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Sökning: WFRF:(Beeckman Dimitri Professor 1982 )

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2.
  • Johansson, Sara, et al. (författare)
  • Nytt forskningsprojekt om medicinsk häfta
  • 2023
  • Ingår i: Sårjournalen. - : Sårsjuksköterskor i Sverige. - 2003-8054. ; :1, s. 12-12
  • Forskningsöversikt (populärvet., debatt m.m.)
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  • Torsy, Tim, et al. (författare)
  • Accuracy of the corrected nose-earlobe-xiphoid distance formula for determining nasogastric feeding tube insertion length in intensive care unit patients : A prospective observational study
  • 2020
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 110
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: As nasogastric feeding tube insertion is a frequently applied, non-risk-free nursing technique, a high level of evidence-based nursing care is required. Little evidence is available regarding the accurate determination of the insertion length of nasogastric feeding tubes. The method of using the nose-earlobe-xiphoid distance as measurement is inadequate and not supported by evidence. Findings from a recent randomized trial led to an alternative calculation: the corrected nose-earlobe-xiphoid distance formula: (nose-earlobe-xiphoid distance × 0.38696) + 30.37 + 6 cm.Objectives: To test the accuracy of the corrected nose-earlobe-xiphoid distance formula for determining the required nasogastric feeding tube insertion length in adults admitted on an intensive care unit and to investigate the probability to successfully obtain gastric aspirate for pH measurement.Design: Prospective, single‐centre observational study.Participants and methods: Adult intensive care unit patients in a general hospital (N=218) needing a small-bore nasogastric feeding tube were included between March and September 2018. Correct tip positioning was defined as a tube tip located > 3 cm under the lower esophageal sphincter. Tip positioning was verified using X-ray.Results: All nasogastric feeding tube tips were correctly positioned > 3 cm under the lower esophageal sphincter. The chance of successfully obtaining gastric aspirate within 2 hours after placement of the tube was 77.9%.Conclusions: With all tips positioned > 3 cm in the stomach and zero tubes migrating back into the oesophagus, the corrected nose-earlobe-xiphoid distance formula can be considered a more accurate method to determine nasogastric feeding tube insertion length.
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  • Torsy, Tim, et al. (författare)
  • Factors associated with insufficient nasogastric tube visibility on X-ray : a retrospective analysis
  • 2021
  • Ingår i: European Radiology. - : Springer. - 0938-7994 .- 1432-1084. ; 31:4, s. 2444-2450
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Chest X-ray imaging is frequently used for verifying the position of a blindly inserted nasogastric tube. A high-quality X-ray increases the likelihood of conclusive visibility of tube tip positioning, thus avoiding risks due to a misplaced tube (e.g., pulmonary intubation, pneumothorax, small bowel insertion). Therefore, this study aims to determine patient-related and environmental factors affecting the visibility of nasogastric tubes on X-ray in adults.Methods: A retrospective descriptive analysis of routinely collected clinical datawas performed on all included patients (N = 215) from a prospective randomized trial in a general hospital. A chest X-ray was taken of each patient needing a nasogastric feeding tube, after which visibility and positioning of the tube on X-ray was independently evaluated by 3 radiologists.Results: In 14.9% (n = 32) of all patients, image quality was insufficient, so no conclusive visibility of nasogastric tube positioning could be found. A patient-related predictor regression model (sex, age, body mass index) explained 21% of variance for an insufficient visibility of the nasogastric tube (Nagelkerke R2 = 0.21). An environmental factor regression model demonstrates a guidewire being inside the tube or not during X-ray as a predictor for a conclusive visibility on X-ray.Conclusions: High body mass index, male sex, and the absence of a guidewire inside the nasogastric tube at the time of chest Xray are associated with a risk of insufficient visibility of the tube on X-ray. Patient profiles can be defined in which supplementary attention is needed when obtaining chest X-rays whose purpose is to confirm nasogastric tube positioning.
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7.
  • Torsy, Tim, et al. (författare)
  • The accuracy of methods for determining the internal length of a nasogastric tube in adult patients : A systematic review
  • 2022
  • Ingår i: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 116:3, s. 798-811
  • Forskningsöversikt (refereegranskat)abstract
    • BACKGROUND: Blind insertion of nasogastric tubes is performed for several reasons: Nutrition and medication administration, gastric aspiration/decompression, and other, diagnostic reasons. Accidental intraesophageal and intestinal placement is common, and increases the risk of serious complications. Therefore, accurate determination of the internal length of the nasogastric tube prior to placement is considered a prerequisite for achieving correct gastric positioning.OBJECTIVES: To identify, assess and summarize the evidence on the accuracy of methods for determining the internal length of a nasogastric tube in adults.METHODS: Cochrane Library, EMBASE, PubMed, CINAHL, and Web of Science were searched up to January 31, 2022. Studies were eligible when reporting data on the accuracy of methods for determining internal nasogastric tube length in adults. Study selection, risk-of-bias assessment, and data extraction were performed independently by two investigators. Risk-of-bias was assessed using the Cochrane Risk-of-Bias Tool and the JBI Critical Appraisal Checklist for Cross Sectional Studies. A narrative synthesis of the results was then conducted.RESULTS: Twelve papers were included in this review. All studies were observational, cross-sectional in nature, except for one RCT. Ten methods for determining the internal length of a nasogastric tube were described. Correctly positioned NG tubes ranged from 13% to 99%. Results showed that the nose-earlobe-xiphoid (NEX) distance + 10 cm (M = 59.9 - 60.7 cm) and (NEX x 0.38696) + 30.37 + 6 cm (M = 56.6 - 56.7 cm) could potentially result in accuracy as high as 97.4 and 99.0%, respectively.CONCLUSIONS: Current data do not provide conclusive evidence of 100% accuracy in finding a correctly placed nasogastric tube when using a method for determining the internal length. Blind placement, using any of the documented methods, cannot be considered safe without additional verification of tube tip positioning. Furthermore, using any of these ten methods does not reduce the risk of pulmonary intubation.
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10.
  • Antierens, Alain, et al. (författare)
  • How much of Toyota's philosophy is embedded in health care at the organisational level? A review
  • 2018
  • Ingår i: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 26:4, s. 348-357
  • Forskningsöversikt (refereegranskat)abstract
    • AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies.BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care.EVALUATION: Sixty studies were identified for the final analysis.KEY ISSUE(S): Some Toyota Way principles appear more deeply embedded in health care institutions than others are.CONCLUSION: Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse.IMPLICATIONS FOR NURSING MANAGEMENT: This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.
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11.
  • Antierens, Alain, et al. (författare)
  • Wanted in health care : Lean experts with a broad perspective
  • 2019
  • Ingår i: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 27:6, s. 1332-1336
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To reflect on Lean experts' perspective on components of Lean management in health care and its implications for practice.BACKGROUND: The involvement of Lean experts is one of the key success factors of a sustainable Lean transformation in health care.EVALUATION: Thirteen Lean experts participated in two focus groups. They all had experience in the implementation of Lean in healthcare organizations.KEY ISSUES: Lean experts all seem to have a unique perspective on Lean management in health care. Experts without a healthcare degree appear to focus more on the entire management system, where experts with a nursing degree seem to concentrate more on the soft Lean principles.CONCLUSION: The description of Lean and its components in health care differed between Lean experts. Their professional background appears to have an influence.IMPLICATIONS FOR NURSING MANAGEMENT: In selecting a Lean expert, nurse managers may want to gauge what elements the Lean expert tends to emphasize. It seems plausible to opt for a Lean expert without a healthcare degree to accomplish the Lean transformation as they have a broader view on Lean. It may also be useful for managers to involve several Lean experts, all with complementary perspectives and backgrounds.
