| 1. |
- Barakat-Johnson, Michelle, et al.
(författare)
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Development and Psychometric Testing of a Knowledge Instrument on Incontinence-Associated Dermatitis for Clinicians : The Know-IAD
- 2022
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 49:1, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to describe the development and evaluation of the psychometric properties of an instrument used to assess clinician knowledge of Incontinence-associated dermatitis (IAD).Design: The instrument was developed in three phases: Phase 1 involved item development; Phase 2 evaluated content validity of the instrument by surveying clinicians and stakeholders within a single state of Australia and, Phase 3 used a pilot multisite cross-sectional survey design to determine composite reliability and evaluate scores of the knowledge tool.Subjects and settings: In Phase 1, the instrument was developed by five persons with clinical and research subject expertise in the area of IAD. In Phase 2, content validity was evaluated by a group of 13 clinicians (nurses, physicians, occupational therapists, dietitians, and physiotherapists) working in acute care across one Australian state, New South Wales, along with two consumer representatives. In Phase 3, clinicians, working across six hospitals in New South Wales and on wards with patients diagnosed with incontinence-associated dermatitis, participated in pilot-testing the instrument.Methods: During Phase 1, a group of local and international experts developed items for a draft tool based on an international consensus document, our prior research evaluating incontinence-associated dermatitis knowledge, and agreement among an expert panel of clinicians and researchers. Phase 2 used a survey design to determine content validity of the knowledge tool. Specifically, we calculated item- and scale-level content validity ratios and content validity indices for all questions within the draft instrument. Phase 3 comprised pilot-testing of the knowledge tool using a cross-sectional survey. Analysis involved confirmatory factor analysis to confirm the hypothesized model structure of the knowledge tool, as measured by model goodness-of-fit. Composite reliability testing was undertaken to determine the extent of internal consistency between constituent items of each construct.Results: During Phase 1, a draft version of the Barakat-Johnson Incontinence-Associated Dermatitis Knowledge tool (Know-IAD), comprising 19 items and divided into three domains of IAD-related knowledge: 1) Etiology and Risk, 2) Classification and Diagnosis, and 3) Prevention and Management was developed. In Phase 2, 18 of the 19 items demonstrated high scale content validity ratios scores on relevance (0.75) and clarity (0.82); and high scale-content validity indices scores on relevance (0.87) and clarity (0.91). In Phase 3, the final 18-item Know-IAD tool demonstrated construct validity by a model goodness-of-fit. Construct validity was excellent for the Etiology and Risk domain (root mean squared error=0.02) and Prevention and Management domain (root mean squared error=0.02); it was good for the Classification and Diagnosis domain (root mean squared error=0.04). Composite reliability (CR) was good in the Etiology and Risk domain (CR=0.76), Prevention and Management domains (CR=0.75), and adequate in the Classification and Diagnosis domain (CR=0.64). Respondents had good understanding of etiology and risk (72.6% correct responses); fairly good understanding of prevention and management of IAD (64.0% correct responses) and moderate understanding of classification and diagnosis (40.2% correct responses).Conclusions: The Know-IAD demonstrated good psychometric properties and provides preliminary evidence that it can be applied to evaluate clinician knowledge on IAD.
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| 2. |
- Carlsson, Eva, 1959, et al.
(författare)
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Concerns and quality of life before surgery and during the recovery period in patients with rectal cancer and an ostomy
- 2010
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott, Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 37:6, s. 654-661
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Rectal cancer is the most common reason for a person to undergo ostomy surgery. The aim of this study was to assess concerns and health-related quality of life (HRQOL) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer. SUBJECTS AND SETTINGS: The sample comprised 57 patients at a university hospital in Gothenburg, Sweden. Their median age was 66 years (range, 30-87); 35 men and 22 women participated in the study. METHODS: Participants prospectively answered questionnaires preoperatively, and at 1, 3, and 6 months postoperatively.Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns, and HRQOL was evaluated using the 36-Item Short Form Health Survey. Results were compared with population norms. RESULTS: Participants expressed concerns associated with developing cancer, being a burden on others, and related to the uncertain nature of disease. Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively, but scores improved at 6 months. There were significant differences between preoperative study group scores and population norms on physical and emotional role function, social function, and for mental health domains. Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health. Participants identified good relations with significant others, social and leisure activities, psychological issues, and health as important for maintaining QOL. Obstacles to maintaining QOL included fatigue, pain, illness-induced limitations in life, and worries over what their new life would entail. CONCLUSION: Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months. © 2010 Wound, Ostomy and Continence Nurses Society.
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| 3. |
- Carlsson, Eva, 1959, et al.
(författare)
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Positive and Negative Aspects of Colostomy Irrigation A Patient and WOC Nurse Perspective
- 2010
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Ingår i: JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING. - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 37:5, s. 511-516
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Colostomy irrigation (CI) is an effective method to achieve fecal continence in selected persons with a colostomy. The primary aims of the study were to find out to what extent the WOC nurses used CI in their practice and what kind of information the WOC nurses gave patients if they provided explanations and potential solutions when irrigation was not successful in preserving continence. A further aim was to find out, from a patients' perspective, the positive and negative aspects of practicing CI and how they perform CI. METHODS: The study employed a mixed quantitative and qualitative approach. Data from WOC nurses were obtained by means of a structured questionnaire and by means of structured telephone interviews with patients who performed CI. SUBJECTS AND SETTING: Questionnaires were sent out to 89 WOC nurses in Sweden, and 61 (69%) questionnaires were returned. Thirty-nine patients, median age 67 years, from 5 hospitals participated in the interview study. RESULTS: Sixty-four percent of the WOC nurse respondent always informed patients about CI. Forty-four percent of patients did not remember all the information they had been given by the WOC nurse regarding CI before starting with the procedure. Eighty-seven percent reported changing routines from how they initially performed CI over the years. Almost all (97%) of the respondents described positive aspects of CI. The 2 primary positive aspects described by participants were (1) feeling secure and (2) having an empty pouch. CONCLUSION: Persons living with a colostomy who regularly performed CI reported positive benefits associated with the procedure including a feeling of security and having an empty pouch. Despite these potential benefits, not all patients with a colostomy who are appropriate candidates for CI are offered information about the method from the WOC nurses.
