Scoping study into wound management nurse practitioner models of practice

2015 ◽  
Vol 39 (2) ◽  
pp. 220 ◽  
Author(s):  
Michelle A. Gibb ◽  
Helen E. Edwards ◽  
Glenn E. Gardner
Keyword(s):  
Patient Outcomes ◽  
Nurse Practitioner ◽  
Survey Methodology ◽  
Response Rate ◽  
Wound Management ◽  
Scoping Study ◽  
Wound Debridement ◽  
Australian Context ◽  
Practice Parameters ◽  
Baseline Information

Objectives The primary objective of this research was to investigate wound management nurse practitioner (WMNP) models of service for the purposes of identifying parameters of practice and how patient outcomes are measured. Methods A scoping study was conducted with all authorised WMNPs in Australia from October to December 2012 using survey methodology. A questionnaire was developed to obtain data on the role and practice parameters of authorised WMNPs in Australia. The tool comprised seven sections and included a total of 59 questions. The questionnaire was distributed to all members of the WMNP Online Peer Review Group, to which it was anticipated the majority of WMNPs belonged. Results Twenty-one WMNPs responded (response rate 87%), with the results based on a subset of respondents who stated that, at the time of the questionnaire, they were employed as a WMNP, therefore yielding a response rate of 71% (n = 15). Most respondents (93%; n = 14) were employed in the public sector, with an average of 64 occasions of service per month. The typical length of a new case consultation was 60 min, with 32 min for follow ups. The most frequently performed activity was wound photography (83%; n = 12), patient, family or carer education (75%; n = 12), Doppler ankle–brachial pressure index assessment (58%; n = 12), conservative sharp wound debridement (58%; n = 12) and counselling (50%; n = 12). The most routinely prescribed medications were local anaesthetics (25%; n = 12) and oral antibiotics (25%; n = 12). Data were routinely collected by 91% of respondents on service-related and wound-related parameters to monitor patient outcomes, to justify and improve health services provided. Conclusion This study yielded important baseline information on this professional group, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are measured. What is known about the topic? The nurse practitioner (NP) is an established and legitimised entity of health service in Australia, with NPs in a range of specialities. To date, there is a paucity of research on the role and practice parameters of WMNP in the Australian context. What does this paper add? This paper provides important baseline information on WMNP models of practice in the Australian context, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are currently measured. This information will help inform the development of WMNP roles and highlights potential areas of evaluation for WMNP models of care. What are the implications for practitioners? Measurement of outcomes is essential to demonstrate efficacy of NP service. Yet, there is no way currently to measure these outcomes for WMNP service. Nationally consistent data collection on processes of care and patient outcomes supports ongoing development of the WMNP role.

scholarly journals Dynamic Question Ordering in Online Surveys

2017 ◽  
Vol 33 (3) ◽  
pp. 625-657 ◽  
Author(s):  
Kirstin Early ◽  
Jennifer Mankoff ◽  
Stephen E. Fienberg
Keyword(s):  
Case Studies ◽  
Survey Methodology ◽  
Response Rate ◽  
General Survey ◽  
Online Surveys ◽  
Rule Based ◽  
Past Work ◽  
National Surveys ◽  
Question Order ◽  
Rule Based Approach

Abstract Online surveys have the potential to support adaptive questions, where later questions depend on earlier responses. Past work has taken a rule-based approach, uniformly across all respondents. We envision a richer interpretation of adaptive questions, which we call Dynamic Question Ordering (DQO), where question order is personalized. Such an approach could increase engagement, and therefore response rate, as well as imputation quality. We present a DQO framework to improve survey completion and imputation. In the general survey-taking setting, we want to maximize survey completion, and so we focus on ordering questions to engage the respondent and collect hopefully all information, or at least the information that most characterizes the respondent, for accurate imputations. In another scenario, our goal is to provide a personalized prediction. Since it is possible to give reasonable predictions with only a subset of questions, we are not concerned with motivating users to answer all questions. Instead, we want to order questions to get information that reduces prediction uncertainty, while not being too burdensome. We illustrate this framework with two case studies, for the prediction and survey-taking settings. We also discuss DQO for national surveys and consider connections between our statistics-based question-ordering approach and cognitive survey methodology.

scholarly journals The effect of a web-push survey on physician survey response rates: a randomized experiment.

