Conectar
There is an urgent need for effective interventions to aid diabetes-related foot ulcer (DFU) healing. This study aimed to test the deliverability of a proposed trial of extracorporeal shockwave therapy (ESWT) for DFU healing. A pilot double-blinded randomised controlled trial. Patients with a DFU present for ≥ 4 weeks were randomised to high dose (500 shocks/cm2), low dose (100 shocks/cm2) or sham (0 shocks/cm2) ESWT, plus standard care. Follow-up was for 24 weeks. Primary outcome was deliverability of the trial. Secondary outcomes were healing, quality of life and healthcare resource use. One-hundred and forty-one (15.6%) screened patients were eligible and 74 (52.5%) patients were recruited. Follow-up attendance was 97.3% (72/74), 93.2% (69/74) and 87.8% (65/74) at 6, 12 and 24 weeks. The median DFU healing time was high dose: 54.0 (IQR 119.0), low dose: 78.5 (IQR 61.0) and sham: 83.0 (IQR 85.0) days. The mean EQ-5D-5L utility value at 24 weeks was high dose: 0.621 (95% CI 0.438–0.804), low dose: 0.779 (95% CI 0.683–0.876) and sham: 0.806 (95% CI 0.717–0.895). Healthcare resource use was lowest in the low-dose ESWT arm. The pilot trial has demonstrated that patients with a DFU are willing to engage in the proposed trial and suggest the optimal way to deliver the definitive trial.
This study investigates cortical reorganisation and hemodynamic responses in individuals with lower extremity amputation and replantation using functional near-infrared spectroscopy (fNIRS). A total of 15 healthy controls, four left lower limb amputees and one replantation patient were included. Oxyhemoglobin (oxy-Hb) activations were measured during 10 unilateral lower limb motor tasks (toe, ankle, knee and hip movements). Non-parametric analyses revealed significant differences in cortical activation between amputees and controls, particularly during knee flexion and extension. Three-dimensional contrast maps demonstrated that oxy-Hb activity in amputees extended from the M1-leg area into somatosensory regions, reflecting neuroplastic remapping. In contrast, the replantation patient exhibited activation patterns closer to the control group, especially in knee and hip tasks. These findings indicate that fNIRS can sensitively capture hemispheric dynamics during unilateral lower limb movements and highlight neuroplastic adaptations following amputation and replantation. Such insights may guide future neuroprosthetic design and rehabilitation strategies.
Assess US registered nurse genomic competency.
Administered the Genetics and Genomics Nursing Practice Survey (GGNPS).
GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data.
1065 registered nurses responded. Most (41%) were Master's prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%).
Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low.
Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.
Burnout, a form of moral suffering, has become more commonplace among health care workers in recent years. Measures of general resilience have been widely used to capture improvement in burnout but lack the ability to capture the anguish that comes with burnout from a moral standpoint. The purpose of this analysis was to understand whether moral resilience is uniquely related to burnout beyond a measure of general resilience in a sample of interprofessional health care workers.
Secondary analysis of cross-sectional survey data.
In total, 702 interprofessional health care workers participated in a cross-sectional survey. Key measures included the Rushton Moral Resilience Scale (RMRS), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Hierarchical multiple regression modeling was used to examine the effect of moral resilience (RMRS) in predicting the three dimensions of burnout (MBI-HSS) over and above general resilience (CD-RISC-10).
Moral resilience explained five, six, and 4% of variance for personal accomplishment, depersonalization, and emotional exhaustion, respectively, after accounting for general resilience (CD-RISC-10) and all covariates.
Findings highlight the clear conceptual differences between general and moral resilience and their unique relationship to burnout. Accounting for moral resilience will facilitate an improved multi-level response to moral suffering among health care workers.
Measuring and understanding the differences between general resilience and moral resilience is vital for us to better facilitate the necessary support(s) for health care workers experiencing moral suffering. This will contribute to more sustainable clinical environments, reduced burnout and suffering, and improved patient outcomes.