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| 4. |
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| 5. |
- Ehrenberg, Anna, et al.
(författare)
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Why using research matters
- 2004
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 31:2, s. 62-64
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Forsgren-Brusk, Ulla, et al.
(författare)
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Method for Bacterial Growth and Ammonia Production and Effect of Inhibitory Substances in Disposable Absorbent Hygiene Products
- 2017
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 44:1, s. 78-83
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:: The purpose of this study was to evaluate a pragmatic laboratory method to provide a technique for developing incontinence products better able to reduce malodor when used in the clinical setting. METHODS:: Bacterial growth and bacterially formed ammonia in disposable absorbent incontinence products was measured by adding synthetic urine inoculated with bacteria to test samples cut from the crotch area of the product. The inhibitory effectʼs of low pH (4.5 and 4.9) and 3 antimicrobial substances—chlorhexidine, polyhexamethylene biguanide (PHMB), and thymol—at 2 concentrations each, were studied. RESULTS:: From the initial inocula of 3.3 log colony-forming units per milliliter (cfu/mL) at baseline, the bacterial growth of the references increased to 5.0 to 6.0 log cfu/mL at 6 hours for Escherichia coli, Proteus mirabilis, and Enterococcus faecalis. At 12 hours there was a further increase to 7.0 to 8.9 log cfu/mL. Adjusting the pH of the superabsorbent in the incontinence product from 6.0 to pH 4.5 and pH 4.9 significantly (P < .05) inhibited the bacterial growth rates, in most cases, both at 6 and 12 hours. The effect was most pronounced at pH 4.5. Chlorhexidine had significant (P < .05) inhibitory effect on E. coli and E. faecalis, and at 12 hours also on P. mirabilis. For PHMB and thymol the results varied. At 6 hours, the ammonia concentration in the references (pH 6.0) was 200 to 300 ppm and it was 1500 to 1600 ppm at 8 hours. At pH 4.5, no or little ammonia production was measured at 6 and 8 hours. At pH 4.9, there was a significant reduction (P < .01). Chlorhexidine and PHMB exerted a significant (P < .01 or P < .001) inhibitory effect on ammonia production at both concentrations and at 6 and 8 hours. Thymol 0.003% and 0.03% showed inhibitory effect at both 6 hours (P < .01 or P < .001) and at 8 hours (P < .05 or P < .001). CONCLUSION:: The method described in this study can be used to compare the ability of various disposable absorbent products to inhibit bacterial growth and ammonia production. This technique, we describe, provides a pragmatic method for assessing the odor-inhibiting capacity of specific incontinence products.
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| 7. |
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| 8. |
- Hall, Gunnar, et al.
(författare)
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Identification of Key Odorants in Used Disposable Absorbent Incontinence Products
- 2017
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 44:3, s. 269-276
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:The purpose of this study was to identify key odorants in used disposable absorbent incontinence products.DESIGN:Descriptive in vitro study SUBJECTS AND SETTING:: Samples of used incontinence products were collected from 8 residents with urinary incontinence living in geriatric nursing homes in the Gothenburg area of Sweden. Products were chosen from a larger set of products that had previously been characterized by descriptive odor analysis.METHODS:Pieces of the used incontinence products were cut from the wet area, placed in glass bottles, and kept frozen until dynamic headspace sampling of volatile compounds was completed. Gas chromatography-olfactometry was used to identify which compounds contributed most to the odors in the samples. Compounds were identified by gas chromatography-mass spectrometry.RESULTS:Twenty-eight volatiles were found to be key odorants in the used incontinence products. Twenty-six were successfully identified. They belonged to the following classes of chemical compounds: aldehydes (6); amines (1); aromatics (3); isothiocyanates (1); heterocyclics (2); ketones (6); sulfur compounds (6); and terpenes (1).CONCLUSION:Nine of the 28 key odorants were considered to be of particular importance to the odor of the used incontinence products: 3-methylbutanal, trimethylamine, cresol, guaiacol, 4,5-dimethylthiazole-S-oxide, diacetyl, dimethyl trisulfide, 5-methylthio-4-penten-2-ol, and an unidentified compound.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited.
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| 9. |
- Hultin, Lisa, et al.
(författare)
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Information and Communication Technology Can Increase Patient Participation in Pressure Injury Prevention A Qualitative Study in Older Orthopedic Patients
- 2019
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : LIPPINCOTT WILLIAMS & WILKINS. - 1071-5754 .- 1528-3976. ; 46:5, s. 383-389
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to assess the participatory capabilities of hospitalized older adults in response to the Continuous Bedside Pressure Mapping system placed on the beds to prevent pressure injuries. DESIGN: Descriptive study. SUBJECTS AND SETTING: A convenience sample of 31 orthopedic patients were recruited from an orthopedic rehabilitation unit at a university hospital in Uppsala, Sweden, that served patients aged 65 years and older. METHODS: Semistructured interviews were conducted between November 2016 and February 2017, audio-recorded, and transcribed verbatim. Data were analyzed using qualitative content analysis. RESULT: The overall theme from 21 interviews was "A new way of understanding helped patients to recognize vulnerable pressure points and to take action in their own care" from which 2 categories, "awareness" and "action," emerged. The study showed that verbally adapted information combined with using information and communication technology increased most participants' knowledge and as they became aware of increased pressure, they started to take preventative action by changing position. CONCLUSIONS: It is possible for older participants in a rehabilitation unit who had recent orthopedic surgery to understand and use new information and communication technology and should be invited to participate in pressure injury prevention.
