| 1. |
- Dunk, Ann Marie, et al.
(author)
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Clinical signs and symptoms of diaper dermatitis in newborns, infants, and young children : A scoping review
- 2022
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In: Journal of tissue viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 31:3, s. 404-415
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Research review (peer-reviewed)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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| 2. |
- Fourie, Anika, et al.
(author)
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Development of prone positioning and skin damage prevention digital education : the PRONEtect project
- 2023
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In: Journal of Wound Care. - : MA Healthcare Ltd.. - 0969-0700 .- 2052-2916. ; 32:9, s. 570-578
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Journal article (peer-reviewed)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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| 3. |
- Fourie, Anika, et al.
(author)
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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
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In: Journal of tissue viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 33:2, s. 298-304
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Journal article (peer-reviewed)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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| 4. |
- Fourie, Anika, et al.
(author)
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Exploring the learning needs of clinicians in Belgium and Sweden regarding prone positioning and skin damage prevention : A qualitative study
- 2023
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In: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 128
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Journal article (peer-reviewed)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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| 5. |
- Fourie, Anika, et al.
(author)
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Skin damage prevention in the prone ventilated critically ill patient : A comprehensive review and gap analysis (PRONEtect study)
- 2021
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In: Journal of tissue viability. - : Elsevier. - 0965-206X. ; 30:4, s. 466-477
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Research review (peer-reviewed)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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| 6. |
- Hansen, Preben, et al.
(author)
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Third Space, Information Sharing and Participatory Design
- 2021
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Book (other academic/artistic)abstract
- Society faces many challenges in workplaces, everyday life situations, and education contexts. Within information behavior research, there are often calls to bridge inclusiveness and for greater collaboration, with user-centered design approaches and, more specifically, participatory design practices. Collaboration and participation are essential in addressing contemporary societal challenges, designing creative information objects and processes, as well as developing spaces for learning, and information and research interventions. The intention is to improve access to information and the benefits to be gained from that. This also applies to bridging the digital divide and for embracing artificial intelligence. With regard to research and practices within information behavior, it is crucial to consider that all users should be involved. Many information activities (i.e., activities falling under the umbrella terms of information behavior and information practices) manifest through participation, and thus, methods such as participatory design may help unfold both information behavior and practices as well as the creation of information objects, new models, and theories. Information sharing is one of its core activities. For participatory design with its value set of democratic, inclusive, and open participation towards innovative practices in a diversity of contexts, it is essential to understand how information activities such as sharing manifest itself. For information behavior studies it is essential to deepen understanding of how information sharing manifests in order to improve access to information and the use of information.
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| 7. |
- Meyer, Anika, et al.
(author)
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A participatory design informed framework for information behaviour studies
- 2020
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In: Information research. - : University of Borås, Borås, Sweden. - 1368-1613. ; 25:4
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Journal article (peer-reviewed)abstract
- Introduction. Applying participatory design in educational contextscan improve the congruence between perceptions of students, teachers and instructional designers. Information behaviour activities such as collaborative information seeking and information sharing are core to participatory design. Information behaviour studies related to participatory design must be guided by an information behaviourframework informed by the principles of participatory design. Albeit a few examples of frameworks, reference is mostly only to participatory design steps, phases and stages, with limited acknowledgement of information activities. This paper suggests a participatory design information behaviour framework for studies in educational contexts.Method. Scoping review of selected publications on participatory design and information behaviour, and participatory design in education.Analysis. Thematic analysis applied in educational context as exemplar.Results. A participatory design information behaviour framework must allow for the following constructs: context, participant selection (i.e., actors, stakeholders), definition of shared visions and purposes; roles and tasks; information resources and access; iterative information activities; participatory design steps, phases and stages; consideration of intervening factors; and finer nuances of all of these constructs.Conclusion. The suggested framework can guide information behaviour studies on participatory design with a focus on information activities.
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| 8. |
- Raepsaet, Charlotte, et al.
(author)
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Management of incontinence-associated dermatitis : A systematic review of monetary data
- 2020
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In: International Wound Journal. - : Wiley-Blackwell Publishing Inc.. - 1742-4801 .- 1742-481X. ; 18:1, s. 79-94
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Research review (peer-reviewed)abstract
- The objective was to systematically review monetary data related to management of incontinence-associated dermatitis (IAD) in an adult population. Six electronic databases were searched: MEDLINE, CINAHL, Web of Science, EMBASE, The Cochrane Library and EconLit. The search string combined index terms and text words related to IAD and monetary data. The quality of the articles was assessed using the consensus on Health Economic Criteria. Results were synthesised narratively because of methodological heterogeneity. Nine studies were included. Only direct medical costs were reported. The product cost per application for prevention ranged between $0.05 and $0.52, and for treatment between $0.20 and $0.35. The product cost per patient/day for prevention ranged between $0.23 and $20.17. The product cost of IAD prevention and treatment per patient/day ranged between $0.57 and $1.08. The cost to treat IAD did not consider the treatment of secondary infection. The calculation of labour cost and total cost differed considerably between studies. Summarising monetary data is a challenge because of heterogeneity in currencies, settings, samples, time horizons, health- and cost outcome valuation, IAD definition and measurements, and included costs. Procedures for health economic evaluations are to be clarified to guarantee valid interpretation and comparison with other studies.