Exploring the potential relationships among moral distress (MD), general health (GH) levels, secondary traumatic stress (STS) and levels of empathy within nursing personnel is of specific interest.
This study aimed to investigate the occurrence of MD and its associations with GH, STS, and empathy levels among nurses employed in eight public hospitals across the Attica Basin in Greece.
Between January and March 2020, a cross-sectional study was conducted among nursing staff working in surgical, medical, and psychiatric units of 6 public hospitals and 2 psychiatric institutions in the Attica Basin. Respondents completed the validated Greek versions of the Moral Distress Scale–Revised, the Jefferson Scale of Empathy for Health Professionals, the 28-item General Health Questionnaire, and the Secondary Traumatic Stress Scale. Participants were asked to complete a paper-pencil data sheet consisting of 27 sociodemographic questions.
A total of 267 out of 350 distributed questionnaires were completed and returned, corresponding to a response rate of 76.3%. The findings showed that nurses experienced moderate MD in both frequency and intensity, moderate-to-high GH and empathy, and moderate levels of STS. Psychiatric nurses reported lower STS and better GH than their counterparts in general hospital settings. Multivariate analysis demonstrated a statistically significant association between increased STS and deterioration in GH. A rise in the frequency of MD is significantly linked to an increase in its intensity.
Incorporating proven screening methods, programs that build resilience, supportive workplace cultures, ongoing evaluations over time, and peer support systems creates a complete approach to lowering moral distress and secondary traumatic stress, improving nurse well-being, maintaining work efficiency, and enhancing the overall safety and quality of healthcare services.
Nurses' burnout, work instability (WI), and job satisfaction (JS) in their practice environment (PE) are well established in the literature. However, perinatal missed care (PMC), a subset of missed nursing care, remains underreported among maternity nurses.
To examine the mediating role of PE and burnout in the associations of WI, JS, and PMC among maternity nurses.
A cross-sectional and correlational study employed consecutive sampling to recruit maternity nurses (n = 312) from five hospitals in Saudi Arabia (three government and two private hospitals in Hail and Makkah regions, respectively). Maternity staff nurses, regardless of their sex, years of professional nursing experience, or nationality, who met inclusion criteria were included in this study. Data was collected from July to September 2024 using four standardized self-report scales. Structural equation modeling was utilized for statistical analyses.
Maternity nurses' WI negatively influenced PE (β = −0.23, p = 0.014), while positively affected PMC (β = 0.15, p = 0.031). The PE positively affected JS (β = 0.24, p = 0.034) but had a negative effect on burnout (β = −0.24, p = 0.007) and PMC (β = −0.21, p = 0.038). Burnout negatively affected JS (β = −0.25, p = 0.028), while positively associated with PMC (β = 0.20, p = 0.022). PE mediated the associations between WI and burnout (β = 0.05, p = 0.019), JS (β = −0.07, p = 0.020), and PMC (β = −0.06, p = 0.008). Meanwhile, burnout mediated between PE and JS (β = 0.05, p = 0.030) and PMC (β = −0.04, p = 0.023).
Understanding the relationships among maternity nurses' burnout, JS, PE, and PMC is key to improving the quality of perinatal care and ensuring the patients' well-being. By focusing on strategies to enhance the PE (e.g., adequate staffing and resources, improved nurse–patient ratio), reduce burnout (e.g., meditation and mindfulness programs, coping intervention programs), and improve JS (e.g., work schedule flexibility, facilitate work-life balance, staff professional development), healthcare organizations can mitigate the occurrence of PMC.