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12.
  • Barakat-Johnson, Michelle, et al. (författare)
  • Development and Psychometric Testing of a Knowledge Instrument on Incontinence-Associated Dermatitis for Clinicians : The Know-IAD
  • 2022
  • Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 49:1, s. 70-77
  • 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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  • Beeckman, Dimitri, Visiting Professor, 1982-, et al. (författare)
  • A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents
  • 2019
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 97, s. 105-113
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Pressure ulcers are a global issue and substantial concern for healthcare systems. Various types of support surfaces that prevent pressure ulcer are available. Data about the effectiveness and cost of static air support surfaces and alternating air pressure mattresses is lacking.Objectives: To compare the effectiveness and cost of static air support surfaces versus alternating air pressure support surfaces in a nursing home population at high risk for pressure ulcers.Design: Prospective, multicentre, randomised controlled clinical, non-inferiority trial.Setting: Twenty-six nursing homes in Flanders, Belgium.Participants: A consecutive sample of 308 participants was selected based on the following eligibility criteria: high risk for pressure ulcer and/or with category 1 pressure ulcer, being bedbound and/or chair bound, aged > 65 years, and use of an alternating air pressure mattress.Methods: The participants were allocated to the intervention group (n = 154) using static air support surfaces and the control group (n = 154) using alternating air pressure support surfaces. The main outcome measures were cumulative incidence and incidence density of the participants developing a new category II-IV pressure ulcer within a 14-day observation period, time to develop a new pressure ulcer, and purchase costs of the support surfaces.Results: The intention-to-treat analysis revealed a significantly lower incidence of category II-IV pressure ulcer in the intervention group (n = 8/154, 5.2%) than in the control group (n = 18/154, 11.7%) (p = 0.04). The median time to develop a pressure ulcer was significantly longer in the intervention group (10.5 days, interquartile range [IQR]: 1-14) than in the control group (5.4 days, [IQR]: 1-12; p = 0.05). The probability to remain pressure ulcer free differed significantly between the two study groups (log-rank X-2 = 4.051, df =1, p = 0.04). The overall cost of the mattress was lower in the intervention group than in the control group.Conclusions: A static air mattress was significantly more effective than an alternating air pressure mattress in preventing pressure ulcer in a high-risk nursing home population. Considering multiple lifespans and purchase costs, static air mattresses were more cost-effective than alternating air pressure mattresses.
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  • Beeckman, Dimitri, Visiting Professor, 1982-, et al. (författare)
  • Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers : a pragmatic non-commercial multicentre randomised open label parallel group medical device trial
  • 2021
  • Ingår i: British Journal of Dermatology. - : Blackwell Science Ltd.. - 0007-0963 .- 1365-2133. ; 185:1, s. 52-61
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital-acquired pressure ulcers (PUs).OBJECTIVES: Determine if silicone foam dressings in addition to standard prevention reduce PU incidence category 2 or worse compared to standard prevention alone.METHODS: Multicentre, randomised controlled, medical device trial conducted in eight Belgian hospitals. At risk adult patients were centrally randomised (n=1633) to study groups based on a 1:1:1 allocation: experimental group 1 (n=542) and 2 (n=545) - pooled as the treatment group - and the control group (n=546). Experimental groups received PU prevention according to hospital protocol, and a silicone foam dressing on these body sites. The control group received standard of care. The primary endpoint was the incidence of a new PU category 2 or worse at these body sites.RESULTS: In the intention-to-treat population (n=1605); 4.0% of patients developed PUs category 2 or worse in the treatment group and 6.3% in the control group (RR=0.64, 95% CI 0.41 to 0.99, P=0.04). Sacral PUs were observed in 2.8% and 4.8% of the patients in the treatment group and the control group, respectively (RR=0.59, 95% CI 0.35 to 0.98, P=0.04). Heel PUs occurred in 1.4% and 1.9% of patients in the treatment and control group respectively (RR=0.76, 95% CI 0.34 to 1.68, P=0.49).CONCLUSIONS: Silicone foam dressings reduce the incidence of PUs category 2 or worse in hospitalised at-risk patients when used in addition to standard of care. Results show a decrease for sacrum, but no statistical difference for heel/trochanter areas.
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  • Beeckman, Dimitri, Professor, 1982-, et al. (författare)
  • The role community-based healthcare providers play in managing hard-to-heal wounds
  • 2024
  • Ingår i: International Wound Journal. - : Wiley-Blackwell Publishing Inc.. - 1742-4801 .- 1742-481X. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • It is common for community-based healthcare providers (CHPs)-many of whom have not received specialised training in wound care-to deliver initial and ongoing management for various wound types and diverse populations. Wounds in any setting can rapidly transition to a stalled, hard-to-heal wound (HTHW) that is not following a normal healing trajectory. Failure to recognise or address issues that cause delayed healing can lead to increased costs, healthcare utilisation and suffering. To encourage early intervention by CHPs, a panel of wound care experts developed actionable evidence-based recommendations for CHPs delineating characteristics and appropriate care in identifying and treating HTHWs. A HTHW is a wound that fails to progress towards healing with standard therapy in an orderly and timely manner and should be referred to a qualified wound care provider (QWCP) for advanced assessment and diagnosis if not healed or reduced in size by 40%-50% within 4 weeks. HTHWs occur in patients with multiple comorbidities, and display increases in exudate, infection, devitalised tissue, maceration or pain, or no change in wound size. CHPs can play an important initial role by seeing the individual's HTHW risk, addressing local infection and providing an optimal wound environment. An easy-to-follow one-page table was developed for the CHP to systematically identify, evaluate and treat HTHWs, incorporating a basic toolkit with items easily obtainable in common office/clinic practice settings. A flow chart using visual HTHW clinical cues is also presented to address CHPs with different learning styles. These tools encourage delivery of appropriate early interventions that can improve overall healthcare efficiency and cost.
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17.
  • Beele, Hilde, et al. (författare)
  • Incontinence-Associated Dermatitis : Pathogenesis, Contributing Factors, Prevention and Management Options
  • 2018
  • Ingår i: Drugs & Aging. - : Wolters Kluwer. - 1170-229X .- 1179-1969. ; 35:1, s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region. Due to the lack of well-established clinical trials, recommendations about prevention and treatment are based on expert opinion and best practice. Gentle cleansing, use of hydrating topical agents and application of barrier products are the main elements in the prevention and treatment of IAD. It is important to translate these recommendations and general guidelines into ready-to-use protocols that can be implemented for each specific clinical manifestation of IAD.
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18.
  • Browning, Paul, et al. (författare)
  • Report of the proceedings of a UK skin safety advisory group
  • 2018
  • Ingår i: British Journal of Nursing. - : Mark Allen Publishing Ltd.. - 0966-0461 .- 2052-2819. ; 27:20, s. S34-S40
  • Tidskriftsartikel (refereegranskat)abstract
    • Moisture-associated skin damage, especially incontinence-associated dermatitis, continues to present significant health challenges and requires multidisciplinary input to provide effective prevention and treatment. In the absence of mandatory reporting such damage is under- or wrongfully reported, resulting in a lack of accurate data on prevalence and costs of associated care. In March this year, a multidisciplinary team of experts met in the UK to seek to determine measures to improve patient skin care. They aimed to identify activities to increase awareness and education, collect data, and improve prevention and treatment regimes. This article describes that discussion and the conclusions made by the group, such as the key actions required to effect policy changes.
