Measured Wound Outcome Feedback Improves Surgical Site Infection Rates

2021 ◽  
Vol 33 (12) ◽  
pp. 334-336
Author(s):  
Laura Bolton
Keyword(s):  
Hand Hygiene ◽  
Randomized Clinical Trials ◽  
Chronic Wounds ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Care Practice ◽  
Written Feedback ◽  
Outcome Feedback ◽  
Hygiene Practices ◽  
Orthopedic Surgeons

Feedback supports learning. No matter how effective medical professionals think they are, evidence of measured patient wound outcomes helps inform their wound care practice, empowering them to improve patient outcomes. Prospective randomized clinical trials (RCTs) proved this principle in relation to healing chronic wounds. Measuring wound healing outcomes and providing caregivers with feedback about the 4-week healing progress increased the percentage of diabetic foot ulcers healed within 20 weeks and venous leg ulcers healed within 24 weeks. Longitudinal research2 suggests this principle holds true in preventing surgical site infections (SSIs). When individual orthopedic surgeons were provided written feedback about their hand hygiene practices and corresponding SSI rates, surgeon hand hygiene improved and SSI rates in their patients were reduced. This Evidence Corner describes systematic review evidence indicating that feedback given to responsible wound care professionals reduced SSI incidence for patients undergoing orthopedic or trauma surgery3 and abdominal surgery.

scholarly journals Telemedicine for wound management

2012 ◽  
Vol 45 (02) ◽  
pp. 412-417 ◽  
Author(s):  
Ravi K. Chittoria
Keyword(s):  
Health Care ◽  
Chronic Wounds ◽  
Wound Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Wound Management ◽  
Care Practice ◽  
Telemedicine Technology ◽  
Store And Forward ◽  
Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

scholarly journals Principles of Best Diagnostic Practice in Tissue Repair and Wound Healing: An Expert Consensus

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 50
Author(s):  
David G. Armstrong ◽  
Karen Bauer ◽  
Greg Bohn ◽  
Marissa Carter ◽  
Robert Snyder ◽  
...  
Keyword(s):  
Protease Activity ◽  
Pathogenic Bacteria ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Signs ◽  
Care Practice ◽  
Invasive Infection ◽  
Consensus Panel ◽  
Advanced Therapies

Chronic wound treatment currently relies heavily on visual assessment by clinicians; however, the clinical signs and symptoms of infection and inflammation are unreliable in chronic wounds. The specialty of wound care has witnessed the advent of advanced interventions, such as cellular and/or tissue based products (CTP). The success of advanced therapies relies on preparing the wound bed by reducing bacterial burden and inflammation. The lack of diagnostics in chronic wound care leads to uncertainty in the adequacy of wound bed preparation. Recent research suggests that two novel point-of-care diagnostic tests can assist in the detection of chronic inflammation known as elevated neutrophil derived protease activity (EPA) and bacterial pathogenesis known as bacterial protease activity(BPA) in chronic wounds. Despite the evidence, however, clinicians report that incorporating diagnostics into every day practice is challenging and across the globe, they have requested guidance on their use. Methods and Recommendations: A panel of wound care experts, experienced with these tests, met to develop guidelines on their use in wound care practice. The consensus panel concluded that the clinician should test for BPA first. The panel maintained that the risk of invasive infection resulting from the presence of pathogenic bacteria was the greatest threat to the patient’s health. If the BPA test is negative, the panel recommended testing for EPA. In addition, it was suggested that if the wound failed to progress after the elevated BPA was treated and subsequent testing was negative for BPA, the clinician should consider testing for EPA. Conclusions: In this manuscript, the consensus panel suggests pathways for testing, treating, and retesting for EPA and BPA. The panel expects that following the algorithm has the potential to improve healing outcomes, result in more cost-effective use of advanced therapies, and improve antimicrobial stewardship by guiding antimicrobial use.

scholarly journals Autologous Matrix of Platelet-Rich Fibrin in Wound Care Settings: A Systematic Review of Randomized Clinical Trials

2020 ◽  
Vol 11 (2) ◽  
pp. 31 ◽  
Author(s):  
Chayane Karla Lucena de Carvalho ◽  
Beatriz Luci Fernandes ◽  
Mauren Abreu de Souza
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Chronic Wounds ◽  
Wound Care ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Control Group ◽  
Clinical Heterogeneity ◽  
Platelet Rich Fibrin