The article describes the outcomes of a single-centre investigation on the use of OZOILE to improve the healing process in patients with chronic diabetic ulcers. This is a non-randomised interventional study which aims to assess the differences between two groups (total 200 patients) by evaluating healing time at 15, 30, 45, 60, 75 and 90 days. Pain assessment with VAS scale at 15, 30 and 45 days, biofilm test and tissue regeneration by histological evaluation were also taken into consideration. The outcomes show faster healing, reduced pain, control of local infection, aesthetically pleasing and qualitatively better healing. Our treatment strategy involves applying OZOILE detergent without rinsing, Ozoile spray oil and Ozoile cream followed by a non-adherent dressing (paraffin gauze). This integrated protocol shows a safe and effective treatment for diabetic chronic wound healing in a cost-effective manner. The group treated with the Rigenoma/Ozoile protocol demonstrated significantly superior outcomes compared to the control group, including accelerated healing, reduced pain levels, effective management of unpleasant odour, and high levels of compliance from both patients and surgeons. Overall, Ozoile markedly reduced healing time compared with standard care, with results robust across multiple analytical approaches.
EPIFIX, a dehydrated human amnion/chorion membrane allograft, received regulatory approval as a medical device in 2021 by the Ministry of Health, Labour and Welfare following review by the Pharmaceuticals and Medical Devices Agency, for the treatment of refractory ulcers, including diabetic foot ulcers. Insurance reimbursement under the Japanese national health insurance system was approved in 2022. This study investigated the efficacy of EPIFIX for diabetic foot ulcers in Japan. This study included 55 patients who were treated with EPIFIX after debridement, evaluating the treatment duration and wound outcomes. Treatment was considered complete upon successful wound closure (i.e., reconstruction or epithelialization) or when adverse events (i.e., wound infection, death, or other complications) occurred. The wounds were classified as either healed or nonhealed. Wound healing was observed in 43 patients. Comparing the patients with healed and non-healed wounds, there was a significant difference in the presence of chronic kidney disease (G5d), coronary artery disease, and certain laboratory findings (albumin, C-reactive protein, white blood cell count, and haemoglobin) (p < 0.05). The treatment duration was similar between the healed and non-healed groups (24.39 vs. 24.83 days, p = 0.14). Wound bed preparation and an improved general health condition were key factors for healing. EPIFIX promotes wound healing in diabetic foot ulcers, although careful patient selection is essential to maximise its effectiveness.
Hard-to-heal wounds are frequently associated with underlying conditions such as diabetes, vascular disease, and biofilm-related infections. Accurate identification of microbial origin is essential, but is often hindered by biofilms. This study evaluated whether sonication of wound dressings, combined with different sample transport methods, improves bacterial detection in venous leg ulcers. In a prospective observational case–control study, six patients with hard-to-heal venous leg ulcers received treatments with medical-grade honey (MGH) (n = 1), ceramic dressings – “Cerdak” (n = 2), or hydroactive dressings (n = 3). Three microbiological samples were collected per patient: (1) conventional wound swab (Levin's technique) in Amies medium; (2) sonicate fluid from used dressings transported in sterile tubes without medium; and (3) sonicate fluid in haemoculture tubes (BACT/ALERT). Total pathogen count and diversity were compared across sampling methods. Patient quality of life (QoL) was assessed using the Wound-QoL instrument. Sonication revealed additional pathogens not detected by conventional swabs. The highest number of pathogens was found in sonicate fluid transported in haemoculture tubes (n = 43), followed by swabs (n = 39) and sterile tube transport (n = 30). Adequate treatment significantly improved patients' QoL during the healing process. Dressing sonication, especially with haemoculture tube transport, enhances microbial identification and may improve diagnosis and management of hard-to-heal wounds.
With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age groups from 1990 to 2021.
This study utilized data from the Global Burden of Diseases (GBD) 2021 to determine the age-standardized incidence rate (ASR) of PI stratified by age groups from 1990 to 2021. Estimated annual percentage changes (EAPCs) were calculated to measure corresponding temporal trends.