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| 9. |
- Smet, Steven, et al.
(author)
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The measurement properties of assessment tools for chronic wounds : A systematic review
- 2021
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 121
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Research review (peer-reviewed)abstract
- BACKGROUND: Chronic wounds are an increasing problem in the aging population, patients experience a lower health-related quality of life and the care for these patients is associated with high costs. Thorough wound assessments facilitate objective monitoring of wound status and progress. A wound assessment tool can guide clinicians in these wound assessments and in recording wound progress or deterioration.OBJECTIVE: Systematically identify assessment tools for chronic wounds, investigate their measurement properties, and summarize the data per assessment tool.DESIGN: Systematic reviewMETHODS: The databases Medline (PubMed interface), Embase, CINAHL, and CENTRAL were systematically searched until May 2020 (updated in February 2021). Studies reporting the development and/or the evaluation of measurement properties of assessment tools for chronic wounds were included. The "Consensus-based Standards for the selection of health Measurement Instruments" risk of Bias checklist was applied to evaluate the methodological quality of the included studies. Each reported measurement property was rated against criteria for good measurement properties. The evidence was summarized and the quality of the evidence was graded using a modified Grades of Recommendation, Assessment, Development, and Evaluation approach. Study selection, data extraction and quality appraisal were conducted independently by two reviewers and double-checked by a third reviewer.RESULTS: Twenty-seven studies describing the measurement properties of fourteen assessment tools for chronic wounds were included. None of the studies reported a content validity evaluation by a relevance study or a comprehensiveness study in professionals. Six articles reported the development or revision of an existing assessment tool. The reported measurement properties included: structural validity (5 studies), reliability (18 studies), hypotheses testing for construct validity (18 studies) and responsiveness (7 studies). Internal consistency, cross-cultural validity / measurement invariance and measurement error were not reported. If criterion validity was assessed, the results were allocated to hypotheses testing for construct validity as no 'gold standard' is available.CONCLUSIONS: Fourteen assessment tools for chronic wounds were identified. Construct validity (by hypotheses testing) and responsiveness of the Pressure Ulcer Scale for Healing version 3.0 were supported by sufficient ratings based on moderate to high level quality of evidence. Reliability of the (Revised) Photographic Wound Assessment Tool had a sufficient rating based on moderate quality of evidence. The ratings of the measurement properties of the other wound assessment tools were either insufficient or indeterminate, or a sufficient result was supported by low to very low quality of evidence. Registration number in PROSPERO: CRD42020183920. Tweetable abstract: "A systematic review giving a clear overview of the measurement properties of available assessment tools for chronic wounds."
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| 10. |
- Smet, Steven, et al.
(author)
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The process of clinical decision-making in chronic wound care : A scenario-based think-aloud study
- 2024
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In: Journal of tissue viability. - : Elsevier. - 0965-206X .- 1876-4746. ; 33:2, s. 231-238
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Journal article (peer-reviewed)abstract
- AIMS: To undertake a comprehensive investigation into both the process of information acquisition and the clinical decision-making process utilized by primary care nurses in the course of treating chronic wounds.DESIGN: Scenario-based think-aloud method, enriched by the integration of information processing theory. The study was conducted within the framework of home care nursing organizations situated in [placeholder]. A cohort of primary care nurses (n = 10), each possessing a minimum of one year of nursing experience, was recruited through the collaboration of three home care nursing organizations.METHODS: Two real-life clinical practice scenarios were employed for the interviews, with the researcher adopting the roles of either the patient or another clinician to enhance the realism of the think-aloud process. Each think-aloud session was promptly succeeded by a subsequent follow-up interview. The Consolidated criteria for Reporting Qualitative research checklist was followed to guarantee a consistent and complete report of the study.RESULTS: Amidst noticeable variations, a discernible pattern surfaced, delineating three sequential concepts: 1. gathering overarching information, 2. collecting and documenting wound-specific data, and 3. interpreting information to formulate wound treatment strategies. These concepts encompassed collaborative discussions with stakeholders, while the refinement of wound treatment strategies was interwoven within both concepts 2 and 3.CONCLUSIONS: Evident variations were identified in chronic wound care clinical decision-making, regardless of educational background or experience. These insights hold the potential to inform the development of clinical decision support systems for chronic wound management and provide guidance to clinicians in their decision-making endeavours.
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