sternal wound after open heart surgery. Appropriate dressing and assessment contributed to the healing of the sternal wound in 5 weeks.

Efficacy of Polyhexamethylene Biguanide in Reducing Post-Operative Infections: A Systematic Review and Meta-Analysis.

Background: Post-operative infections are a substantial cause of morbidity and mortality worldwide. Polyhexamethylene biguanide (PHMB) is an antimicrobial agent that has been used in various surgical settings to prevent infections. However, the literature on its efficacy in reducing post-operative infections remains unclear. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of PHMB in reducing post-operative infections. The risk of bias and methodologic quality of the included studies were also assessed. Results: The systematic review included nine RCTs, and eight were included in the meta-analysis that showed that the use of PHMB was associated with a reduction in the rate of post-operative infections. The overall effect size was statistically significant, with moderate heterogeneity across the included studies (log Peto's odds ratio [OR], -0.890; 95% confidence interval [CI], -1.411 to -0.369; I2 = 41.89%). However, the diversity in the application of PHMB and the potential influence of other factors, such as adherence to infection prevention protocols and organizational-level variables, underscore the need for further primary studies. Conclusions: Polyhexamethylene biguanide appears to be a promising intervention for reducing post-operative infections. However, more high-quality, well-designed RCTs are needed to confirm these findings and to explore the most effective ways to use PHMB within specific infection prevention bundles. Future research should also aim to control for potential confounding factors to provide a more comprehensive understanding of the efficacy of PHMB in reducing post-operative infections.