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| 10. |
- Hultin, Lisa, et al.
(författare)
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Pressure Mapping in Elderly Care : A Tool to Increase Pressure Injury Knowledge and Awareness Among Staff
- 2017
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 44:2
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to evaluate the use of a pressure mapping system with real-time feedback of pressure points in elderly care, with specific focus on pressure injury (PI) knowledge/attitudes (staff), interface pressure, and PI prevention activities (residents). DESIGN: Descriptive, 1-group pretest/posttest study. SUBJECTS AND SETTING: A convenience sample of 40 assistant nurses and aides participated in the study; staff members were recruited at daytime, and 1 nighttime meeting was held at the facility. A convenience sample of 12 residents with risk for PI were recruited, 4 from each ward. Inclusion criteria were participants older than 65 years, Modified Norton Scale score 20 or less, and in need of help with turning in order to prevent PI. The study setting was a care facility for the elderly in Uppsala, Sweden. METHODS: A descriptive, comparative pretest/posttest study design was used. The intervention consisted of the use of a pressure mapping system, combined with theoretical and practical teaching. Theoretical and practical information related to PI prevention and the pressure mapping system was presented to the staff. The staff (n = 40) completed the Pressure Ulcer Knowledge and Assessment Tool (PUKAT) and Attitudes towards Pressure Ulcer (APuP) before and following study intervention. Residents' beds were equipped with a pressure mapping system during 7 consecutive days. Peak pressures and preventive interventions were registered 3 times a day by trained study nurses, assistant nurses, and aides. RESULTS: Staff members' PUKAT scores increased significantly (P = .002), while their attitude scores, which were high pretest, remained unchanged. Peak interface pressures were significantly reduced (P = .016), and more preventive interventions (n = 0.012) were implemented when the staff repositioned residents after feedback from the pressure mapping system. CONCLUSIONS: A limited educational intervention, combined with the use of a pressure mapping system, was successful as it improved staff members' knowledge about PI prevention, reduced interface pressure, and increased PI prevention activities. As many of the staff members lacked formal education in PI prevention and management, opportunities for teaching sessions and reflection upon PI prevention should be incorporated into the workplace. More research is needed to evaluate the effect of continuous pressure mapping on the incidence of PI.
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| 11. |
- Johansen, Edda, et al.
(författare)
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Incontinence-Associated Dermatitis (IAD) : Prevalence and Associated Factors in 4 Hospitals in Southeast Norway
- 2018
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 45:6, s. 527-531
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to investigate the prevalence and severity of incontinence-associated dermatitis (IAD) and associated factors in acute care settings in Southeast Norway.DESIGN: Descriptive, multisite epidemiologic survey.SUBJECTS AND SETTING: The study setting was 29 wards across 4 hospitals, in a hospital trust in the southeast of Norway. Data were collected from 340 patients (age ≥18 years). More than half (56.2%) were 70 years or older (median age category 70-79 years) and 53.3% were male.METHODS: Data collection was conducted in parallel with a pressure injury prevalence study undertaken in 2016. A modified Pressure Injury Prevalence Minimum Data Set, including documentation of fecal or urinary incontinence, use of indwelling fecal collection system or urinary catheter, and presence of IAD, was completed. RNs participating in the study were trained by the researchers on skin assessment and data extraction from the electronic medical record. Descriptive statistics were used for prevalence figures; the Kruskal-Wallis and χ tests were used to determine associated factors.RESULTS: Analysis revealed that 16.5% (56 out of 340) of the sample were incontinent. The prevalence of IAD in the total population was 7.6% (26 out of 340). The prevalence of IAD was 29% (16 out of 56) among patients with urinary or fecal incontinence. Of those identified with IAD, 5.2% (18 out of 340) had category 1 (red intact skin) and 2.4% (8 of 340) had category 2 (red skin with breakdown). Bivariate analysis revealed that fecal incontinence (P < .001), immobility (P < .01), and 70 years or older (P < .03) were associated with IAD.CONCLUSIONS: The overall prevalence (patients with and without incontinence) of IAD was lower than reported in prior studies; frequent use of indwelling urinary catheters and a relatively low prevalence of incontinence may explain this finding. Similar to prior studies, almost 1 in 3 patients who were incontinent suffered from IAD, showing a need for evidence-based guidelines to prevent IAD in hospitalized patients. Findings suggest that particular attention should be given to prevent IAD among patients with fecal incontinence patients, 70 years and older, and those with immobility.
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| 12. |
- Kanerva Rice, Sophie, et al.