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  • Búřilová, Petra, et al. (författare)
  • A ten-year follow-up of the prevalence of pressure injuries in the Czech Republic : Analysis of the National Registry
  • 2022
  • Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 19:7, s. 1870-1877
  • Tidskriftsartikel (refereegranskat)abstract
    • The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs were used in the period 2010-2019. A total of 264 442 records of patients with diagnoses of L89.0-L89.9 were identified from 2010 to 2019 (26 444 patients per year on average). The numbers are increasing every year, and there is a 40% increase between 2010 and 2019. When comparing recorded PIs, the percentage of PIs occurrence in category I decreased, and the number of PIs in category IV increased in the second analysed period. Still, in absolute numbers, there is an increase across all categories. The age of patients with recorded PIs also rose slightly in the second analysed period. We have proven the PIs prevalence increase in an ageing population.
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  • Cilluffo, Silvia, et al. (författare)
  • Risk of skin tears associated with nursing interventions : A systematic review
  • 2023
  • Ingår i: Journal of Tissue Viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 32:1, s. 120-129
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Skin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions.Objectives: To examine which nursing interventions increase the risk of skin tears.Design: Systematic review. Data sources: The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022.Publication years: Publications included were from 2012 to 2022.Results: Seventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehydrated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears.Conclusion: Nursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin.
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21.
  • Dabas, Mai, et al. (författare)
  • Application of artificial intelligence methodologies to chronic wound care and management : A scoping review
  • 2023
  • Ingår i: Advances in wound care. - : Mary Ann Liebert. - 2162-1918 .- 2162-1934. ; 12:4, s. 205-240
  • Forskningsöversikt (refereegranskat)abstract
    • SIGNIFICANCE: As the number of hard-to-heal wound cases rises with the aging of the population and the spread of chronic diseases, healthcare professionals struggle to provide safe and effective care to all their patients simultaneously. This study aimed to provide an in-depth overview of the relevant methodologies of artificial intelligence (AI) and their potential implementation to support these growing needs of wound care and management.RECENT ADVANCES: MEDLINE, Compendex, Scopus, Web of Science and IEEE databases, were all searched for new AI methods or novel uses of existing AI methods for diagnosis or management of hard-to-heal wounds. We only included English peer-reviewed original articles, conference proceedings, published patent applications or granted patents (not older than 2010) where the performance of the utilized AI algorithms was reported. Based on these criteria, a total of 75 studies were eligible for inclusion. These varied by the type of the utilized AI methodology, the wound type, the medical record/database configuration and the research goal.CRITICAL ISSUES: AI methodologies appear to have a strong positive impact and prospect in the wound care and management arena. Another important development that emerged from the findings is AI-based remote consultation systems utilizing smartphones and tablets for data collection and connectivity.FUTURE DIRECTIONS: The implementation of machine learning algorithms in the diagnosis and management of hard-to-heal wounds is a promising approach for improving the wound care delivered to hospitalized patients, while allowing healthcare professionals to manage their working time more efficiently.
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22.
  • De Meyer, Dorien, et al. (författare)
  • Delphi Procedure In Core Outcome Set Development : Rating Scale And Consensus Criteria Determined Outcome Selection
  • 2019
  • Ingår i: Journal of Clinical Epidemiology. - : Elsevier. - 0895-4356 .- 1878-5921. ; 111, s. 23-31
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To compare two different rating scales within one Delphi study for defining consensus in core outcome set development and to explore the influence of consensus criteria on the outcome selection.STUDY DESIGN: Randomized controlled parallel group trial with 1:1 allocation within the first Delphi round of the Core Outcome Set in the Incontinence-Associated Dermatitis (CONSIDER) project. Outcomes were rated on a three-point or nine-point Likert scale. Decisions about which outcomes to retain were determined by commonly used consensus criteria (i.e., (combinations of) proportions with restricted ranges, central tendency within a specific range and decrease in variance).RESULTS: Fifty-seven participants (group 1=28, group 2=29) rated 58 outcomes. The use of the nine-point scale resulted in almost twice as many outcomes being rated as 'critical' compared to the three-point scale (24 versus 13). Stricter criteria and combining criteria led to less outcomes being identified as 'critical'.CONCLUSION: The format of rating scales in Delphi studies for core outcome set development and the definition of the consensus criteria influence outcome selection. The use of the nine-point scale might be recommended to inform the consensus process for a subsequent rating or face-to-face meeting. The three-point scale might be preferred when determining final consensus.
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23.
  • De Meyer, Dorien, et al. (författare)
  • Knowledge of nurses and nursing assistants about pressure ulcer prevention : A survey in 16 Belgian hospitals using the PUKAT 2.0 tool
  • 2019
  • Ingår i: Journal of tissue viability. - : Elsevier. - 0965-206X. ; 28:2, s. 59-69
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Pressure ulcers have a high impact on patients and their families. Profound and up-to-date knowledge among nurses is important given the effect on attitudes and preventative behaviour. To gain insight into educational needs and priorities, regular knowledge assessments are needed.OBJECTIVE: To gain insight into the knowledge of nurses and nursing assistants about pressure ulcer prevention.DESIGN: Cross-sectional multicentre study.METHODS: 474 nurses and nursing assistants recruited at 29 wards in 16 hospitals completed individually the PUKAT 2.0, a valid and reliable questionnaire to measure nurses knowledge about pressure ulcer prevention. Data were collected between February 2016 and December 2017. Independent sample t-tests, one-way analyses of variance and Kruskal-wallis tests were performed to analyse the results.RESULTS: The mean total score was 50.7%. The lowest scores were found in the themes knowledge about prevention (42.7%), aetiology (45.6%) and prevention for specific patient groups (46.6%). Higher educational level (H = 40.43, p < 0.001) and attending additional training about pressure ulcers or wound care in general (t = 2.93, p = 0.004) resulted in significant higher total knowledge scores.CONCLUSION: The results of this study highlight an important knowledge deficit about pressure ulcer prevention. The PUKAT 2.0 knowledge assessment tool made it possible to differentiate between a variety of cognitive process levels. This allowed to identify knowledge gaps and focus areas for continuing professional education. Education curricula for nurses and associated healthcare professionals are to be screened thoroughly and the identified knowledge gaps should be covered. Besides, multifaceted strategies are needed to improve clinical practice.
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24.
  • De Meyer, Dorien, et al. (författare)
  • Outcome measurement instruments for erythema associated with incontinence-associated dermatitis : systematic review
  • 2019
  • Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 75:11, s. 2393-2417
  • Forskningsöversikt (refereegranskat)abstract
    • AIM: To: (1) examine which outcome measurement instruments for erythema associated with incontinence-associated dermatitis with supporting evidence about measurement properties are available; (2) evaluate the methodological quality of the studies and the quality of the measurement properties; and (3) identify eligible instruments to measure erythema in incontinence-associated dermatitis research.DESIGN: Systematic review.DATA SOURCES: MEDLINE, EMBASE, CINAHL and CENTRAL were systematically searched until July 2018 (update December 2018). Additional input was gathered from 151 incontinence-associated dermatitis experts. Cited and citing references of included studies were screened.REVIEW METHODS: The COSMIN Risk of Bias checklist was applied to evaluate the methodological quality of the studies. Reported measurement properties were rated against criteria for good measurement properties.RESULTS: Fourteen studies, describing 10 measurement instruments, were included. In five instruments, erythema was captured as a separate concept, two studies provided empirical evidence about the measurement properties. The most studied measurement properties were reliability (9 studies), measurement error (4 studies) and criterion validity (4 studies). In one study, internal consistency was examined.CONCLUSION: No instrument measuring exclusively erythema associated with incontinence-associated dermatitis exists. There is no single composite incontinence-associated dermatitis measurement instrument that outperforms others. Development or adaption of an instrument to measure erythema associated with incontinence-associated dermatitis is one option to solve this challenge.IMPACT: The evidence about measurement properties of instruments measuring erythema associated with incontinence-associated dermatitis has not been summarized to date. The lack of an instrument should trigger activities to measure this domain accurately in future clinical trials.