Platelet-rich fibrin (PRF) consists of a matrix that provides the necessary elements for wound healing, acting as a biodegradable scaffold for cell migration, proliferation, and differentiation, in addition to the delivery of growth factors and angiogenesis. This study aims to determine the effectiveness of the autologous PRF in the treatment of wounds of different etiologies. We carried out a systematic review of randomized clinical trials, guided by the recommendations of the Cochrane Collaboration using the following databases: Pubmed/MEDLINE, EMBASE, Web of Science, and CENTRAL. The search strategy resulted in the inclusion of ten studies that evaluated the use of PRF dressings for the healing of acute or chronic wounds of multiple etiologies. Among the 172 participants treated with PRF in wounds of varying etiologies and different segment times, 130 presented favorable events with the use of the intervention. Among the 10 studies included, only two of them did not demonstrate better results than the control group. The studies showed clinical heterogeneity, making it impossible to perform a meta-analysis. The findings do not provide enough evidence to support the routine use of PRF dressings as the first line of treatment for the healing of acute or chronic wounds of different etiologies. There was great variability in the application of the various protocols and the ways to prepare the PRF, resulting in clinical heterogeneity. Therefore, it makes it impossible to synthesize and to collect evidence from different types of studies in the meta-analysis, which affects the results and their proper discussion.

scholarly journals Hand hygiene as a caring practice: a reflection on professional responsibility

2017 ◽  
Vol 70 (2) ◽  
pp. 442-445 ◽  
Author(s):  
Aline Santa Cruz Belela-Anacleto ◽  
Maria Angélica Sorgini Peterlini ◽  
Mavilde da Luz Gonçalves Pedreira
Keyword(s):  
Hand Hygiene ◽  
Nursing Care ◽  
Prevention And Control ◽  
Professional Responsibility ◽  
Care Practice ◽  
Ethical Aspects ◽  
Effective Measure ◽  
Hygiene Practices ◽  
The World ◽  
And Control

ABSTRACT Hand hygiene represents a fundamental nursing care practice and is traditionally considered the most important and effective measure in the prevention and control of healthcare-related infections. However, studies indicate that adherence to the procedure is unsatisfactory throughout the world, and show low adherence rates. In a context in which patient safety stands out as a priority, this text submits refl ections about professional responsibility when not adhering to hand hygiene practices, and ethical aspects related to this conduct.

Implementing wound dressing protocol to reduce post cesarean section surgical site infections in Mibilizi District Hospital, Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 369-376 ◽  
Author(s):  
Augustin Bahufite ◽  
Albert Ndagijimana ◽  
Eva Adomako ◽  
Abraham Zerihun ◽  
Calliope Akintije Simba ◽  
...  
Keyword(s):  
Wound Dressing ◽  
District Hospital ◽  
Management Practice ◽  
Wound Care ◽  
Surgical Site Infections ◽  
Wound Management ◽  
Standards Of Care ◽  
Care Practice ◽  
Content Type ◽  
Management Protocol

Purpose Caesarean section (CS) is one of the most common surgeries in the world. Although the procedure saves lives, it poses important risks such as post-caesarean surgical site infection (PCS-SSI). Basic patient care procedures can prevent PCS-SSI, however, they are not always followed. The purpose of this study is to describe how strategic problem solving (SPS) was used to implement a wound dressing protocol in a district hospital in Rwanda to reduce PCS-SSI rates. Design/methodology/approach To address variations in wound care practice, a new clinical protocol was developed and implemented by a quality improvement team which included clinicians. Training and supervision was also provided to the maternity team. Findings The intervention reduced PCS-SSI from 5.1 to 1.8 per cent. It also significantly improved the compliance to recommended wound dressing practices. Practical implications By applying SPS and effective leadership skills, the authors secured buy-in and support from stakeholders and introduced a wound management protocol in a district hospital of Rwanda. The intervention significantly improved wound management practice; however, long term follow-up will be necessary to sustain the improvements. Originality/value The results will inform hospitals in resource-limited settings of how to improve basic standards of care using SPS and leadership without additional cost to the hospital.