(författare)
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Rationale and Design of a Novel Method to Assess the Usability of Body-Worn Absorbent Incontinence Care Products by Caregivers
- 2018
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 45:5, s. 456-464
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to develop and test a new method to measure the usability of absorbent incontinence care products from the caregivers' perspective and to investigate if the method can be used to differentiate between product types in a product change.DESIGN: Process evaluation and validation study.SUBJECTS AND SETTING: Product developers and end users participated in designing the new method. Thereafter, professional caregivers acted as testers of the new method, ranking usability when performing absorbent product changes on patients in a simulated nursing home care environment, assisted by third-party research institute moderators.METHODS: Design and evaluation of a new method designed to assess the usability of body-worn absorbent incontinence care products for lay caregivers were completed. The evaluation included formative and summative evaluations of effectiveness (product fit), efficiency (time and physical workload), and satisfaction. A person-centered approach aimed at including all subjects and settings to generate a single usability score for decision making and product benchmarking. Experienced caregivers changed 4 types of products: (1) disposable body-worn pads with mesh briefs (2-piece system); (2) disposable all-in-one briefs; (3) disposable, T-shaped, and belted brief; and (4) disposable pull-up pants on simulated patients in standing or lying position. Each product change was performed by 1 unassisted experienced caregiver. The probability of success as a score for each product type was calculated across the 4 metrics and reported with 95% confidence intervals (CIs). Descriptive and inferential statistics were developed assuming a binary statistical model, using the weighted scores from each of the factors. An overall usability score was calculated.RESULTS: The method we developed discriminated between usability of different product types. The overall score for the disposable pull-up product (90%; CI: 83%-97%) was better (P < .05) than for the disposable T-shaped brief (83%; CI: 77%-89%), the disposable brief (53%; CI: 45%-61%), and the disposable body-worn pad with mesh pant (61%; CI: 56%-66%) in standing patients. For lying patients, the overall score for the disposable T-shaped brief product (81%; CI: 73%-89% was better (P < .05) than the disposable brief (65%; CI: 45%-61%) and the disposable body-worn pads with mesh brief (62%; CI: 55%-69%). Reliability was evaluated quantitatively in terms of measurement uncertainties in the results.CONCLUSION: The method we described demonstrated differentiation of usability based on product type indicating concurrent validity. Further testing in diverse real-world care environments is needed to evaluate and confirm the validity and to assess reliability of this method in the research setting.
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| 13. |
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| 14. |
- Leijon, Siv, et al.
(författare)
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Pressure Ulcer Prevalence, Use of Preventive Measures, and Mortality Risk in an Acute Care Population : A Quality Improvement Project
- 2013
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 40:5, s. 469-474
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this quality improvement project was to determine pressure prevalence, risk of mortality, and use of preventive measures in a group of hospitalized patients. Two hundred fifty-eight patients recruited from Skaraborg Hospital in Sweden were assessed. A 1-day point prevalence study was carried out using a protocol advocated by the European PU Advisory Panel. Patients' age, gender, severity of PU (grades I-IV), anatomical location of PU, and use of preventive measures were recorded. The Swedish language version of the Modified Norton Scale was used for PU risk assessment. Data were collected by nurses trained according to the Web-based training: PU classification, “ePuclas2.” After 21 months, a retrospective audit of the electronic records for patients identified with pressure ulcers was completed. The point prevalence of pressure ulcers was 23%. The total number of ulcers was 85, most were grade 1 (n = 39). The most common locations were the sacrum (n = 15) and the heel (n = 10). Three percent of patients (n = 9) had been assessed during their current hospital stay using a risk assessment tool. There was a statistically significant relationship between pressure ulcer occurrence and a low total score on the Modified Norton Scale. The patients' ages correlated significantly to the presence of a pressure ulcer. Patients with a pressure ulcer had a 3.6-fold increased risk of dying within 21 months, as compared with those without a pressure ulcer. Based on results from this quality improvement project, we recommend routine pressure ulcer risk assessment for all patients managed in a hospital setting such as ours. We further recommend that particular attention should be given to older and frail patients who are at higher risk for pressure ulcer occurrence and mortality.
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| 15. |
- Lindholm, Elisabet, 1946, et al.
(författare)
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Ostomy-Related Complications After Emergent Abdominal Surgery : A 2-Year Follow-up Study.
- 2013
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 40:6, s. 603-610
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.RESULTS: The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P < .0001), end ileostomy (P < .0081), loop ileostomy (P = .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.
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| 16. |
- Raepsaet, Charlotte, et al.
(författare)
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A Fully Automated Pulsating Support System for Pressure Injury Prevention and Treatment in 10 Belgium Nursing Homes : An Observational Study
- 2021
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 48:2, s. 115-123
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We studied pressure injury (PI) stage II-IV cumulative incidence and the change of PI status in the sacral area of nursing home residents associated with the use of a fully automated pulsating support system air mattress in use for 30 days. We also assessed caregivers', residents', and their family members' experiences and perceptions of mattress comfort and other factors such as pain.DESIGN: Multicenter cohort study.SUBJECT AND SETTING: A convenience sample of 40 residents residing in 10 Belgian nursing homes was recruited.METHODS: Pressure injury classification was confirmed using the European Pressure Ulcer Advisory Panel classification system. The Pressure Ulcer Scale for Healing (PUSH) tool was used to assess and measure PI status change. A comfort assessment was performed at end of the study. Cumulative PI incidence of stages II-IV was calculated, and frequencies and percentages were used to describe the results of the comfort assessments.RESULTS: Residents were allocated to the prevention group (n = 22) and to the treatment group (n = 18). The cumulative PI incidence was 4.5% (n = 1/22) in the prevention group. In the treatment group, the mean score on the PUSH tool decreased from 9.36 to 7.70 during the observation period, indicating an overall improvement. Four of the existing PIs healed, 17 PIs remained stable, and 1 PI deteriorated. The comfort questionnaires were completed by 76 nursing home caregivers, 21 family members, and 11 residents in the 10 participating nursing homes; the mattress comfort was perceived as very good, and pain was noted to decrease.CONCLUSIONS: Low cumulative PI incidence findings were observed with use of the mattress for the prevention of PIs and resulted in improvements in existing PIs, results which are consistent with several existing studies. The majority of the caregivers, residents, and family members evaluated the mattress as comfortable. Future research is needed to corroborate findings in larger randomized clinical trials.