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25.
  • De Roose, Marjon, et al. (författare)
  • Knowledge, attitude, and practices regarding miscarriage : A cross-sectional study among Flemish midwives
  • 2018
  • Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 56, s. 44-52
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: to examine the knowledge, attitude and practices (KAP) of Flemish midwives regarding miscarriage.DESIGN AND SETTING: a cross-sectional KAP study was conducted in 28 hospitals in Flanders (Northern region of Belgium) from September 2015 to January 2016.PARTICIPANTS: a total of 647 out of 1200 midwives (53.9%) working on maternity, labour and gynaecological wards, maternal and neonatal (intensive) care units, antenatal consultations, and reproductive medicine were recruited.MEASUREMENTS: data were collected using a semi-structured, self-administered questionnaire.FINDINGS: = 96.574, df = 1, p<0.001). The majority (72.4%) indicated a lack of knowledge regarding miscarriage. Almost 89% expressed a need for extra training.CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: midwives in Flanders assist in the care for couples with miscarriage and consider themselves as a key healthcare provider in the psychosocial support. This study highlighted several barriers regarding miscarriage care, e.g. a lack of knowledge and incapability. Adequate training in knowledge and communication skills is important and necessary in order to promote appropriate care to couples experiencing pregnancy loss and increase awareness among all health professionals involved in obstetric care. Further research should investigate to what extent miscarriage is included in the educational midwifery programmes, and how the current healthcare practice regarding miscarriage care is organised.
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26.
  • Debyser, Bart, et al. (författare)
  • Mental health nurses and mental health peer workers : Self-perceptions of role-related clinical competences
  • 2018
  • Ingår i: International Journal of Mental Health Nursing. - : Blackwell Publishing. - 1445-8330 .- 1447-0349. ; 27:3, s. 987-1001
  • Tidskriftsartikel (refereegranskat)abstract
    • In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.
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27.
  • Debyser, Bart, et al. (författare)
  • The evaluation of nursing students by patients instrument (ENSPA) : Development and validation
  • 2020
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 89
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Patient participation is increasingly used in different aspects of healthcare due to its positive outcomes. Still, instruments for involving patients in the evaluation of nursing students during their internship are scarce.OBJECTIVES: To develop and validate an instrument that enables patients to evaluate nursing students during their internship.DESIGN AND METHODS: A 3-phased validation process was conducted: (1) development of an instrument through literature and patient interviews; (2) content and response process validation by use of cognitive interviews and pilot-testing; (3) testing construct validity and reliability of the instrument which was completed by 244 hospitalized patients.SETTINGS AND PARTICIPANTS: Patients from a variety of wards in a general hospital were recruited for the different phases. In phase 1, 17 interviews and 47 thought shower sessions with patients were performed. In phase 2, 9 cognitive interviews and pilot testing by 4 patients evaluating actual nursing students were used to refine the instrument. In phase 3, 380 patients were eligible to participate. Of these patients, 317 completed the instrument. A sample of 244 completed instruments was useful to perform the psychometric analyses. To assess the test-retest reliability, 50 patients completed the instrument twice with a 4 hour time interval.RESULTS: The 19-item Evaluation of Nursing Students by Patients instrument (ENSPa) is designed. The ENSPa-instrument comprises 7 items that assess whether the patient can place trust in the student, 5 items evaluating person-oriented skills, 4 items appraising caring and 3 items to grade the integrity and honesty of the nursing students. Each item is scored both for importance and rating. The instrument shows high reliability and consistency ratings.CONCLUSIONS: The ENSPa-instrument is a valuable instrument for collecting data on the performance and skills of nursing students during their internship from the patient's perspective. By receiving structured feedback from patients, important learning opportunities are created for nursing students.
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28.
  • Deprez, Julie, 1996-, et al. (författare)
  • What are the prognostic factors for the development of incontinence-associated dermatitis (IAD) : a protocol for a systematic review and meta-analysis
  • 2023
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research. Methods and analysis This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I 2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance. Ethics and dissemination No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal. 
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29.
  • Desmet, Karel, et al. (författare)
  • Associated factors of nurse-sensitive patient outcomes : A multicentred cross-sectional study in psychiatric inpatient hospitals
  • 2023
  • Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Blackwell Publishing. - 1351-0126 .- 1365-2850. ; 30:6, s. 1231-1244
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction The lack of evidence on patient characteristics and relational-contextual factors influencing nurse-sensitive patient outcomes of a nurse-patient relationship is a possible threat to the quality and education of the nurse-patient relationship.Aim To measure nurse-sensitive patient outcomes of the nurse-patient relationship and to explore the associations between nurse-sensitive patient outcomes and a range of patient characteristics and relational-contextual factors.Method In a multicenter cross-sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse-Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted.Results Overall, patient-reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital.Discussion The results may help nurses to become more sensitive and responsive to factors associated with nurse-sensitive patient outcomes of the nurse-patient relationship.Implications The nurse-sensitive results can support nurses in designing future nurse-patient relationships.
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30.
  • Desmet, Karel, et al. (författare)
  • Patient-reported outcomes of the nurse-patient relationship in psychiatric inpatients hospitals : a multicentred descriptive cross-sectional study
  • 2023
  • Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Blackwell Publishing. - 1351-0126 .- 1365-2850. ; 30:3, s. 568-579
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Identifying patient-reported outcomes of the nurse-patient relationship is a priority in inpatient mental healthcare to guide clinical decision-making and quality improvement initiatives. Moreover, demonstrating nurse-sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing.AIM/QUESTION: To measure nurse-sensitive patient outcomes of the nurse-patient relationship.METHOD: In a multicentred cross-sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse-Sensitive Patient Outcome-Scale (MH-NURSE-POS). The MH-NURSE-POS consists of 21 items (six-point Likert-scale) in four domains: 'growth', 'expression', 'control', and 'motivation'.RESULTS: Participants displayed moderate to good average scores for the MH-NURSE-POS total (4.42) and domain scores (≥4.09). Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60).DISCUSSION: The results demonstrate that patients perceive the nurse-patient relationship and the care given by psychiatric and/or mental health nurses as contributing to their treatment.IMPLICATIONS FOR PRACTICES: Patient-reported outcomes can guide nurses and managers to provide and organize nursing care and to build a nurse-patient relationship that has a positive impact on these outcomes. Additionally, outcomes can create nursing visibility as a profession in- and outside mental healthcare.
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31.