Over three decades, the incident cases of PI have doubled from 1.1 million to 2.5 million worldwide. The incidence of PI showed an exponential rise with increasing age groups in 2021. The significant increasing trends were observed in the population aged 20–54 years (EAPC = 0.11) and 55+ years (EAPC = 0.55) from 1990 to 2021. The ASR among males has increased from 32.53 to 33.34 per 100,000 population, with an EAPC of 0.27, while the ASR among females decreased. The ASR was increased with higher income levels and the highest ASR was observed in the high-income region (49.95 per 100,000 population). Among six regions, the Americas had the highest ASR in 2021 (90.20 per 100,000 population), while South-East Asia showed the fastest increase (EAPC = 1.22).
The global burden of PI is a growing global health problem among the elderly population, particularly in the Americas. A greater incidence burden in males and high-income level regions was found. This study advocates for urgent attention to coping strategies for aging populations and older people with PI.
This study advocates for urgent attention to coping strategies for aging populations.
The research-to-practice gap often occurs when evidence-based practice (EBP) is inadequately implemented into clinical practice. Nurses are critical to bridging the gap in EBP implementation (EBPI) and identifying effective strategies to promote its use in practice; however, they need a supportive work environment to develop the necessary research capacity/culture (RCC).
The purpose of this study was to examine relationships between nurses' perceptions of individual RCC and EBPI, team RCC and EBPI, and health care organization RCC and EBPI, adjusting for educational background, health care organization setting, and health care organization type.
Survey data were collected from 175 nurses across the United States using a prospective cross-sectional study design. The Research Capacity in Context (RCC) tool and EBPI scale were used to measure nurses' perception of RCC and nurses' EBPI, respectively. Simple linear regression was used to assess the relationship between organizational, team, and individual RCC and EBPI. Multiple linear regression was used to adjust for pertinent participant demographics.
The results of this study indicated that organization (R 2 = 0.033, p = 0.016), team (R 2 = 0.064, p < 0.001), and individual (R 2 = 0.155, p < 0.001) RCC were significantly associated with nurse EBPI. Moreover, findings remained significant after adjusting for educational background, health care organization setting, and type. The regression model suggested that education significantly predicted EBPI (R 2 = 0.142, p < 0.001).
These results emphasize the importance of building RCC in health care organizations, as it can be an effective strategy to increase nurses' EBPI, which has been shown to impact patient outcomes directly. Future research should identify strategies to assist organizations and leadership in building RCC among nurses.
This study evaluates the predictive value of the WIfI (Wound, Ischemia, and foot Infection) classification system and pre-amputation transcutaneous oxygen pressure (TcPO2) measurements in forecasting post-amputation complications in major lower limb amputations (MLLA). A retrospective analysis was conducted on 132 MLLA patients with complete WIfI data and 87 patients with documented TcPO2 values. Associations between WIfI stage, TcPO2, and post-amputation outcomes—including healing time, surgical revisions, re-amputation, and wound complications—were assessed using statistical modeling and receiver operating characteristic (ROC) curve analyses. Higher WIfI stages correlated with prolonged healing (WIfI 4 failure rate: 12.8%) but did not significantly predict complications. Unexpectedly, WIfI 2 patients had a 4.4-fold higher risk of revision (p = 0.011) and a 3.1-fold higher re-amputation risk (p = 0.033) compared to WIfI 4. TcPO2 levels showed a significant relationship with healing outcomes, with a 36.9% failure rate in TcPO2 < 15 mmHg. A TcPO2 cut-off of > 46 mmHg optimized healing prediction (HR = 2.81, p = 0.004). TcPO2 is a stronger predictor of post-amputation complications than WIfI staging. A cut-off of > 46 mmHg at the amputation site is recommended to improve healing outcomes.