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| 17. |
- Raepsaet, Charlotte, et al.
(författare)
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Integrating Sensor Technology in Disposable Body-Worn Absorbent Products : A Qualitative Study to Define User Profile, (Technical) Criteria, Conditions, and Potential Benefits
- 2021
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 48:6, s. 560-567
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to define the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials.DESIGN: Qualitative study using a framework method.SUBJECT AND SETTING: The sample included residents with incontinence, nurses, and decision-makers in a selection of Flemish nursing homes (Belgium).METHODS: Semistructured interviews were performed between June and August 2020. The interviews with nurses included open-ended questions focusing on the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials. The interviews with decision-makers were supplemented with questions about purchase cost and other economic criteria (such as reimbursement). Interviews with residents included questions about wearing comfort. Interviews were tape-recorded and transcribed verbatim. Data were analyzed using a framework method.RESULTS: The user profile was defined as (1) residents with cognitive impairment and (2) residents who are bedridden or are severely limited in mobility. The following (technical) criteria emerged from the analyses: a small, thin, and oval/circular sensor, an adaptable or in front attachment of the sensor on the absorbent product, a real-time indication of the absorbent product's saturation, leakage detection, liquid stool detection, the automatic recording of incontinence-related data, a durable sensor easy to disinfect, and receiving notifications on a wearable device. Conditions included a stable connection between the wearable device and the sensor, accurate measurements, user-friendly system, comprehensible training, affordability, and data protection. Potential benefits included workload reduction, increased comfort for residents and staff, more person-centered care, increased quality of care, less skin damage and economic (eg, less costs due to less excessive absorbent product changes), and/or environmental (e.g. less waste) gains.CONCLUSION: Study findings identified the user profile, (technical) criteria, conditions, and potential benefits of the integration of sensor technology in disposable body-worn incontinence materials. Respondents reported problems with changing routines and skepticism about the sensor's accuracy. Based on findings from this study, we recommend involving representatives of all relevant stakeholders in the design of sensor technology to ensure users' needs and increase the use of sensor technology. Comprehensive education is recommended to inform nurses, residents, and their family members on the importance and benefits of the technology and to aid overcoming barriers to use (skepticism, resistance to new technologies, and changing care routines). Study findings also indicate that the sensor technology cannot replace the existing voiding programs; rather it should be an addition to routine continence care.
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| 18. |
- Wallin, Lars, et al.
(författare)
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Implementing nursing practice guidelines : a complex undertaking
- 2005
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 32:5, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Clinical practice guidelines have been proposed to significantly reduce the gap between available scientific evidence and clinical practice. Evidence-based guidelines are also being produced at an ever-increasing pace. However, guidelines do not implement themselves, and the research to support implementation does not provide straightforward answers. What works in one setting does not necessarily work in another. In short, guideline implementation and change of practice is complex and messy. The purpose of this article is to discuss the implementation of clinical practice guidelines using the Promoting Action on Research Implementation in Health Services framework. More specifically, 3 key components are highlighted: (1) the evidence base for guideline recommendations, (2) the clinical context where guidelines are to be implemented, and (3) the nature of facilitation needed to ensure a successful change process. An overview of the literature in the field is provided, and the authors' experiences are shared, and a few recommendations are tentatively provided.
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| 19. |
- Widen, Heléne, et al.
(författare)
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Sensory Characterization of Odors in Used DisposableAbsorbent Incontinence Products
- 2017
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 44:3, s. 277-282
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSEThe objectives of this study were to characterize the odors of used incontinence products by descriptive analysis and to define attributes to be used in the analysis. A further objective was to investigate to what extent the odor profiles of used incontinence products differed from each other and, if possible, to group these profiles into classes.SUBJECTS AND SETTINGUsed incontinence products were collected from 14 residents with urinary incontinence living in geriatric nursing homes in the Gothenburg area, Sweden.METHODSPieces were cut from the wet area of used incontinence products. They were placed in glass bottles and kept frozen until odor analysis was completed. A trained panel consisting of 8 judges experienced in this area of investigation defined terminology for odor attributes. The intensities of these attributes in the used products were determined by descriptive odor analysis. Data were analyzed both by analysis of variance (ANOVA) followed by the Tukey post hoc test and by principal component analysis and cluster analysis.RESULTSAn odor wheel, with 10 descriptive attributes, was developed. The total odor intensity, and the intensities of the attributes, varied considerably between different, used incontinence products. The typical odors varied from "sweetish" to "urinal," "ammonia," and "smoked." Cluster analysis showed that the used products, based on the quantitative odor data, could be divided into 5 odor classes with different profiles.CONCLUSIONSThe used products varied considerably in odor character and intensity. Findings suggest that odors in used absorptive products are caused by different types of compounds that may vary in concentration.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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| 20. |
- Berndtsson, Ina, 1953, et al.