  • Desmet, Karel, et al. (författare)
  • The development and psychometric evaluation of the Mental Health Nurse-Sensitive Patient Outcome-Scale (MH-NURSE-POS) for inpatient psychiatric hospital settings
  • 2021
  • Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 30:4, s. 988-1000
  • Tidskriftsartikel (refereegranskat)abstract
    • Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse-sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse-Sensitive Patient Outcome Scale (MH-NURSE-POS) for inpatient psychiatric hospital settings. This three-staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two-round Delphi-procedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse-sensitive patient outcomes were determined in a sample of 353 patients. The cross-sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser-Meyer-Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity χ2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and reliability (Cronbach's Alpha 0.854) were evaluated. The factor analysis resulted in a four-factor solution representing growth, expression, control, and motivation. The Mental Health Nurse-Sensitive Patient Outcome Scale is a valid and reliable tool to measure the effectiveness of mental health nurses from the patient perspective. 
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32.
  • Dunk, Ann Marie, et al. (författare)
  • Clinical signs and symptoms of diaper dermatitis in newborns, infants, and young children : A scoping review
  • 2022
  • Ingår i: Journal of tissue viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 31:3, s. 404-415
  • Forskningsöversikt (refereegranskat)abstract
    • RATIONALE: Diaper dermatitis (DD) is a significant problem in the care of newborns, infants, and young children and good recognition of signs and symptoms optimises timely treatment. There is also a need for a standardised set of related descriptors to enable communication between health care providers about diagnosis and treatment.OBJECTIVE: The study aimed to review the literature for descriptive words to define the clinical signs, symptoms, and characteristics, including anatomical locations and assessment scales or tools, in the newborn, infants and young children population who have been diagnosed with DD.METHODS: A systematic review process utilising PRISMA guidelines [1] was conducted using advanced search techniques to analyse the terms from the database thesauri and keywords. Data bases including Ovid MEDLINE® and Epub Ahead of Print, in-Process & Other Non-Indexed Citations, Daily and Versions® were searched from 1946 to March 18, 2021. Cochrane Handbook Searching for and selecting studies were used as a guide and as best practice to conduct the search.RESULTS: Of the 551 publications originally identified, 55 full text publications were examined and 21 met the inclusion criteria. The wide range of descriptors used in the literature for DD supports the need for a clearer approach to report the signs and symptoms, and the severity, of DD.CONCLUSIONS: These findings point to gaps in the literature, both in recording signs and symptoms of DD and features such as wetness, infection, anatomical location, severity and pain in newborns, infants, and young children. There is a need to develop a robust methodological tool to bridge the gap and link a common terminology on signs and symptoms to support diagnosis of the severity of DD.
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33.
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34.
  • Duprez, Veerle, et al. (författare)
  • Capturing motivating versus demotivating self-management support : Development and validation of a vignette-based tool grounded in Self-determination Theory
  • 2021
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 116
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The trend towards more active involvement of patients in the management of their chronic condition requires professionals to interact in a way that facilitates patients' autonomy and motivation. A self-assessment tool that measures simultaneously motivating and demotivating interaction styles in counselling chronic ill patients is currently not available.OBJECTIVES: Grounded in Self-Determination Theory, this study aimed to develop and validate a self-report tool that captures healthcare professionals' motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) interaction styles while supporting patients towards self-management.METHODS: The Situations In Self-management support - HealthCare Professionals (SIS-HCP) was developed throughout a five-phased psychometric validation study with (1) construct definition, (2) development of the vignette-based questionnaire, (3) ecological validation and piloting, (4) psychometric evaluation (round 1) by multidimensional scaling analysis, and (5) psychometric evaluation (round 2) by internal and construct validity, and reliability testing procedures in 5 independent samples (total N = 1133), between August 2015 and March 2018.RESULTS: Multidimensional scaling analysis provided evidence for a two-dimensional structure, with motivating, relative to demotivating counselling and high, relative to low, directive counselling representing the two axes. Four styles could be distinguished: autonomy-support (rather motivating and non-directive), structure (rather motivating & directive), control (rather demotivating & directive) and chaos (rather demotivating & non-directive) within self-management support. The SIS-HCP demonstrated good construct validity, and high internal consistency and test-retest reliability.CONCLUSION: The SIS-HCP is a vignette-based tool, which allows to explore, in an integrative way, which motivating (i.e., autonomy-support and structure) and demotivating (i.e., control and chaos) styles healthcare professionals use when counselling patients living with a chronic illness. The SIS-HCP might enhance professionals' awareness of their (de)motivating counselling styles and the extent to which they promote ownership among patients. The SIS-HCP represents an interesting addition to existing instruments which measure what professionals do in the field of self-management support, and how confident they feel doing so. The thorough process of development and validation led to a theoretical underpinned tool, with the identified (de)motivating dimensions yielding strong psychometric properties. The SIS-HCP can be used as a reflective tool for professionals and for tailored training.
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35.
  • Duprez, Veerle, et al. (författare)
  • Is nurses' self-esteem interwoven with patients' achievements? The concept of patient-invested contingent self-esteem
  • 2019
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 28:21-22, s. 3858-3865
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To explore the notion of Patient-invested Contingent Self-Esteem (Pa-CSE) and investigate its association to nurses' self-reported engagement in controlling or autonomy-supportive interactions with chronic care patients.BACKGROUND: Considering the high number of patients sub-optimally managing their chronic condition, nurses might experience a drop and rise in self-worth when patients fail and succeed, respectively, in managing their chronic condition. This dynamic has not received prior research attention.DESIGN: Multivariate analysis employing cross-sectional data according to STROBE guidelines.METHODS: Self-reports among nurses employed in chronic care (N=394) from eight randomly selected hospitals in Belgium. Exploratory factor analysis and stepwise linear regression analyses were conducted.RESULTS: Success-based and failure-based orientations could be distinguished and refer to nurses' tendency to associate, respectively, patients' successes with feelings of professional success and self-worth and patients' failures with feelings of professional failure, shame, and inadequacy. Nurses' self-esteem is fairly interwoven with patients' achievements in the management of their chronic condition. A success-based orientation was positively related to autonomy-supportive care in case a failure-based orientation was low. Nurses with a simultaneous success-based and failure-based orientation interacted in a more controlling way.CONCLUSIONS: The findings of this study suggest that basing one's self-worth on patients' accomplishments may be a double-edged sword. Although tying one's personal glory to the successes of one's patient is related to greater patient participation and support of autonomy, these effects only emerge if nurses' self-worth is not interwoven with patients' failures. In fact, having both success- and failure-oriented contingent self-worth is related to a more pressuring approach.RELEVANCE TO CLINICAL PRACTICE: To prevent nurses from developing inferior professional feelings when their patients fail to manage their condition, a reflective stance towards the impact of patients' behaviour on the nurses' professional feeling of (in)adequacy is an important step to deal with such situations.
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36.