Wireless Badge Tracks Hand-Hygiene Practices

2009 ◽  
Vol 2 (4) ◽  
pp. 10
Author(s):  
MIRIAM E. TUCKER
Keyword(s):  
Hand Hygiene ◽  
Hygiene Practices

Nurses' hand hygiene practices: Effects of scenario, knowledge, and locus of control

2010 ◽  
Author(s):  
Anne Collins McLaughlin ◽  
Grace E. Anxieter ◽  
Amanda T. Hemmer
Keyword(s):  
Locus Of Control ◽  
Hand Hygiene ◽  
Hygiene Practices

The Analysis of Nurses’ Positive Deviance Behaviours as a Measure in Preventing the Transmission of Healthcare-Associated Infections (HAIs) at M. Djamil Hospital, Padang, West Sumatera

2018 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Esthika Ariany Maisa ◽  
Yulastri Arif ◽  
Wawan Wahyudi
Keyword(s):  
Grounded Theory ◽  
Wound Care ◽  
Positive Deviance ◽  
Care Practice ◽  
Theory Approach ◽  
Nursing Managers ◽  
Theoretical Sampling ◽  
Develop Theory ◽  
Healthcare Associated ◽  
Grounded Theory Approach

Purpose: To explore the nurses’ positive deviance behaviors as an effort to provide solutions in preventing and controlling infections in the hospital. Method: This is a qualitative research using grounded theory approach. Thirteen nurses from Dr.M.Djamil hospital were selected based on theoretical sampling in order to develop theory as it appears. Nurses were interviewed from June to September 2014. Interviews were thematically analyzed using techniques of grounded theory to then generate a theory from themes formed. Findings: The modes of positive deviance behavior identified were practicing hand hygiene beyond the standards (bringing handsanitizer from home), applying nursing art in wound care practice, placing patients with MRSA infections at the corner side, giving a red mark on a MRSA patient’s bed for easy identification by nurses, changing clothes and shoes in hospital, reducing hooks on the wall, and cleaning the ward on scheduled days. Conclusion: The study shows that nurses have a number of positive deviance behaviors to prevent infection transmission in the wards. It is sugested that the hospital management and nursing managers adopt some of the uncommon solution highlighted by the nurses to solve the HAIs problems in the hospital.

Health Personnel Practices Regarding Hand Hygiene in the Delivery Room at the Middle Euphrates Teaching Hospitals

2017 ◽  
Vol 9 (04) ◽  
Author(s):  
Wafa A K Abbas ◽  
Muntahaa Rashaan
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Control Measure ◽  
Relevant Literature ◽  
Delivery Room ◽  
Health Care Personnel ◽  
Teaching Hospitals ◽  
Infection Prevention And Control ◽  
Health Staff ◽  
Hygiene Practices

Literatures proved that Hand hygiene is the most important and effective infection prevention and control measure to prevent the spread of microorganisms causing HAIs and improving hand hygiene is consider a vital intervention to promote optimum patient safety in delivery room. Aim of the study; This study conducted to assess hand hygiene practices of health care personnel in the delivery room at the middle Euphrates teaching hospitals. Methods; A Descriptive qusi-expremental research design begin in 20th February to 26th May 2016, Current study sample involve all midwives and physicians in the delivery room (Total coverage.). Questionnaire used for data collection by interview forms and observational checklist was obtain from the extensive review of relevant literature and related studies Data analyzed through utilize (SPSS) software version (16) where, included descriptive analysis and inferential data analysis. The study conducted among 37 physicians and 97 midwives working in the delivery room are females. The current study indicate that the overall evaluation for the health staff practices regarding hand hygiene is fair at Karbala, Al-Najaf, Babylon and Diwaniah with high difference in health staff practices regarding infection control precautions (hand hygiene) and the different studied governorates at pvalue 0.001. based on the finding of present study majority of health care personnel have fair applies related to hand hygiene practices at different studied governorate hospitals. Updating practice of health care personnel through continuing inservice educational programs. Regular inspection and follow-up from the ministry of health for assurances good hand hygiene, the important of exist motivation system and punishment system to the neglected health care personnel.

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