(författare)
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Thirty years of experience living with a continent ileostomy
- 2005
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Ingår i: Journal of Wound, Ostomy, and Continence Nursing. - 1071-5754. ; 32:5, s. 321-26
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study describes long-term adjustment of people with a continent ileostomy. SUBJECTS AND METHODS: Subjects were 68 people (25 males and 43 females) who underwent an operation for ulcerative colitis with a continent ileostomy (Kock pouch). The median number of years subjects had lived with a continent reservoir was 31 (range 29-36) at follow-up and the median subject age was 60 (40-89). Subjects completed a 36-item questionnaire designed to assess adjustment to ostomy surgery. Subjects ranked the questionnaire using a 6-point Likert scale; a response alternative "not relevant" was available. Content analysis was conducted on subjects' responses to an open-ended question covering aspects of their quality of life. RESULTS: High median adjustment ratings were found for all 36 statements; the maximum median rating of 6 appeared on 28 items. Eight items with the lowest median ratings were in the following domains: embarrassing situations, activity, body image, sexuality, and good care. Five items on medical care and 3 items on sexuality were most frequently considered "not relevant" by respondents. The most frequently mentioned quality-of-life domains were family, health, friends, and employment. Content analysis indicated that respondents were self-reliant, although they indicated that they experienced considerable impediments to bowel evacuation outside of the home. CONCLUSIONS: In the long-term, people with a continent ileostomy have good self-care. The quality and availability of public restrooms, however, reduces their daily activities away from home.
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| 21. |
- Fingren, Jeanette, et al.
(författare)
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Perceptions of Phantom Rectum Syndrome and Health-Related Quality of Life in Patients Following Abdominoperineal Resection for Rectal Cancer
- 2013
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Ingår i: Journal of Wound Ostomy and Continence Nursing. - 1071-5754. ; 40:3, s. 280-286
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the study was to investigate how patients described their perceptions of phantom rectum syndrome after abdominoperineal resection and ostomy creation, and its influence on daily living and health-related quality of life. A further aim was to find out strategies patients use to alleviate phantom rectum syndrome sensations. SUBJECTS AND SETTING: Twenty-five patients who underwent abdominoperineal resection and a colostomy (18 men and 7 women; median age 5 63 years; range, 40-78 years) at Sahlgrenska University Hospital, Göteborg, Sweden, participated in the study. METHODS: At follow-up 8 months postsurgery, a WOC nurse interviewed patients with a structured questionnaire about the experience of nonpainful and painful sensations in the perineal area. Health-related quality of life was evaluated using a general cancer-specific instrument (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0). RESULTS: Twenty-four patients (96%) experienced painful or nonpainful phantom rectum syndrome at some point during the first 8 postoperative months. The nonpainful sensations (20 patients) occurred in connection with emptying of feces via the stoma, when performing colostomy irrigation, at rest, or in various positions. Fifteen patients experienced painful sensations, characterized as pins and needles, pain in the perineal area, stinging, and burning occurring mostly in sitting positions. Patients with painful sensations had statistically significant higher scores regarding pain and lower scores for social function than those without painful sensations (P < .031). Phantom rectum symptoms caused worries and concerns and influenced daily life in 29% (n = 5). CONCLUSIONS: Phantom rectum syndrome is prevalent in patients undergoing abdominoperineal resection and ostomy creation. Information about phantom rectum syndrome should be shared preoperatively and during follow-up in order to promote optimal quality of life and alleviate bothersome symptoms and concerns associated with phantom rectum syndrome.
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| 22. |
- Forsgren-Brusk, U., et al.
(författare)
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Method for Bacterial Growth and Ammonia Production and Effect of Inhibitory Substances in Disposable Absorbent Hygiene Products
- 2017
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Ingår i: Journal of Wound Ostomy and Continence Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1071-5754. ; 44:1, s. 78-83
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to evaluate a pragmatic laboratory method to provide a technique for developing incontinence products better able to reduce malodor when used in the clinical setting. METHODS: Bacterial growth and bacterially formed ammonia in disposable absorbent incontinence products was measured by adding synthetic urine inoculated with bacteria to test samples cut from the crotch area of the product. The inhibitory effect's of low pH (4.5 and 4.9) and 3 antimicrobial substanceschlorhexidine, polyhexamethylene biguanide (PHMB), and thymolat 2 concentrations each, were studied. RESULTS: From the initial inocula of 3.3 log colony-forming units per milliliter (cfu/mL) at baseline, the bacterial growth of the references increased to 5.0 to 6.0 log cfu/mL at 6 hours for Escherichia coli, Proteus mirabilis, and Enterococcus faecalis. At 12 hours there was a further increase to 7.0 to 8.9 log cfu/mL. Adjusting the pH of the superabsorbent in the incontinence product from 6.0 to pH 4.5 and pH 4.9 significantly (P < .05) inhibited the bacterial growth rates, in most cases, both at 6 and 12 hours. The effect was most pronounced at pH 4.5. Chlorhexidine had significant (P < .05) inhibitory effect on E. coli and E. faecalis, and at 12 hours also on P. mirabilis. For PHMB and thymol the results varied. At 6 hours, the ammonia concentration in the references (pH 6.0) was 200 to 300 ppm and it was 1500 to 1600 ppm at 8 hours. At pH 4.5, no or little ammonia production was measured at 6 and 8 hours. At pH 4.9, there was a significant reduction (P < .01). Chlorhexidine and PHMB exerted a significant (P < .01 or P < .001) inhibitory effect on ammonia production at both concentrations and at 6 and 8 hours. Thymol 0.003% and 0.03% showed inhibitory effect at both 6 hours (P < .01 or P < .001) and at 8 hours (P < .05 or P < .001). CONCLUSION: The method described in this study can be used to compare the ability of various disposable absorbent products to inhibit bacterial growth and ammonia production. This technique, we describe, provides a pragmatic method for assessing the odor-inhibiting capacity of specific incontinence products.
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| 23. |
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| 24. |
- Persson, Eva, 1953, et al.
(författare)
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Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery.
