Impact of home visits on the functional capacity of patients with venous ulcers

ABSTRACT Objective: to compare the impact of home visits, before and after instructions, on the functional capacity of adult and elderly patients with venous ulcers, by means of the KATZ-EIAVD Scale. Method: experimental, clinical, randomized, non-blind and controlled study, developed with 32 patients (case and control groups). The research settings were the Wound Care Clinic of the University Hospital Antonio Pedro, and the homes of patients assisted in this clinic. Data collection took place from February to June 2014, by means of a health unit evaluation tool, the KATZ-EIAVD Scale, and a script of instructions to be given to the research subjects that had received a home visit. Results: the studied population present excellent independence for activities of daily living, with no significant variation among them. Conclusion: the studied groups have functional capacity with similar progress.

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Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study (Preprint)

10.2196/preprints.14346 ◽

2019 ◽

Author(s):

Jeremy Peuchot ◽

Etienne Allard ◽

Bertrand Dureuil ◽

Benoit Veber ◽

Vincent Compère

Keyword(s):

Conversion Rate ◽

Outpatient Surgery ◽

University Hospital ◽

Controlled Study ◽

Full Time ◽

Medical Safety ◽

Hospitalization Costs ◽

Sms Reminder ◽

Sms Reminders ◽

The Impact

BACKGROUND Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. OBJECTIVE The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. METHODS We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. RESULTS A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. CONCLUSIONS In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.

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Efficacy of a bacterial fluorescence imaging device in an outpatient wound care clinic: a pilot study

Journal of Wound Care ◽

10.12968/jowc.2019.28.7.438 ◽

2019 ◽

Vol 28 (7) ◽

pp. 438-443 ◽

Cited By ~ 8

Author(s):

Ciaran M. Hurley ◽

Pat McClusky ◽

Ryan M. Sugrue ◽

James A. Clover ◽

Jason E. Kelly

Keyword(s):

Real Time ◽

Fluorescence Imaging ◽

Predictive Value ◽

Pathogenic Bacteria ◽

Wound Care ◽

Bacterial Species ◽

University Hospital ◽

Fluorescent Light ◽

Care Clinic ◽

Imaging Device

Objective: Subsurface bacterial burden can be missed during standard wound examination protocols. The real-time bacterial fluorescence imaging device, MolecuLight i:X, visualises the presence of potentially harmful levels of bacteria through endogenous autofluorescence, without the need for contrast agents or contact with the patient. The intended use of the imaging device is to assist with the management of patients with wounds by enabling real-time visualisation of potentially harmful bacteria. The aim of this study was to establish the accuracy of the wound imaging device at detecting pathogenic bacteria in wounds. Methods: A single-centre, prospective observational study was conducted in Cork University Hospital in an outpatient plastic surgery wound care clinic. Patients had their wounds photographed under white and autofluorescent light with the imaging device. Auto-fluorescent images were compared with the microbiological swab results. Results: A total of 33 patients and 43 swabs were included, of which 95.3% (n=41) were positive for bacteria growth. Staphylococcus aureus was the most common bacterial species identified. The imaging device had a sensitivity of 100% and specificity of 78% at identifying pathological bacteria presence in wounds on fluorescent light imaging. The positive predictive value (PPV) was 95.4%. The negative predictive value (NPV) was 100%. It demonstrated a sensitivity and specificity of 100% at detecting the presence of Pseudomonas spp. Conclusion: The imaging device used could be a safe, effective, accurate and easy-to-use autofluorescent device to improve the assessment of wounds in the outpatient clinic setting. In conjunction with best clinical practice, the device can be used to guide clinicians use of antibiotics and specialised dressings.

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Controlled study of the impact of educational home visits by pharmacists to high-risk older patients

Journal of Community Health ◽

10.1007/bf01350254 ◽

1990 ◽

Vol 15 (3) ◽

pp. 163-174 ◽

Cited By ~ 30

Author(s):

Victor W. Sidel ◽

Judith L. Beizer ◽

Donna Lisi-Fazio ◽

Kurt Kleinmann ◽

John Wenston ◽

...