2019 ◽  
Author(s):  
Cristine D. Delnevo ◽  
Binu Singh
Keyword(s):  
Survey Methodology ◽  
Response Rate ◽  
Mail Survey ◽  
Cost Effective ◽  
Response Rates ◽  
National Sample ◽  
High Response Rate ◽  
Future Research ◽  
Effective Delivery ◽  
The Web

Abstract Background: Achieving a high response rate for physicians has been challenging and with response rates declining in recent years, innovative methods are needed to increase rates. An emerging concept in survey methodology has been web-push survey delivery. In this delivery method, contact is made by mail to request a response by web. This study explored the feasibility of a web-push survey on a national sample of physicians. Methods: 1000 physicians across six specialties were randomly assigned to a mail only or web-push survey delivery. Each mode consisted of four contacts including an initial mailing, reminder postcard, and two additional follow-ups. Response rates were calculated using AAPOR’s response rate 3 calculation. Data collection occurred between Febuary – April 2018 and analyzed March 2019. Results: Overall reponse rates for the mail only vs. web-push survey delivery were comparable (51.2% vs. 52.8%). Higher response rates across all demographics were seen in the web-push delivery with the exception of pulmonary/critical care and physicians over the age of 65. The web-push survey yielded a greater response after the first mailing requiring fewer follow-up contacts resulting in a more cost-effective delivery. Conclusions: A web-push mail survey is effective in achieveing a comparable response rate to traditional mail only delivery for physicians. The web-push survey was more efficient in terms of cost and in receiving responses in a more timely manner. Future research should explore the efficiency of a web-push survey delivery across various health care provider populations.

The Colectomy Improvement Project: Do Evidence-Based Guidelines Improve Institutional Colectomy Outcomes?

2016 ◽  
Vol 82 (9) ◽  
pp. 830-834 ◽  
Author(s):  
Danny Mammo ◽  
Claire Peeples ◽  
Marc Grodsky ◽  
Drew Honaker ◽  
Harry Wasvary
Keyword(s):  
Patient Outcomes ◽  
Educational Intervention ◽  
Best Practice ◽  
Improvement Project ◽  
Best Practice Guidelines ◽  
Improved Outcomes ◽  
Practice Parameters ◽  
Surgical Infections ◽  
Specific Practice ◽  
Evidence Based Guidelines

This study evaluates whether increased adherence to eight specific practice parameters leads to improved outcomes in patients undergoing elective colorectal resections. In addition, we analyzed whether physicians with better compliance achieved better patient outcomes. Compliance to practice parameters and subsequent outcomes were compared between two groups relative to an educational intervention promoting the eight best practice guidelines selected. A total of 485 patients were identified over a 4-year period and were separated into a pre- (n = 273) and post-education (n = 212) group. After the educational intervention, there was increased compliance in five of the eight practice parameters ( P < 0.05). When outcomes where examined, the readmission rate (2.4% vs 8.4%; P = 0.005) and the incidence of deep surgical infections (0% vs 1.8%; P = 0.01) were significantly decreased when comparing the posteducational group to that of the group before intervention. A lower rate of anastomotic leaks were identified in the posteducation group, but this did not reach significance (1.9% vs 5.1%; P = .09). When analyzed individually, the most compliant physicians achieved better patient outcomes than their peers. Education of the operative team improved adherence to practice parameters and this may have contributed to improving patient outcomes.

The veterinary nurse's role in the management of wound drains

2020 ◽  
Vol 11 (6) ◽  
pp. 264-269
Author(s):  
Evie Yon
Keyword(s):  
Wound Healing ◽  
Patient Outcomes ◽  
Wound Management ◽  
Surgical Reconstruction ◽  
Normal Process ◽  
Initial Management ◽  
Accurate Knowledge ◽  
Wound Breakdown ◽  
Potential Applications ◽  
The Ideal

Wound management is an exciting and well-researched area of veterinary medicine. It is a key area for veterinary nursing involvement from initial management to possible surgical reconstruction. An essential aspect of this is provision of the ideal wound environment to encourage normal and effective wound healing, and to reduce the incidence of wound breakdown and dehiscence. Throughout this clinical review, consideration will be given to the normal process of wound healing and how this can be assisted by drain placement. The types of drain used in practice, in addition to novel drainage techniques, will be considered throughout, as well as the veterinary nurse's role in their management. Comprehensive and accurate knowledge and understanding of different drain types, in addition to their potential applications, can help to ensure more informed veterinary nursing and, in turn, better wound healing and patient outcomes.