- 2002
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Ingår i: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. - 1071-5754. ; 29:2, s. 103-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to describe patients' experiences, with a focus on body image, 6 to 12 weeks after a stoma operation. METHOD: Nine patients (8 of whom received preoperative teaching) and who were expected to have their colostomy, ileostomy, or urostomy for at least 6 months were interviewed about their feelings, attitudes, and life experiences after undergoing ostomy surgery. MAIN OUTCOME: Seven themes were identified: alienation from the body, altered body image, influences on sexual life, uncertainty, influences on social life, influences on sports and leisure activities, and physical problems. CONCLUSION: Despite the fact that 8 of the 9 subjects were given comprehensive preoperative teaching, all of the interviewees reported that the stoma influenced their daily life in many unexpected ways, and some expressed severe difficulty in coming to terms with the stoma. With a deeper understanding of patients' experiences, the WOC nurse and other health care staff can more effectively prepare and support patients in adapting to their new situation.
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| 25. |
- Persson, Eva, 1953, et al.
(författare)
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Information to the relatives of people with ostomies: is it satisfactory and adequate?
- 2005
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Ingår i: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. - 1071-5754. ; 32:4, s. 238-45
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to evaluate how relatives of patients with an ostomy rated the various aspects of care, how they perceived the quality of the care provided, and how they ranked their involvement in the care. Patients' satisfaction was also sought, particularly their perception of relatives' involvement. DESIGN: Descriptive cross-sectional. SETTINGS AND SUBJECTS: The study comprised a colostomy group (32 pairs) and an ileostomy group (28 pairs). All patients attended a stoma outpatient clinic. METHODS: Quality of care was assessed using the identity-oriented dimension of the validated questionnaire Qualityof Care from the Patient's Perspective. Questionnaires were mailed to patients and their relatives. RESULTS: Relatives and patients in both study groups considered most topics covered by the questionnaire to be important. Half of the patients with an ileostomy and their relatives and approximately 30% of those in the colostomy group were dissatisfied with the information they received, however. Moreover, a greater proportion (41-89%) of the patients were unhappy with the opportunities they were offered to participate in the decision-making process. Patients with an ileostomy and their relatives tended to be more dissatisfied with the quality of care than the colostomy group, but the difference was not statistically significant. CONCLUSION: The topics covered by the questionnaire were considered important to both patients and their relatives. Information and counseling offered by the ET nurses and the colorectal surgeons were judged to be unsatisfactory, indicating the need for frequently assessing and improving general standards of quality of care.
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| 26. |
- Rajabali, Saima N., et al.
(författare)
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Effectiveness of a Smart Urinary Continence Care Assessment System for Nursing Home Residents: A Quasi-Experimental, Sequential Quantitative-Qualitative Methods Trial
- 2023
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Ingår i: Journal of Wound, Ostomy and Continence Nursing. - 1071-5754. ; 50:1, s. 48-56
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to compare the effect of use of an electronic urinary continence assessment system versus usual care on construction of care plans, resource use, and continence care for nursing home (NH) residents. DESIGN: Convergent mixed-methods study comprising a prospective, parallel arm-controlled phase, and concurrent qualitative component. SUBJECTS AND SETTING: The study setting was Alberta, a province in Western Canada. Residents requiring a continence assessment or reassessment in an NH with 2 units assigned to intervention (I) and 2 units to usual care (UC). One hundred one residents (I: n = 49; UC: n = 52) participated; 89 (I: n = 43; UC: n = 46) completed the study. The mean age of the UC group was 88.5 (SD = 6.9) years, whereas the mean age of the intervention group was 85.6 (SD = 7.5) years. METHODS: Quantitative data on assessment, resource use, resident quality of life, and continence care outcomes were collected at weeks 0, 2, and 8; plan adherence was assessed at week 16. Qualitative data were collected via interviews. RESULTS: Analysis revealed a significant change in the proportion of residents achieving a reduction in 24-hour pad absorbency (50.6% vs 39.1%, P =.034) at week 8. There were significant differences in between-group changes (total absorbency of pads used in 24 hours and total cost of night pads used). Both groups reported improved health-related quality of life. Analysis of qualitative data revealed 3 themes: resource use; quality of continence care; and system utility and limitations. CONCLUSIONS: A technological solution offering a standardized system of continence assessment provided benefit in terms of quality of care for residents and use of continence containment products; utility was validated by staff.
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| 27. |
- Ryttsen, F., et al.
(författare)
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A Laboratory Method for Determining Bacterially Formed Odorants and Reducing Odor in Absorbent Incontinence Products
- 2019
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Ingår i: Journal of Wound Ostomy and Continence Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1071-5754. ; 46:6, s. 519-523
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to design a laboratory test method to mimic the formation of bacterially formed odorants during the use of absorbent urinary incontinence products. Three odor inhibitors with different modes of action were tested and evaluated. METHODS: Bacterially formed odorants in incontinence products were evaluated by adding a synthetic urine inoculated with a mixture of 4 bacterial strains to product samples cut from the incontinence products. The product samples were incubated in sealed flasks. The odorants that formed in the head space were sampled onto adsorbent tubes and analyzed by gas chromatography. The inhibitory effects of low pH, ethylenediaminetetraacetic acid (EDTA), and activated carbon were then measured. RESULTS: This technique enabled production of known odorants 3-methylbutanal, guaiacol, diacetyl, and dimethyl disulfide (DMDS) in concentrations of 50 to 600 ng/L in incontinence products. The method was further evaluated by testing 3 types of odor inhibitors; EDTA significantly reduced formation of all 4 odorants (P < .001). Lowering the pH from 6.0 to 4.9 decreased levels of 3-methylbutanal, DMDS, and guaiacol (P < .001); however, diacetyl levels increased (P < .001). Activated carbon significantly reduced the formation of diacetyl, DMDS, guaiacol, and 3-methylbutanal (P < .001). CONCLUSIONS: The technique we developed can be used to evaluate inhibitors with different modes of action to determine odor control in incontinence products. The odorants formed are produced by bacteria and have been identified as key contributors to the odor of used incontinence products. This work can be a step toward establishing a standard in the field of incontinence and odor control; creation of a standard will help the health care sector compare products to be purchased and benefit patients through the development of better products.