  • Duprez, Veerle, et al. (författare)
  • Nurses' interaction styles when supporting patients in self-management : A profile approach
  • 2020
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 110
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The rising attention to participation and self-regulation in chronic care requires nurses to move towards an approach in which patients' perspectives and choices are central, and in which patients' competency is fostered. According to Self-Determination Theory, nurses can differ in the way they interact with patients living with a chronic illness. That is, they can interact in an autonomy-supportive, controlling, structuring or chaotic way. However, in practice, nurses often use these styles side by side depending on personal and situational demands.Objective: Rooted in Self-Determination Theory, this study sought to identify distinct profiles among nurses involving the co-occurrence of autonomy support, structure, control and chaos (aim 1), and to examine whether such profiles are meaningfully driven by nurse-related indicators (aim 2).Design: A cross-sectional design with latent profile analysis.Methods: Data were collected using validated self-report questionnaires among nurses counselling chronically ill patients (N = 389). Latent profile analysis was performed to shed light on how nurses use different styles side by side; and subsequent MANCOVA testing was used to examine differences between the profiles in terms of nurse-related indicators.Results: Four profiles could be identified, each characterised by a unique combination of differing degrees of autonomy support, structure, control and chaos. The profiles included a motivating profile (20.31%) characterised by the dominant presence of autonomy support and structure; a demotivating chaotic profile (17.74%) characterised by the dominant presence of chaos; an active profile (24.17%) where all styles were highly present; and an undifferentiated profile (37.79%) characterised by an average presence of all styles. These four profiles were meaningfully related to a set of nurse-related indicators. Multivariate analysis (Pillai's Trace test =.38, F(15, 756) = 7.28; p <.001; eta(2) =.13) indicated that job competency, job autonomy and high-quality motivation were most elevated in the motivating profile.Conclusion: Profiling has supported our understanding of the natural co-occurrence of more motivating and demotivating styles among nurses when counselling patients in self-managing their life with chronic illness. The pattern of retained profiles indicates that, for some nurses, it will be important to move away from controlling or chaotic interactions. Future intervention development should augment nurses' competence levels and high-quality motivation, with attention to reduce the pressure in nurses to act in a result-based manner. Profiling can also be valuable to better assign nurses to an employment in chronic care, and to support their personal professional growth.
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37.
  • Duprez, Veerle, et al. (författare)
  • Nurses' perceptions of success in self-management support : An exploratory qualitative study
  • 2020
  • Ingår i: Research in Nursing & Health. - : John Wiley & Sons. - 0160-6891 .- 1098-240X. ; 43:3, s. 274-283
  • Tidskriftsartikel (refereegranskat)abstract
    • Nurses play an important role in supporting patients in self-managing their chronic conditions. However, it is uncertain how nurses define their success and what might create feelings of disillusionment. This exploratory qualitative study sought to understand the origin, meanings, and processes underlying nurses' feelings of success in supporting patients to self-manage their life with a chronic illness. Semi-structured interviews were held with 16 nurses who were purposively sampled. Data were iteratively collected and analyzed (November 2017-September 2018). The origin and meaning of nurses' feelings of success in supporting patients in self-management converged around the intertwining of "maintaining and promoting health" as a primary goal in chronic care, while an "intrapersonal conflict" arises. Patients maintaining physical health by optimal medical management boost nurses' feelings of success, whereas patients dealing with sub-optimally provoke "an intrapersonal conflict". When nurses observe unhealthy patient behavior, this is difficult to accept as it conflicts with their normative ideas of good care and health. Nurses' perception of success is refined by three interconnected processes, namely "keeping on track", "considering own role," and "protecting self". Nurses experienced and processed success differently depending on whether they interacted with patients from a more directive approach or an attuning approach. This study highlighted the fact that nurses expect compliance from patients, and thereby often feel empty-handed. By adopting a broader perspective of what successful patient behavior is, nurses might be able to provide a more comprehensive meaning to their own success regarding the care of patients living with a chronic illness.
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38.
  • Falk-Brynhildsen, Karin, 1959-, et al. (författare)
  • Swedish translation, cultural adaptation and psychometric evaluation of the pressure ulcer knowledge assessment tool for use in the operating room
  • 2023
  • Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 20:5, s. 1534-1543
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to psychometrically evaluate the Swedish operating room version of PUKAT 2.0. In total, 284 Swedish operating room nurses completed the survey of whom 50 completed the retest. The item difficulty P-value of 14 items ranged between 0.38 and 0.96 (median 0.65). Three items were found to be too easy (0.90-0.96). The D-value of 14 items ranged between 0.00 and 0.42 (median 0.46). Three items had a D-value lower than 0.20 (0.11-0.16) and eight items scored higher than 0.40 (0.45-0.61). The quality of the response alternatives (a-value) ranged between 0.00 and 0.42. This showed that nurses with a master's degree had a higher knowledge than nurses with a professional degree (respectively 9.4/14 versus 8.6/14; t = -2.4, df = 199, P = 0.02). The ICC was 0.65 (95% CI 0.45-0.78). The ICCs for the domains varied from 0.12 (95% CI = -0.16-0.39) to 0.59 (95% CI = 0.38-0.75). Results indicated that 11 of the original items contributed to the overall validity. However, the low participation in the test-retest made the reliability of the instrument low. An extended evaluation with a larger sample should be considered in order to confirm aspects of the psychometric properties of this instrument.
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39.
  • Falk-Brynhildsen, Karin, 1959-, et al. (författare)
  • The Swedish version of the attitude towards pressure ulcer prevention instrument for use in an operating room context (APUP-OR) : A nationwide psychometric evaluation
  • 2022
  • Ingår i: JOURNAL OF TISSUE VIABILITY. - : Elsevier. - 0965-206X .- 1876-4746. ; 31:1, s. 46-51
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: To assess operating room (OR) nurses' attitudes towards pressure ulcer prevention, the Attitude towards Pressure Ulcer Prevention (APuP) instrument was developed. Aim: The aim of this study was to psychometrically evaluate the Attitude towards Pressure Ulcer Prevention (APuP) instrument in a Swedish OR context. Materials and methods: A psychometric evaluation study was conducted, using a convenience sample, between February and August 2020. Validity (content, construct, discriminatory power) and reliability (stability and internal consistency) were evaluated. Results: The first survey (test) was completed by 284 Swedish OR nurses, of whom n = 50 (17.6%) completed the second survey (retest). A Principal Component Analysis was conducted for the 13-item instrument. The KMO value for this model was 0.62. Bartlett's test for sphericity was statistically significant (p 0.001). Five factors were identified which accounted for 56% of the variance in responses related to attitudes toward pressure ulcer prevention. The Cronbach's a for the instrument "attitude towards Pressure Ulcer Prevention" was 0.66. The intraclass correlation coefficient was 0.49 (95% CI = 0.25-0.67). Conclusion: This Swedish version of the APuP- OR is the first step in the development of an instrument to measure OR nurses' attitudes towards PU prevention in a Swedish OR context. The reliability of the instrument was low and the validity moderate. A larger sample and the revision or addition of items related to the context of the operating room should be considered in order to confirm aspects of the psychometric properties.
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40.
  • Flæten, Øystein Øygarden, et al. (författare)
  • Incidence, characteristics, and associated factors of pressure injuries acquired in intensive care units over a 12-month period : a secondary analysis of a quality improvement project
  • 2024
  • Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 81
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To determine the 12-month cumulative incidence, characteristics, and associated factors of pressure injuries acquired in Intensive Care Units.Setting: Four intensive care units in a Norwegian University Hospital.Research methodology: A prospective observational cohort study using data from daily skin inspections during a quality improvement project. We used descriptive statistics and logistic regression. Variables associated with the development of intensive care unit-acquired pressure injuries are presented with odds ratios (OR), and 95% confidence intervals.Results: The 12-month cumulative incidence of patients (N = 594) developing intensive care unit-acquired pressure injuries was 29 % (172/594) for all categories and 16 % (95/594) when excluding category I pressure injuries (no skin loss). Cumulative incidence for patients acquiring medical device-related pressure injuries was 15 % (91/594) and 11 % (64/594) for category II or worse. Compression stockings (n = 51) and nasogastric tubes (n = 22) were the most frequent documented medical devices related to pressure injuries. Development of pressure injuries category II or worse was significantly associated with vasoactive drug infusions (OR 11.84, 95 % CI [1.59; 88.13]) and longer intensive care unit length of stay (OR 1.06, 95 % CI [1.04; 1.08]).Conclusion: The 12-month cumulative incidence of intensive care unit-acquired pressure injuries was relatively high when category I pressure injuries were included, but comparable to other studies when category I was excluded. Some medical device-related pressure injuries were surprisingly frequent, and these may be prevented. However, associated factors of developing pressure injuries were present and deemed non-modifiable.Implications for clinical practice: Awareness about pressure injury prevention is needed in the intensive care unit considering high incidences. Nurses can detect category I pressure injuries early, which may be reversed. Our findings show several factors that clinicians can control to reduce the risk of pressure injuries in the intensive care unit.