Diabetic foot ulcers (DFUs) are severe complications of diabetes that often lead to major amputations. Despite care advancements, approximately 50% of minor amputations do not heal, resulting in major amputations and increased mortality. This study evaluated the effectiveness of adipose-derived stem cells (ASCs) obtained through superficial enhanced fluid fat injection (SEFFI) in improving healing rates after minor amputations in DFUs. It was a prospective, single-arm, observational cohort study. The patients were monitored for half a year using monthly assessments. The primary endpoint was the healing rate of the amputation stumps after minor amputations coupled with ASC injections. Secondary endpoints included safety, feasibility, adverse events and analysis of variables associated with healing including the analysis of the injected mesenchymal adipose stem cell populations. Of the 256 screened patients, 40 were enrolled. At 6 months, 55% of the treated stumps had healed completely. The median healing time was 69 days. Technical success was achieved in all cases without device-related complications. Multivariable Cox models identified haemodialysis, opioid use and the injected number of CD45-positive cells as risk factors for healing failure. CD73 expression was positively associated with healing. The SEFFIDiFA trial demonstrated a promising 69% healing probability at 6 months post-amputation. This minimally invasive approach showed a higher healing rate with fewer complications. This study supports the potential of ASCs in enhancing wound healing in DFUs and highlights the importance of CD73 expression for successful outcomes. Further research is warranted to validate these findings and optimise the technique.
This study aimed to determine if skin types can be accurately assessed via melanin scores measured with a colormeter, and whether scar characteristics of people with different skin types are different at various stages of healing. Melanin scores of a Cortex DSM Colormeter were validated against the Fitzpatrick skin type questionnaire in healthy volunteers and unaffected skin of burn and scar patients (N = 137) to determine melanin index cut-offs per skin type. Scar quality in children and adults at 3, 6, and 12 months post-burn using DSM Colormeter and the Patient and Observer Scar Assessment Scale (POSAS) was analysed in a cohort of > 1000 patients. Data from 137 individuals showed good correlation between melanin index and Fitzpatrick skin types (Spearman's rho: 0.72 Dermaspectrometer, 0.69 DSM II; p < 0.0001). Scar characteristics varied by skin type for erythema, pigmentation, vascularization, and overall POSAS scores. Children had significantly thicker scars than adults, regardless of skin type, varying from 0.3 to 1.4 points difference on the observer scale at 12 months post burn. We conclude that skin type can be objectively classified using the melanin index, showing a strong correlation with the Fitzpatrick questionnaire. Skin type influences scar outcomes, especially pigmentation and vascularization. Children, particularly those with lighter skin, tend to develop thicker scars than adults. Recognising these differences can improve scar management and patient education.
Evidence-based practice (EBP) is essential for improving the quality of care and health outcomes in healthcare organizations. This study aimed to analyze the association between the nursing work environment and EBP elements, including attitude, training, implementation and quality of care.
A multicenter, cross-sectional study was conducted with 1022 registered nurses from 57 primary care centers and four public hospitals in northern Spain. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess the nursing work environment. Data collection also included the Health Sciences Evidence-Based Practice (HS-EBP) questionnaire to evaluate attitudes toward EBP, and self-reported measures of EBP training, EBP implementation, and overall quality of care. Odds ratios (OR) and 95% confidence intervals for the association between the nursing work environment and EBP elements were calculated using logistic regression adjusted for sociodemographic and occupational characteristics.
Compared to nurses who reported working in unfavorable environments (n = 220; 21.5%), those working in favorable environments (n = 437; 42.8%) exhibited a positive attitude toward EBP (OR = 2.89; 95% CI [2.00, 4.18]), EBP implementation (OR = 2.30; 95% CI [1.52, 3.39]) and higher quality of care (OR = 2.35; 95% CI [1.61, 3.44]). Using a composite measure that considered all EBP elements, favorable environments were associated with overall EBP engagement (OR = 3.47; 95% CI [2.38, 5.07]). The most influential environmental dimensions were adequate staffing and strong nursing foundations.
A favorable nursing work environment was strongly associated with a positive attitude toward EBP, the implementation of EBP, and a commitment to providing high-quality care. Key strategies to promote EBP should involve healthcare and academic institutions working together to establish a healthy work environment with appropriate staffing and care foundations rooted in nursing theory.