Keyword(s):

High Risk ◽

Older Patients ◽

Home Visits ◽

Controlled Study ◽

The Impact

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Orientações em saúde: estratégia de promoção à capacidade funcional nas úlceras venosas

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i7a231417p1901-1911-2018 ◽

2018 ◽

Vol 12 (7) ◽

pp. 1901

Author(s):

Karoline Moreira Duffrayer ◽

Fabiana Lopes Joaquim ◽

Alessandra Conceição Leite Funchal Camacho

Keyword(s):

Functional Capacity ◽

Wound Repair ◽

Care Plan ◽

Research Subjects ◽

Venous Ulcers ◽

Varicose Ulcer ◽

Home Context ◽

Multiple Case ◽

Care Health ◽

Quantitative Descriptive

RESUMOObjetivo: avaliar a efetividade das orientações em saúde no contexto domiciliar na capacidade funcional de idosos com úlceras venosas. Método: estudo quantitativo, descritivo, do tipo estudo de múltiplos casos, realizado no Ambulatório de Reparo de Feridas e domicílios de pacientes. A coleta de dados ocorreu por meio de instrumento de avaliação da unidade de saúde, da Escala de KATZ-EIAVD, do Índice de TINETTI e de roteiro de orientações a serem prestadas aos sujeitos da pesquisa que receberam visita domiciliar. Resultados: os casos estudados apresentaram melhoras sobre a capacidade funcional após a realização de orientações em saúde. Conclusão: as melhoras percentuais observadas apontam que o enfermeiro na visita domiciliar deve considerar e avaliar as necessidades dos pacientes com úlcera venosa estabelecendo um plano assistencial. Descritores: Cuidados de Enfermagem; Úlcera Varicosa; Visita Domiciliar; Assistência Ambulatorial; Atenção à Saúde; Saúde Pública.ABSTRACTObjective: to evaluate the effectiveness of health guidelines in the home context regarding the functional capacity of older adults with venous ulcers. Method: quantitative, descriptive, multiple-case study conducted at the Wound Repair Outpatient Clinic and patient's homes. Data collection was done through a tool for evaluation of the health unit, the KATZ-EIAVD Scale, the TINETTI Index, and the script of guidelines to be provided to research subjects who received home visits. Results: the cases studied showed improvement of functional capacity after the application of health guidelines. Conclusion: the percentage of improvement observed indicates that nurses should consider and evaluate the needs of patients with venous ulcers to establish a care plan. Descriptors: Nursing care; Varicose ulcer; Home visit; Ambulatory Care; Health Care; Public Health.RESUMENObjetivo: evaluar la efectividad de las orientaciones en salud en el contexto domiciliario en la capacidad funcional de ancianos con úlceras venosas. Método: estudio cuantitativo, descriptivo, del tipo estudio de múltiples casos, realizado en el Ambulatorio de Reparo de Heridas y domicilios de pacientes. La recolección de datos fue por medio de instrumento de evaluación de la unidad de salud, de la Escala de KATZ-EIAVD, del Índice de TINETTI y de guía de orientaciones a ser prestadas a los sujetos de la investigación que recibieron visita domiciliaria. Resultados: los casos estudiados presentaron mejoras sobre la capacidad funcional después de la realización de orientaciones en salud. Conclusión: las mejorías de porcentaje observadas apuntan que el enfermero en la visita domiciliaria debe considerar y evaluar las necesidades de los pacientes con úlcera venosa estableciendo un plano asistencial. Descriptores: Atención de Enfermería; Úlcera Varicosa; Visita Domiciliaria; Atención ambulatoria; Atención a la Salud; Salud Pública.

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Placenta praevia in Najran University hospital: incidence and risk factors

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171561 ◽

2017 ◽

Vol 6 (5) ◽

pp. 1758

Author(s):

Sana B. Mustafa ◽

Abdulhadi M. Elbashir ◽

Adil Y. Waddad ◽

Abdelrahman M. A. Ibrahim

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Significant Risk ◽

Placenta Praevia ◽

University Hospital ◽

Age Group ◽

Cross Sectional ◽

Care Clinic ◽

One Year ◽

The Impact

Background: Placenta praevia is a source of drastic pregnancy, fetal and neonatal complications. There was variable incidence in the literature in different parts of the world and within the same country regions. We carried out this study to find the impact in our area and the possible risk factors for this serious obstetric problem.Methods: This study is a cross-sectional descriptive, one-year retrospective one-year prospective study, carried out from April 2014 to April 2016. All pregnant women attended the antenatal care clinic in Najran University Hospital during the study period, were included.Results: The incidence of placenta praevia was found to be 2.7%. AMONG the study group, the most affected age group was between 20-29 years. Previous placenta praevia and previous caesarean section were the significant risk factors P=0.00 and 0,017 repectively.Conclusions: The incidence of placenta praevia in Najran KSA in this study was high, compared to other regions in Saudi Arabia and the majority of the international figures. Caesarean section and previous placenta praevia were the significant risk factors for placenta praevia in this study.

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Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study

Critical Care ◽

10.1186/s13054-021-03466-z ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Laurent Zieleskiewicz ◽

Alexandre Lopez ◽

Sami Hraiech ◽

Karine Baumstarck ◽

Bruno Pastene ◽

...