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41.
  • Fourie, Anika, et al. (författare)
  • Development of prone positioning and skin damage prevention digital education : the PRONEtect project
  • 2023
  • Ingår i: Journal of Wound Care. - : MA Healthcare Ltd.. - 0969-0700 .- 2052-2916. ; 32:9, s. 570-578
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The incidence of skin/tissue damage, such as pressure ulcers, remains high in mechanically ventilated patients in the prone position. According to guidelines, critically ill patients with acute respiratory distress syndrome (ARDS) should be prone for at least 12-16 hours to improve oxygenation and decrease mortality. Therefore, educating clinicians on how to reposition and manage the patient safely in a prone position plays a vital role in preventing adverse events. This project aimed to develop accessible online educational content to assist clinicians in safely executing the prone manoeuvre and minimise skin/tissue damage.METHOD: The development of the educational content was based on: a gap analysis and comprehensive review of available educational resources; evidence-based scientific literature; advice from international experts; and a qualitative study exploring the learning needs of 20 clinicians in Belgium and Sweden between February-August 2022.RESULTS: Volunteer clinicians assisted with the creation of eight simulation videos which were professionally filmed and edited. The interactive videos included the supine-to-prone and prone-to-supine manoeuvres, endotracheal and nasogastric tube securement, eye care, stoma care, protecting high-risk areas from pressure damage, and incontinence-associated dermatitis prevention. A prone positioning protocol, a checklist summarising the key aspects of the protocol, and teaching aids (slide deck for didactic lecturing) were developed and validated by a review of the relevant evidence-based literature and the international expert panel. A website was designed to host the content, with free user access, at www.pronetection.com.CONCLUSION: Education is one strategy towards prevention of complications of prone positioning. Accessible education could assist clinicians unfamiliar with prone positioning or current clinicians requiring refresher training to safely manage patients in this position.
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42.
  • Fourie, Anika, et al. (författare)
  • Enhancing prone positioning and skin damage prevention education : A randomized controlled non-inferiority trial comparing a digital education hub (PRONEtect) and a traditional lecture on final-year nursing participants' confidence and knowledge
  • 2024
  • Ingår i: Journal of tissue viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 33:2, s. 298-304
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: The incidence of pressure ulcers remains high in patients with moderate to severe acute respiratory distress syndrome, ventilated in the prone position. A digital platform, dedicated to prone positioning and skin/tissue damage education was developed.OBJECTIVE: To evaluate the impact of the PRONEtect Education Hub versus a traditional lecture on final-year nursing students' confidence levels and knowledge in a non-inferiority study.DESIGN: A multicenter, non-blinded, parallel-group, non-inferiority study with equal randomization (1:1 allocation) was conducted at two nursing schools in Belgium. CLINICALTRIALS: gov (NCT05575869).METHODS: Following baseline assessments, the control group received a 1-h classroom lecture, and the experimental group gained access to the PRONEtect website. Three weeks later, participants completed the knowledge, confidence, and visual knowledge assessment.RESULTS: At baseline, 67 of the 80 participants completed the assessments and post-intervention, 28 and 27 participants respectively completed the confidence, knowledge, and visual knowledge assessments (dropout rate of 66.25%). Confidence levels: a mean ratio of relative change from baseline = 0.96 (Control (C)/Experimental (E)); 97.5% confidence interval (CI): 0.74 to 1.26; p = 0.74. Knowledge assessment: a mean difference in change from baseline = 1.58 (C-E); 97.5% CI: -0.58 to 3.75; p = 0.1. Although confidence and knowledge scores increased in both groups, the study cannot conclude non-inferiority.CONCLUSIONS: The trade-off between the inability to conclude efficacy of the impact of the website and the benefit of having an accessible educational platform on prone positioning and skin damage prevention makes the PRONEtect Education Hub an acceptable adjunct to traditional lecturing.
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43.
  • Fourie, Anika, et al. (författare)
  • Exploring the learning needs of clinicians in Belgium and Sweden regarding prone positioning and skin damage prevention : A qualitative study
  • 2023
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 128
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: During the coronavirus pandemic (COVID -19), the use of prone positioning in critically ill patients with acute respiratory distress syndrome (ARDS) increased substantially. As a result, clinicians had to (re)learn how to treat the patient in the prone position while preventing adverse events such as pressure ulcers, skin tears and moisture-associated skin damage.Aim: The purpose of the study was to determine participants' learning needs related to patients in the prone position and the prevention of skin damage, such as pressure ulcers, and what they perceived as a positive or negative learning experience.Design: This study used a qualitative methodological framework and employed an exploratory design.Participants: A purposive sample of clinicians (n = 20) with direct or indirect work experience with prone ventilated patients was recruited in Belgium and Sweden.Methods: Individual semi-structured interviews were conducted in Belgium and Sweden between February and August 2022. Data were analysed thematically using an inductive approach. The COREQ guideline was utilised to comprehensively report on the study.Findings: Two themes were identified: 'Adapting to a crisis' and 'How to learn', with the latter having two subthemes: 'balancing theory and practice' and 'co-creating knowledge'. Unexpected circumstances necessitated a personal adaption, a change in learning methods and a pragmatic adaptation of protocols, equipment and working procedures. Participants recognised a multifaceted educational approach which would contribute to a positive learning experience regarding prone positioning and skin damage prevention. The importance of poising theoretical teaching with practical hands-on training was highlighted with an emphasis on interaction, discussion, and networking between peers. Conclusions: The study findings highlight learning approaches which may help inform the development of befitting educational resources for clinicians. Prone therapy for ARDS patients is not limited to the pandemic. Therefore, educational efforts should continue to ensure patient safety in this important area.
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44.
  • Fourie, Anika, et al. (författare)
  • Skin damage prevention in the prone ventilated critically ill patient : A comprehensive review and gap analysis (PRONEtect study)
  • 2021
  • Ingår i: Journal of tissue viability. - : Elsevier. - 0965-206X. ; 30:4, s. 466-477
  • Forskningsöversikt (refereegranskat)abstract
    • BACKGROUND: Ventilating critically ill patients with acute respiratory distress syndrome in the prone position is a life-saving strategy, but it is associated with adverse consequences such as skin damage.AIM: To identify, review and evaluate international proning and skin care guidelines and make an inventory of commonly used equipment and training resources.DESIGN: A gap analysis methodology was applied.METHODS: 1) Comprehensive search and evaluation of proning and skin care guidelines, 2) extensive search and listing equipment and educational resources, and 3) international consultation with 11 experts (8 countries).DATA SOURCES: A variety of sources researched through July 2021 were used to identify relevant literature: (1) scientific literature databases and clinical trials registries, (2) intensive care and wound care associations, (3) healthcare organisations, (4) guideline development organisations, and (5) the Google search engine. Eleven international experts reviewed the literature and provided insights in two, 2-h online sessions.FINDINGS: The search yielded 24 guidelines. One clinical practice guideline had high methodological quality. Twenty-five devices/equipment and sixteen teaching materials were identified and discussed with the expert panel. The gap analysis identified a lack of concise, accessible, evidence-based guidelines and educational materials of short duration.CONCLUSION: This analysis forms the basis for designing a competency-based education and training intervention for an interdisciplinary team caring for the skin of critically ill patients in the prone position.IMPACT: The results can assist the multidisciplinary team to review their current protocol for prone positioning. This is a first step in developing a training package for clinicians.