Sensory balance is the individual's ability to regulate internal and external sensory stimuli to remain in a functional and balanced state.
This study aims to explore in depth the experiences of psychiatric nurses caring for trauma victims in building sensory balance and well-being.
Psychiatric nurses caring for trauma victims may be constantly exposed to intense sensory stimuli such as yelling and agitation. It is known that post-traumatic stress disorder and burnout are seen in nurses caring for these individuals; however, it is noteworthy that studies on how this process is reflected sensoryly in individuals are limited.
Snowball sampling method was used in this qualitative phenomenological study. In-depth interviews were conducted with 14 volunteer psychiatric nurses caring for trauma victims. Data were collected using a semi-structured interview form and analyzed using Colaizzi's method. COREQ guidelines were adhered to throughout the research process.
Four categories and a total of eight themes were obtained from the in-depth interviews. “Traces of Traumatic Contact, Emotional Armor and Inner Distance, Transformation through Exhaustion, Institutional Silence and Seeking Solidarity”.
This study shows that psychiatric nurses caring for trauma victims are both professionally and individually traumatized and face the risk of losing their identity. It has also been found that nurses withdraw both sensorially and emotionally and experience burnout. But in some cases this process transforms into the development of awareness and maturity. It was also found that despite adverse working conditions, contact with nature, silence and collegial solidarity played a protective role in rebuilding well-being.
This study addresses in depth the sensory, emotional and identity impacts experienced by psychiatric nurses caring for trauma victims and draws attention to the effects of these conditions on the process of well-being construction. The results of the study provide important points for the development of education, self-care and institutional support mechanisms to support nurses' well-being.
The aim of this study was to assess the performance and safety of daily treatment with a 0.2% hyaluronic acid-based hydrogel (Hyalo4 Skin Gel) in patients with chronic and acute wounds. The primary endpoint was the amelioration rate after 14 days of treatment, defined as the percentage of patients showing improvement in at least one of the following wound characteristics: wound tissue type, exudate amount, or type. Secondary endpoints included assessments of the treatment's effects on wound bed type, exudate amount and type, and patients' quality of life (EQ-5D QoL), as well as its safety and ease of application. Data were collected up to 56 days of treatment. A total of 170 patients were enrolled. Wound bed amelioration was observed in 46.0% of the patients after 14 days. The amelioration rate increased from 0.291 after 7 days to 0.561 after 56 days. The treatment promoted wound healing, increased granulation tissue formation, and normalized exudate levels. Additionally, QoL significantly improved, and the product was deemed easy to apply and safe, with no serious treatment-related adverse events reported. Being effective in enhancing the re-epithelialization of both acute and chronic wounds, Hyalo4 Skin Gel emerges as a promising strategy, improving clinical outcomes across a wide range of patients.
This prospective, double-blind controlled trial was conducted to determine the effect of silicone gel in the reduction of postoperative scar after bilateral inguinal varicocelectomy. Thirty-four patients were enrolled in this study; the right-side inguinal scar was treated with silicone gel and petroleum jelly (Vaseline) applied on the left side as a placebo for 60 consecutive days. Scars were evaluated using the Vancouver Scar Scale, pruritus and pain. The result of this study showed that silicone gel was effective in the regression of postoperative scar after microscopic inguinal varicocelectomy in five key parameters, including vascularity, pigmentation, pliability, height and pruritus in comparison to placebo application (p < 0.05), while its effect on pain was insignificant (p > 0.05). The study showed that silicone gel had a considerable effect in the treatment and management of postoperative scar management. Varicocele is a condition that is considered the most common cause of male infertility. While microscopic inguinal varicocelectomy is considered a gold standard in the management of varicocele, its postoperative complications, such as scar formation remain a concern. Recent studies show that silicone gel can be an effective non-invasive treatment for scar regression. Accordingly, we designed this trial to evaluate the effect of silicone gel after microscopic inguinal surgery. A prospective double-blind controlled trial was conducted on 34 patients who had microscopic bilateral inguinal varicocelectomy (their age ranged from 19 to 41) at Namazi hospital. Two weeks after surgery, each patient received two identical tubes for application on the scars, the first tube containing silicone gel and the second one dispensed with petroleum jelly (Vaseline). The right side was treated with silicone gel, and the left side with Vaseline twice daily for 60 days. Then, patients were evaluated three times: firstly 2 weeks after surgical repair; second appointment after 2 months and third one after 6 months after surgery, using the Vancouver Scar Scale, pruritus and pain score. The collected data were analysed in SPSS 26, using the chi-square and Mann–Whitney U tests. The significance level was defined at p < 0.05. This study showed that silicone gel was highly effective in scar parameters, including pliability, height, vascularity pruritic and pigmentation. However, its effect on pain reduction was not significant (p > 0.05). The results of the study indicated that silicone gel effectively improved scar characteristics following microscopic inguinal varicocelectomy, while its efficacy against pain was not significant.