Keyword(s):

Point Of Care ◽

Circulatory Failure ◽

University Hospital ◽

Controlled Study ◽

Control Group ◽

Point Of Care Ultrasound ◽

Clinical Trial Registration ◽

Ultrasound Device ◽

Management Protocol ◽

The Impact

Abstract Background Rapid response teams are intended to improve early diagnosis and intervention in ward patients who develop acute respiratory or circulatory failure. A management protocol including the use of a handheld ultrasound device for immediate point-of-care ultrasound (POCUS) examination at the bedside may improve team performance. The main objective of the study was to assess the impact of implementing such a POCUS-guided management on the proportion of adequate immediate diagnoses in two groups. Secondary endpoints included time to treatment and patient outcomes. Methods A prospective, observational, controlled study was conducted in a single university hospital. Two teams alternated every other day for managing in-hospital ward patients developing acute respiratory and/or circulatory failures. Only one of the team used an ultrasound device (POCUS group). Results We included 165 patients (POCUS group 83, control group 82). Proportion of adequate immediate diagnoses was 94% in the POCUS group and 80% in the control group (p = 0.009). Time to first treatment/intervention was shorter in the POCUS group (15 [10–25] min vs. 34 [15–40] min, p < 0.001). In-hospital mortality rates were 17% in the POCUS group and 35% in the control group (p = 0.007), but this difference was not confirmed in the propensity score sample (29% vs. 34%, p = 0.53). Conclusion Our study suggests that protocolized use of a handheld POCUS device at the bedside in the ward may improve the proportion of adequate diagnosis, the time to initial treatment and perhaps also survival of ward patients developing acute respiratory or circulatory failure. Clinical Trial Registration NCT02967809. Registered 18 November 2016, https://clinicaltrials.gov/ct2/show/NCT02967809.

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Karakteristik Luka Dan Penggunaan Balutan Luka Modern

Adi Husada Nursing Journal ◽

10.37036/ahnj.v6i1.161 ◽

2020 ◽

Vol 6 (1) ◽

pp. 8

Author(s):

Lilik Sriwiyati ◽

Budi Kristanto

Keyword(s):

Wound Dressing ◽

Chronic Wounds ◽

Wound Care ◽

Common Type ◽

Research Subjects ◽

Care Clinic ◽

Diabetic Ulcer ◽

Wound Area ◽

Basic Color ◽

Different Characteristics

Abstract The most frequent injuries are chronic wounds, where the number is increasing every year. The most common type of wound is diabetic ulcer and the next is cancerous wound. Each wound has different characteristics, so the treatment of each wound is also different. There are various dressings in modern wound care, where each bandage has different indications according to the characteristics of the wound, it is necessary to do research on the characteristics of the wound and the use of modern wound dressing. The purpose of the study To describe the characteristics of wounds and the use of modern wound dressing in the Salud Wound Care Clinic, Kartasura. Research subjects: patients undergoing wound care at the Salud Wound Care Clinic, a total of 9 respondents. Method: Descriptive analytic. Research Results: The types of wounds treated were diabetic ulcer wounds, postoperative wounds, cancer wounds, and decubitus wounds, wound duration varied from 2 weeks to 1 year. Types of wound dressing used were foam, alginate, and hybrid technology dressing, there was a decrease the size of the wound area with a mean of 14,69 to 11,61, the majority of wounds in stage 2, the basic color of the wound is red, and the type of exudate is serous. Conclusion: There is a reduction in wound size, stage, and the wound exudate, as well as repairing the wound’s basic color with wound care using modern wound dressing. Keywords: modern wound dressing, wound characteristics.

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Influence of Rings on the Efficacy of Hand Sanitization and Residual Bacterial Contamination

Infection Control and Hospital Epidemiology ◽

10.1086/510790 ◽

2007 ◽

Vol 28 (3) ◽

pp. 351-353 ◽

Cited By ~ 18

Author(s):

Montri D. Wongworawat ◽

Sidney G. Jones

Keyword(s):