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45.
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46.
  • Gefen, Amit, et al. (författare)
  • Fluid handling by foam wound dressings : From engineering theory to advanced laboratory performance evaluations
  • 2024
  • Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 21:2
  • Forskningsöversikt (refereegranskat)abstract
    • This article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure-function relationships and on advanced laboratory testing methods for pre-clinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions. Based on this comprehensive review, we propose a newly developed testing method, experimental metrics and clinical benchmarks that are clinically relevant and can set the standard for robust fluid handling performance evaluations. The purpose of this evaluative framework is to translate the physical characteristics and performance determinants of a foam dressing into achievable best clinical outcomes. These guiding principles are key to distinguishing desirable properties of a dressing that contribute to optimal performance in clinical settings.
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47.
  • Gefen, Amit, et al. (författare)
  • How should clinical wound care and management translate to effective engineering standard testing requirements from foam dressings? Mapping the existing gaps and needs
  • 2023
  • Ingår i: Advances in wound care. - : Mary Ann Liebert. - 2162-1918 .- 2162-1934. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • SIGNIFICANCE: Wounds of all types remain one of the most important, expensive and common medical problems, e.g., up to approximately two-thirds of the work time of community nurses is spent on wound management. Many wounds are treated by means of dressings. The materials used in a dressing, their microarchitecture and how they are composed and constructed form the basis for the laboratory and clinical performances of any advanced dressing. Recent Advances: The established structure-function principle in material science is reviewed and analyzed in this article in the context of wound dressings. This principle states that the microstructure determines the physical, mechanical, and fluid transport and handling properties, all of which are critically important for, and relevant to the adequate performances of wound dressings.CRITICAL ISSUES: According to the above principle, once the clinical requirements for wound care and management are defined for a given wound type and etiology, it should be theoretically possible to translate clinically-relevant characteristics of dressings into physical test designs resulting specific metrics of materials, mechanical, and fluid transport and handling properties, all of which should be determined to meet the clinical objectives and be measurable through standardized bench testing.FUTURE DIRECTIONS: This multidisciplinary review article, written by an International Wound Dressing Technology Expert Panel, discusses the translation of clinical wound care and management into effective, basic engineering standard testing requirements from wound dressings with respect to material types, microarchitecture and properties, to achieve the desirable performance in supporting healing and improving the quality of life of patients.
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48.
  • Gefen, Amit, et al. (författare)
  • Mechanical and contact characteristics of foam materials within wound dressings : Theoretical and practical considerations in treatment
  • 2023
  • Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 0:6, s. 1960-1978
  • Tidskriftsartikel (refereegranskat)abstract
    • In the treatment of acute and chronic wounds, the clinical performance of a given foam-based dressing, and, ultimately, the wound healing and cost of care outcomes are strongly influenced by the mechanical performance of the foam material/s within that dressing. Most aspects of the mechanical performance of foam materials, for example, their stiffness, frictional properties, conformability, swelling characteristics and durability, and the overall mechanical protection provided by a foam-based dressing to a wound strongly depend on the microstructure of the foam components, particularly on their microtopography, density and porosity. This article, therefore, provides, for the first time, a comprehensive, self-inclusive compilation of clinically relevant theoretical and practical considerations, based on published analytical and experimental research as well as clinical experience related to the mechanical performance of foams in foam-based wound dressings. The current bioengineering information is useful for establishing understanding of the importance of mechanical properties of foams in foam-based dressings among clinicians and researchers in industry and academia, and other potential stakeholders in the wound care field, for example, regulators and buyers. This information is also particularly important for the development of standardised test methods for the evaluation of foam-based wound dressings and resulting standard mechanical performance metrics for these dressings.
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49.
  • Gethin, Georgina, et al. (författare)
  • Nurses are research leaders in skin and wound care
  • 2020
  • Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 17:6, s. 2005-2009
  • Forskningsöversikt (refereegranskat)abstract
    • The World Health Assembly declared 2020, the International Year of the Nurse and the Midwife. Recent editorials and commentaries support the leading role of nurses and midwives as frontline caregivers emphasizing the need to invest in the nursing workforce worldwide to meet global health needs. Today nurses are also leaders in research and one example is skin and wound care. In order to reflect on the contribution of nurses as researchers we conducted a systematic review of published articles in five international leading wound care journals in the years 1998, 2008 and 2018. We aimed to determine the type of research publication and percentage of nurses as first, second or senior authors. The place in the authorship was selected as indicative of leadership as it implies responsibility and accountability for the published work. Across the years 1998, 2008 and 2018, 988 articles were published. The overall proportion of nurse-led articles was 29% (n = 286). The total numbers of articles increased over time and so too did the nurse-led contributions. Nurse-led research was strongest in the design categories 'cohort studies' (46%, n = 44), 'systematic reviews' (46%, n = 19), and 'critically appraised literature and evidence-based guidelines' (47%, n = 55).Results of this review indicate that, in addition to the crucial clinical roles, nurses also have a substantial impact on academia and development of the evidence base to guide clinical practice. Our results suggest that nurse led contributions were particularly strong in research summarizing research to guide skin and wound care practice.
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50.
  • Ghijselings, Lynn, et al. (författare)
  • The OptiLUTS trial : improving care for therapy-resistant symptoms of the pelvis in Belgium
  • 2020
  • Ingår i: Acta Clinica Belgica. - : Taylor & Francis. - 1784-3286 .- 2295-3337. ; 75:5, s. 334-339
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction/Background: The management of therapy-resistant lower urinary tract symptoms (LUTS) and symptoms resulting from pelvic organ dysfunctions are subject to a high variability in the Belgian health-care centres. Practical guidelines and standardized patient clinical care pathways are often lacking and unadapted to the Belgian healthcare system.Objectives: The OptiLUTS trial aims to improve the multidisciplinary care of therapy-resistant symptoms of the pelvis in the Belgian healthcare setting.Project A aims for the improvement of knowledge of 2nd line treatments for LUTS among general practitioners. In project B a treatment algorithm for the overactive bladder syndrome and non-obstructive urinary retention will be developed specifically for Belgium. In Project C a patient customized sacral neuromodulation (SNM) care pathway will be set up.Methods: Part A: Explorative study among general practitioners by distribution of a questionnaire.Part B: Review of existing guidelines and use of the Delphi method to obtain expert consensus. Part C: A single center comparative study to compare outcomes before and after implementation of the SNM care pathway. Patients scheduled for the first stage of Interstim therapy™ will be included (N=100). Primary endpoints are the sensitivity and specificity of a new pelvic symptom assessment tool, the conversion to implant and explantation rates.Conclusion: There is a margin for improvement in the care process of patients with therapy-resistant symptoms of the pelvis in the Belgium healthcare system. In the OptiLUTs trial adapted guidelines and a clinical care pathway will be developed to standardize and increase the efficiency of care.Trial registration: Approval for the trial by the Ethics Committee of the Ghent University hospital: EC/2018/0244.
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