Getting lower leg ulcer evidence into primary health care nursing practice: a case study

2019 ◽  
Vol 27 (2) ◽  
pp. 78-85
Author(s):  
Sue Randall ◽  
Panagiota Avramidis ◽  
Naomi James ◽  
Alanda Vincent ◽  
Michelle Barakat-Johnson
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Lower Leg ◽  
Leg Ulcer ◽  
Venous Disease ◽  
High Morbidity ◽  
Evidence Based ◽  
Local Health ◽  
Primary Health

Venous leg ulcers (VLUs) are open lesions on the lower leg caused by venous disease, which are associated with high morbidity and pose a challenge to manage effectively (Scottish Intercollegiate Guidelines Network, 2010). Gold standard treatment for VLUs is graduated compression therapy to aid venous return. This paper presents an approach to the challenging management of VLUs that is based on a problem, and subsequent local audit. We use a case study that illustrates a collaborative approach to determine gaps in evidence-based practice (EBP), and a nurse-led initiative in consultation with executive managers and doctors. In our sample, 40% of patients had not consulted a vascular specialist. They did not have a formal diagnosis of leg ulcer aetiology and therefore had not received optimum treatment. Access and cost were main factors impacting on leg ulcer care. Nurses providing evidence-based management of VLUs should ensure collaboration with key stakeholders. This assists in implementing diagnosis of ulcer aetiology for best practice measures. At this local health district, a change in policy to reflect EBP for VLU management in primary health care has been achieved.

scholarly journals The “Pasteurization Process” of Local-Grounded Strategies in the Primary Health Care in two Experiences of the Global South (Brazil and Chile)

2020 ◽  
Author(s):  
Eliezer Magno Araújo ◽  
Sebastian Medina ◽  
Esteban Figueroa ◽  
Marília de Castro
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
Local Health ◽  
Collective Case Study ◽  
Post Colonial ◽  
Primary Health ◽  
The Social ◽  
Asymmetric Power

This article explores the process of two emerging local-grounded strategies born in the context of Primary Health Care, in rural locations in Brazil and Chile, using a post-colonial framework. Initially rooted in local health needs and socio-cultural characteristics, both experiences undergo a process of modelling and subsequent replication by the governance of health systems, with an asymmetric power / knowledge structure. We used a Collective Case Study as a methodological strategy and used field records, in-depth interviews and a critical literature review. As a result, we saw that the social participation experienced in community-based health systems has the potential to generate high-impact initiatives, considering local realities. At the same time, through the metaphor of "pasteurization", we emphasize that hegemonic governance can remove the "living components" of these types of local strategies, causing them to lose their emancipatory capacities.

scholarly journals Evidence-Based Practice in Primary Health Care From The Managerial Point of View: – A National Survey

2020 ◽  
Author(s):  
Tobias Abelsson ◽  
Helena Morténius ◽  
Ann-Kristin Karlsson ◽  
Stefan Bergman ◽  
Amir Baigi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
National Survey ◽  
Evidence Based Practice ◽  
Direct Result ◽  
Evidence Based ◽  
Care Organization ◽  
Health Care Managers ◽  
Care Managers ◽  
Primary Health

Abstract Background: The vast availability of and demand for evidence in modern primary health care forces clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary health care managers play a key role in implementing these governing documents. Thus, the aim of this article was to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary health care managers.Methods: The study utilized a quantitative method based on a national survey of primary health care managers. The study population was recruited nationally from Sweden and consisted of 186 respondents. The data were analysed using empirically constructed themes and validated using factor analysis. To determine the statistical significance in making comparisons, the chi-square test was utilized. Associations between variables were calculated using Spearman’s correlation. All tests were two-sided, and the significance level was set to 0.05.Results: A majority (97%) of managers stated there was an impact of guidelines and policy documents on primary health care; 84% of managers could see a direct influence in daily practices. Most of the managers (70%) stated that some adaptation had to be made when new evidence was introduced. The managers emphasised the importance of keeping themselves updated and open to new information about work routines (96%). Conclusions: Evidence-based practice has a fundamental impact on Swedish primary health care. The study illustrated a nearly unanimous response about evidence influencing daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date can be seen as a direct result of this. An information-dense organization such as a primary health care organization would have much to gain from cooperation with regional information resources such as clinical libraries.Trial registration: Not applicable.

Nursing supervised curricular internship in the Covid-19 pandemic: experience in the program Brasil Conta Comigo

2021 ◽  
Vol 55 ◽  
Author(s):  
Lara Arcipreti Boel Souza ◽  
Heliny Carneiro Cunha Neves ◽  
Natália Del Angelo Aredes ◽  
Isabel Cristina Lima Jobim Medeiros ◽  
George Oliveira Silva ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Active Role ◽  
Theory And Practice ◽  
Evidence Based ◽  
Government Program ◽  
Primary Health ◽  
The Government ◽  
Teaching Learning

ABSTRACT Objective: To report the experience of the nursing supervised curricular internship in the program “O Brasil Conta Comigo” carried out in the Covid-19 pandemic. Method: Experience report of activities developed in Primary Health Care in a municipality in the southern region of the state of Goiás during the Covid-19 pandemic, from April to November 2020. Results: The inclusion in the government program allowed the strengthening of the student’s active role in the teaching-learning process and teaching-service approximation, with the student as the point of connection, which resulted in the implementation of actions for the fight against the pandemic in the municipality, such as elaboration, implementation, and evaluation of the service flowchart for people with suspected Covid-19. Conclusion: The experience was successful, as it consolidated knowledge regarding leadership and autonomy, integration between theory and practice, critical thinking, and evidence-based problem solving. The participation in the program allowed for contributions to assistance and management in the actions to combat the new coronavirus in the scope of primary care, as well as for the contribution to the training of the student tutored by nurses in the field and supervised by professors from the federal university of origin.

scholarly journals Use of online knowledge base in primary health care and correlation to health care quality: an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christian Gerdesköld ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract Background Evidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality. Methods The study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic Care Need Index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used. Results Frequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p < 0.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p < 0.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p > 0.05). Adjusting for Care Need Index had almost no effect on the outcomes for the groups. Conclusions Frequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

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