Hand Hygiene ◽

Povidone Iodine ◽

Bacterial Count ◽

University Hospital ◽

Controlled Study ◽

Randomized Controlled ◽

Colony Forming Units ◽

Significant Difference ◽

The Impact ◽

Number Of Bacteria

Background.Previous studies, conducted before widespread use of scrubless, alcohol-based hand sanitizers, demonstrated increased residual bacterial counts after hand hygiene on hands with jewelry.Objective.To compare the impact of finger rings on the effectiveness of scrubless and water-aided alcohol-based hand sanitization methods with that of povidone-iodine scrub.Design.Randomized, controlled study.Setting.University hospital.Participants.Sixty volunteer subjects from a pool of perioperative staff and medical students.Intervention.After recruitment, participants wore a ring on one hand and no ring on the other hand. They were randomly assigned to perform hand hygiene with a povidone-iodine scrub, an alcohol wash, or a waterless alcohol-chlorhexidine lotion (n = 20 subjects per method). After subjects completed hand hygiene, gloves were placed on their hands by means of sterile methods, and a “glove juice” technique was used to obtain samples for culture. The number of colony-forming units in each culture was counted, and the data were compared.Results.There was no significant difference in the number of bacteria between hands with and hands without rings for the groups that used alcohol wash or alcohol-chlorhexidine lotion. However, for the povidone-iodine group, the number of bacteria on hands with rings was greater than the number on hands without rings (P < .05). The hands of participants who used waterless alcohol-chlorhexidine had the lowest bacterial count, regardless of the presence of rings (P < .01).Conclusions.The presence of rings does not negatively impact the effectiveness of alcohol-based hand sanitizers. Use of waterless alcohol-chlorhexidine lotion resulted in the lowest bacterial count.

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Hubungan Lama Menderita Ulkus Diabetik Dengan Kualitas Hidup Pada Penderita Ulkus Diabetikum

Adi Husada Nursing Journal ◽

10.37036/ahnj.v6i1.162 ◽

2020 ◽

Vol 6 (1) ◽

pp. 32

Author(s):

Maria Manungkalit

Keyword(s):

Quality Of Life ◽

Wound Care ◽

Time Frame ◽

Cross Sectional Study ◽

Cross Sectional ◽

Care Clinic ◽

Diabetic Ulcers ◽

Collection Data ◽

The Impact

Chronic complications associated with the presence of neuropathy and / or peripheral disease in people with DMT2 are diabetic ulcers that cause tissue damage. Duration of the ulcer in the treatment anda treatment requires a lot of time. The impact of diabetic ulcers can affect the quality of life for sufferers. This study aimed to analyze the correlation between ulcers duration and Quality of Life (QOL) in DMT2 with patients with diabetic ulcers. This cross-sectional study engaged 40 patients from a particular wound care clinic in Surabaya which were registered as outpatients in April-June 2018. Total sampling was applied to get 40 sample size. The independent variable is ulcer duration, and the dependent variable was QOL. WHOQOL-BREF was used in data collection. Data analysis used Spearman’s Rho correlation test (α<0.05). The majority had diabetic ulcers for 1-<8 months, and most respondents had moderate QOL. There was no significant correlation between ulcers duration and QOL in DMT2 patients with diabetic ulcers (p = 0.496). The insignificant correlation between variables found in this study was potentially occured due to the less varied data of ulcers duration which was 1-<8 months in the majority compared to better varied data of QOL in the same time frame. Keywords: ulcers duration, quality of life diabetic ulcers, dibetes mellitus type 2.

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Impact of endovascular pedal arteries revascularization on wound healing in patients with critical limb ischemia

International Surgery Journal ◽

10.18203/2349-2902.isj20204663 ◽

2020 ◽

Vol 7 (11) ◽

pp. 3633

Author(s):

Mohamed M. El Yamany ◽

Hatem M. Mohamed ◽

Meera R. Boulos ◽

Sherif A. Raffat

Keyword(s):

Wound Healing ◽

Critical Limb Ischemia ◽

Wound Care ◽

Limb Ischemia ◽

Arterial Disease ◽

University Hospital ◽

Endovascular Revascularization ◽

Time Required ◽

The Impact

Background: Critical limb ischemia (CLI) is the final consequence of peripheral arterial disease (PAD). The management of this complex patient population often warrants a multidisciplinary approach with collaboration between endovascular interventionist, vascular surgeons, podiatrist, infectious disease, and wound care specialist. Objective of the study was to evaluate the impact of endovascular pedal arteries revascularization on wound healing in patients with critical limb ischemia.Methods: This was an interventional study conducted on 30 consecutive CLI patients underwent infra-genicular endovascular revascularization who attended to the outpatient department and emergency, Suez Canal university hospital complaining of symptoms of critical lower limb ischemia involving the foot (rest pain, ulcer and gangrene), during the period study from June 2017 till January 2019. Full detailed history, full examination, lab investigation, radiological imaging was done.Results: The pain intensity decreased from 7 to 4 post-procedural at 2nd day post-op, then to 3 at one week follow up and then it totally disappeared at one month follow up visit. The remaining patients who had incomplete PAA reported faster relieve of pain and more dramatic improve over time as it was totally relieved post procedural by time of discharge. The overall mean time required to achieve wound healing was 15±8 weeks.Conclusion: Successful pedal artery revascularization significantly improved wound healing in patients with CLI. Endovascular revascularization is effective to facilitate healing of wounds in CLI and can be performed without significant complications.

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