This study aimed to gain clinician consensus on which signs/symptoms reported to be indicative of biofilm in chronic wounds are likely to be so. An international, two-round eDelphi process including wound care clinicians ran from December 2023 to February 2024. Participants rated 26 items on a 9-point Likert scale. Consensus to include: ≥ 70% of respondents rate an item 7–9, ≤ 15% rate it 1–3. Consensus to exclude: ≥ 70% of respondents rate an item 1–3, ≤ 15% rate it 7–9. Eleven items (visual indicators [a shiny, slimy, persistent layer, easily removed, returns quickly without frequent intervention]; failure to respond to antimicrobials; infection > 30 days duration; poor quality granulation tissue; stalled wound despite optimal management; persistent/prolonged inflammation; wound > 6 weeks duration; soft tissue deterioration despite antimicrobials/debridement; signs of local infection; tunnelling/undermining; presence of slough) achieved consensus to include status. To our knowledge, consensus work on this topic has not previously been performed on such a wide scale. When examined alongside similar work, clinical opinion on the matter lacks coherence. We hope that these findings will help direct us toward greater cohesiveness. The work supports a need for research to quantify the predictive abilities of signs and symptoms reported to be indicative of biofilm in chronic wounds.
This study aimed to explore the perceived preparedness and psychosocial well-being of general ward nurses prior to their deployment into the outbreak intensive care units (ICUs) during the COVID-19 pandemic.
With the surge in COVID-19 cases requiring ICU care, non-ICU nurses maybe deployed into the ICUs. Having experienced through SARS, hospitals in Singapore instituted upskilling programs to secure general ward nurses’ competency in providing critical care nursing. However, no studies have explored the perceptions of general ward nurses on deployment into the ICUs during the COVID-19 pandemic.
Qualitative descriptive study.
The study was conducted at Singapore’s epicentre of COVID-19 management. Five focus groups were conducted following purposive sampling of 30 general ward nurses identified for outbreak ICU deployment. Focus groups were audio-recorded, transcribed verbatim and data thematically analysed. This study was conducted and reported in accordance with the COREQ checklist.
Three salient themes arose, exemplifying the transition from clinical experts in the general wards to practising novices in the outbreak ICUs. Firstly, ‘Into the deep end of the pool’ described general ward nurses’ feelings of anxiety and stress associated with higher exposure risk and expanded responsibilities to nurse critically ill patients. Secondly, ‘Preparing for “war”’ illustrated deployed nurses’ need for clear communication and essential critical care nursing training. Lastly, ‘Call of duty’ affirmed the nurses’ personal and professional commitment to embrace this transition into the ICUs, and their desire for greater psychosocial support.
The study findings highlight that though general ward nurses perceived their impending ICU deployment positively, they require ongoing support to facilitate a smoother transition.
Findings provided an evidence base to improve the preparedness of general ward nurses deployed into the ICUs during the COVID-19 pandemic within key areas of training, information dissemination and psychosocial resilience.
FreshRSS 