scholarly journals 973 The Effect of Implementing A Proactive Care of Older People Undergoing Surgery (‘POPS’) Team on Length of Stay in Older Surgical Patients

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J M Bayram ◽  
D Rangar ◽  
J Dikiciyan ◽  
I Smith
Keyword(s):  
Length Of Stay ◽  
Older People ◽  
Vascular Surgery ◽  
Patient Outcomes ◽  
Nurse Practitioner ◽  
Surgical Patients ◽  
Medical Complications ◽  
Hospital Data ◽  
Proactive Care ◽  
Frailty Score

Abstract Introduction POPS is a well-established service which supports care of older surgical patients across multiple UK hospitals. POPS teams have been shown to reduce peri-operative medical complications, reduce length of stay (LOS) and improve multiple other patient outcomes. Method A POPS team consisting of two consultants, one foundation doctor and one nurse practitioner was implemented to provide dedicated care to older surgical patients on the general and vascular surgery wards of a large urban teaching hospital. Data were collected over 8 weeks from June 2020 - July 2020 following implementation of the POPS team and compared to pre-POPS data from March 2018 - March 2019. All inpatients were screened by age and Clinical Frailty Score (CFS) for appropriateness and received POPS input based on clinical need. Prior to the POPS team, liaison geriatric input was provided by a sole consultant. Results The 36 patients from the POPS group had an average LOS of 15.9 days, which was significantly lower than the LOS of 37.4 days in the 537 patients in the pre-POPS group (p &lt; 0.01). There were no significant differences in demographics between the two groups. Conclusions The implementation of a POPS team significantly reduced length of stay in older surgical patients.

scholarly journals Serratia marcescens: an unusual pathogen associated with snakebite cellulitis

2013 ◽  
Vol 7 (02) ◽  
pp. 152-154 ◽  
Author(s):  
Parimala Subramani ◽  
Gokul Bindiganavile Narasimhamurthy ◽  
Bhaskaran Ashokan ◽  
Beena Prasavangada Madappa
Keyword(s):  
Serratia Marcescens ◽  
Snake Venom ◽  
Wound Management ◽  
Third Generation ◽  
Tissue Necrosis ◽  
Wound Debridement ◽  
Tissue Biopsy ◽  
Right Hand ◽  
The Right ◽  
Third Generation Cephalosporins

This study reports a case of Serratia marcescens cellulitis following a snakebite in a 50-year-old woman. The bite was on the dorsum of the right hand with symptoms of envenomation. She developed swelling and cellulitis with tissue necrosis. Wound debridement was performed.  Pus and tissue biopsy cultures yielded Serratia marcescens sensitive to fluoroquinolones, aminoglycosides, third-generation cephalosporins and carbapenems. The patient responded to anti-snake venom (ASV) therapy, ciprofloxacin, local wound management and recovered uneventfully.

scholarly journals How Good Is Survey Design in Medical Libraries? A Systematic Review of User Surveys

2021 ◽  
Author(s):  
◽  
Rachel Margaret Esson
Keyword(s):  
Survey Methodology ◽  
Response Rate ◽  
Evidence Based Practice ◽  
Survey Design ◽  
Skills Training ◽  
Response Rates ◽  
Evidence Based ◽  
Good Response Rate ◽  
Medical Libraries

<p>Introduction: Medical libraries very often base the decisions they make about library services on information gathered from user surveys. Is the quality of information obtained in this way sufficient to enable evidence-based practice? Aim: To determine what aspects of user survey design and presentation obtain the best response rates and therefore high external validity. Also to provide guidance for medical librarians who may wish to carry out user surveys. Methods: Library and information studies databases and Medline were searched to identify studies that reported the results of library user surveys that measured user perceptions of an existing library service or potential service. Studies that evaluated information skills training or clinical librarianship interventions were excluded as they have been looked in separate systematic reviews. Also studies that reported the results of LibQUAL or SERVQUAL were excluded. Results: 54 studies were included. The quality of the majority of the surveys was not clear as the reporting of the methodology of the user surveys was poor. However, it was determined that, as demonstrated in previous research, paper format surveys reported higher response rates than online-only surveys. It was not possible to extract any relevant data from the identified studies to draw any conclusions relating to presentation of the survey instrument. Conclusions: Unless survey methodology is reported in detail it is not possible to judge the quality of the evidence surveys contain. Good survey design is key to obtaining a good response rate and a good response rate means the results can be used for evidence-based practice. A Reporting Survey results Guideline (Resurge) is recommended to help improve the reporting quality of medical library survey research.</p>