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| 28. |
- Rönner, Anna-Clara, 1971, et al.
(författare)
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The hygienic effectiveness of 2 different skin cleansing procedures.
- 2010
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Ingår i: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. - 1528-3976. ; 37:3, s. 260-4
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to assess the ability of 2 skin cleaning procedures to remove transient microbial flora from the skin.
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| 29. |
- Smith, N., et al.
(författare)
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Where Do Women With Urinary Incontinence Find Information About Absorbent Products and How Useful Do They Find It?
- 2019
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Ingår i: Journal of Wound Ostomy and Continence Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1071-5754. ; 46:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed to determine from what sources women with urinary and dual urinary and fecal incontinence sought and received information about incontinence and absorbent products. We also evaluated source utility. DESIGN: Descriptive, embedded, mixed-methods study with qualitative interviews nested into a survey design in a modified explanatory sequence. SUBJECTS AND SETTING: The target population was community-dwelling women in Canada who used containment products to manage urinary incontinence. Three hundred fifteen women completed the online survey, and 9 participated in interviews. METHOD: Quantitative data were collected using an online survey that was advertised in multiple locations, including continence and urogynecology clinics, non-for-profit health Web sites, and social media. Descriptive statistics were used for analysis. Using initial quantitative data results, a semistructured interview guide was designed to gain further insight. Local survey participants were invited to interviews at the end of the survey. Interview transcripts were coded using content analysis. The codes were then collapsed into categories and finally themes. RESULTS: The most common sources of information (n = 284/315) were retail outlets (43%) and television/radio (42%). The greatest percentages of "useful" or "very useful" resources were healthcare professionals (83%). Content analysis identified 5 themes: (1) using existing knowledge, (2) seeking knowledge, (3) finding the right pad, (4) being safe and secure, and (5) perceptions of healthcare professionals' roles. Product choice was made through trial and error; women drew information from a variety of sources, including product labels. Perceptions of helpfulness of experiences with healthcare professionals varied. CONCLUSION: Although women used multiple sources when selecting containment products, they did not receive information in a manner that suited their needs, resulting in a trial-and-error approach to product selection. Healthcare professionals should actively give information on containment products during their assessment of continence in patient encounters.
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| 30. |
- van Houten, P., et al.
(författare)
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Development of a Toileting and Containment Decision Support Tool
- 2020
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Ingår i: Journal of Wound Ostomy and Continence Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1071-5754. ; 47:1, s. 54-64
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Tidskriftsartikel (refereegranskat)abstract
- A multidisciplinary international expert panel was convened to provide input for a proposed decision support tool. This tool will assist health care professionals who are not specialized in incontinence care to assess individuals with urinary and/or fecal incontinence and recommend appropriate person-centered management options for the home care and ambulatory community settings. A targeted literature review was complemented by a series of interviews with experts in continence management, followed by a practitioner survey and rounds of expert opinion. A set of factors for assessment were defined, along with questions created to identify and quantify the factors. In addition, a range of lifestyle intervention, toileting and containment strategies were identified that were appropriate for the decision support tool. Future steps required to progress this work to a functioning tool are described.
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| 31. |
- Hellgren, Tina, et al.
(författare)
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Thoracic endovascular aortic repair practice in 13 countries : A report from VASCUNET and the International Consortium of Vascular Registries
- 2022
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 276:5, s. e598-e604
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess practice patterns and short-term outcome after TEVAR, based on an international vascular registry collaboration.SUMMARY BACKGROUND DATA: Thoracic endovascular aortic repair (TEVAR) has become the primary surgical treatment modality for descending aortic pathologies, and has expanded to new patient cohorts, including the elderly.METHODS: Data on thoracic aortic aneurysms (TAA), type B aortic dissections (TBAD), and traumatic aortic injuries (TAI) treated with TEVAR from 2012 to 2016 were retrieved from registries and centers in 13 countries.RESULTS: 9518 TEVAR for TAA (n = 4436), TBAD (n = 3976) and TAI (n = 1106) were included. The distribution of TEVAR procedures per pathology varied, with TAA repair constituting from 40% of TEVARs in the US to 72% in the UK (p < 0.001).Mean intact TAA (iTAA) diameter varied from 59 (US) to 69 mm (Nancy, France) (p < 0.001), 25.3% of patients having a diameter of < 60 mm. Perioperative mortality after iTAA repair was 4.9%; combined mortality, stroke, paraplegia and RRT outcome was 12.8%. 18.6% of iTAA patients were ≥80 years old. Mortality was higher in this group (7.2%) than in patients < 80 (3.8%) (p < 0.001). After rTAA repair, perioperative mortality was 26.8%.Mortality was 9.7% after acute (within 14 days from onset of dissection) and 3.0% after chronic TBAD repair (p < 0.001). Mortality after TAI was 7.8%, and depended on injury severity (grade IV (free rupture) 20.9%).CONCLUSIONS:: This registry collaboration provides a unique platform to evaluate cross-border patterns of use and outcomes of TEVAR. A common core dataset is proposed, to achieve harmonization of registry-based quality outcome measures for TEVAR.
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