Survey Methodology

2009 ◽  
Author(s):  
Richard Johnston
Keyword(s):  
World Wide ◽  
Survey Methodology ◽  
Response Rate ◽  
Three Dimensions ◽  
Political Interest ◽  
The Internet ◽  
High Quality ◽  
The World ◽  
Mode Space ◽  
Political Choices

This article addresses three dimensions for data collection: mode, space, and time. It considers the problems of adequately representing persons by ensuring high response rates and measuring opinions validly and reliably through the design of high-quality questions. The advent of the internet and the World Wide Web is dramatically expanding the repertoire for survey research. The evidence suggests that the forces driving response rate down are largely orthogonal to substantive political choices. Surveys overrepresent political interest and its correlates and so may replicate class and other barriers to political participation.

Surgical treatment of septic subtendinous calcaneal bursitis in 2 cows

2019 ◽  
Vol 47 (05) ◽  
pp. 316-325
Author(s):  
Johann Kofler ◽  
Hannah Erlacher ◽  
Geane Pagliosa
Keyword(s):  
Wound Management ◽  
Manuscript Submission ◽  
Wound Debridement ◽  
Intravenous Regional Anesthesia ◽  
Initial Surgery ◽  
Linear Probe ◽  
Superficial Digital Flexor Tendon ◽  
Advanced Stages ◽  
Hindlimb Lameness ◽  
Small Bone

AbstractTwo cows were referred to our clinic with moderate to severe hindlimb lameness due to infected wounds over the lateral and caudal aspect of tuber calcanei (TC) with regional swelling, consistent with septic subtendinous calcaneal bursitis. Ultrasonography (7.5 MHz linear probe) revealed fibrinous/fibrino-purulent inflammatory bursal effusions in both cows, complete rupture of the superficial digital flexor tendon and a small, circumscribed, irregular and rough bone contour of the TC in case 2. Radiography revealed physiological findings in case 1, whereas there were osteomyelitis and later bone sequestration in case 2. Treatment consisted of thorough wound debridement, establishing access to the bursa, removal of all exudate and fibrin, creation of additional drainage portals and meticulous lavage using sterile 0.9 % saline solution containing 0.1 % povidone-iodine performed under sedation and intravenous regional anesthesia. In case 2, the infected bone area of the TC was removed using a curette. However, a small bone sequestration developed from the TC 15 days later, which was associated with osteomyelitis. This was removed during a second surgical intervention. Systemic antimicrobial and anti-inflammatory medications were administered peri- and post-surgically and the bursae flushed repeatedly. The affected tarsi were covered with a modified Robert-Jones bandage or a fiberglass cast. Cows 1 and 2 were discharged from the clinic 25 and 27 days after initial surgery, respectively, displaying mild lameness. Both cows were alive, not lame and were in advanced stages of pregnancy at the time of manuscript submission 8 and 12 months later, respectively. This report describes in detail 2 severe cases of septic fibrino-purulent subtendinous calcaneal bursitis in cows that were successfully treated by surgical debridement and lavage under a practical anesthetic protocol, followed by proper wound management in the post-surgical period. These effective surgical procedures can be performed under field conditions given the availability of adequate equipment.

Mobile-Based Research Methods

2007 ◽  
pp. 639-643
Author(s):  
S. Okazaki ◽  
A. Katsukura ◽  
M. Nishiyama
Keyword(s):  
Data Quality ◽  
Research Methods ◽  
Mobile Device ◽  
Questionnaire Survey ◽  
Survey Methodology ◽  
Response Rate

The aim of this article is to propose a framework of mobile-based survey methodology. Specifically, we attempt to establish guidelines for a questionnaire survey via the mobile device, in terms of cost, questionnaire format, incentives, target respondents, response rate, and data quality.

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