RESUMO
AIMS: To map the existing literature describing medical device-related pressure injuries in patients during surgery, including investigation of the incidence, types of medical devices, risk factors and strategies for preventing medical device-related pressure injuries. DESIGN: A scoping review. DATA SOURCES: In April 2023, three databases were searched. Studies about adult patients undergoing surgery, from 2014 onwards, in English and Chinese were included. Data were extracted about study characteristics and data related to research questions. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework were used to synthesize findings. RESULTS: Two different types of evidence were included in this review; 14 research studies and two quality improvement studies. The incidence of medical device-related pressure injuries in the operating room was 0.56%-24.5% and respiratory devices were the most common medical devices investigated. Length of surgery, age and BMI were risk factors for medical device-related pressure injuries in a few studies. The application of a prophylactic dressing and dressing maintenance was the most common prevention strategy. CONCLUSION: Ongoing research is needed to confirm the incidence of, and risk factors for, medical device-related pressure injuries in the operating room. Additionally, more high-quality evidence is needed to underpin current prevention strategies. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Operating room nurses need to be aware of the risks of medical device-related pressure injuries and assess and plan prevention strategies accordingly. Once more high-quality evidence is available, operating room nurses could implement prevention strategies like prophylactic dressings. REPORTING METHOD: Scoping Reviews (PRISMA-ScR) checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
RESUMO
Shift work disrupts an otherwise normal circadian rhythm, which may result in sleepiness among night-shift workers. Artificial light has been shown to alter the light-dark cycle of shift workers and reset or phase shift the biological clock, improving nighttime alertness in workers. However, the effect of light therapy on improving sleepiness in nighttime workers has not been effectively confirmed in nursing clinical studies, and it is worth using relevant studies to provide the best evidence in any clinical setting. Systematic review and meta-analysis were used. The study was performed using PRISMA. Academic Search Complete, Embase, MEDLINE, the Cochrane Library, and CINAHL were searched, from the inception of each database to 27 December 2021. The Cochrane risk of bias tool was used to assess the methodological quality of each study. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized using a random-effects model to assess the efficacy of lighting intervention to improve sleepiness in night-shift workers. Sensitivity analysis followed by subgroup analysis was employed to examine heterogeneity. The meta-analysis was performed using Review Manager 5.4.1 software. A total of 14 studies from 7 countries were included. The overall result shows that lighting interventions significantly improved sleepiness. Further, the blue-enriched white light with a color temperature greater than 5000 Kelvin was effective in improving sleepiness of night-shift workers. This study unveils the emergent knowledge that light interventions with blue-enriched white were effective in improving sleepiness for night-shift workers, including nurses. This finding can be applied to ensure patient safety, reduce accidents, and improve work efficiency and job satisfaction. Nurses constitute the largest health professional workforce. We suggest that hospitals can insert blue-enriched white light equipment for night-shift healthcare providers. Several evidence-based suggestions are made for further consideration.
Assuntos
Algoritmos , COVID-19/prevenção & controle , Controle de Infecções/organização & administração , Úlcera Cutânea/terapia , Telemedicina/organização & administração , Ferimentos e Lesões/terapia , COVID-19/epidemiologia , COVID-19/transmissão , Doença Crônica , Humanos , Seleção de Pacientes , Úlcera Cutânea/etiologia , Triagem , Ferimentos e Lesões/etiologiaRESUMO
OBJECTIVE: The purpose of this study was to determine whether using Aquacel Ag (ConvaTec, Skillman, New Jersey) with Vaseline (Unilever, London, England) gauze instead of silver sulfadiazine cream (SSD) as the wound care protocol to treat toxic epidermal necrolysis (TEN) can improve wound healing, pain control, and reduction of labor costs. DESIGN: A retrospective chart review. SETTING: A burn center with 2 plastic surgeons and 11 nursing staff. PATIENTS: A pathologist diagnosed TEN in 35 patients admitted to the burn center from 1995 to 2009. MAIN OUTCOME MEASURES: Parameters included the patient's profile, dressing choice, severity-of-illness score for TEN, time to 95% re-epithelialization, visual analog scale pain scores before second dressing change, and labor cost. The exclusion criterion was wound care with neither Aquacel Ag with Vaseline nor SSD exclusively. RESULTS: Twenty patients were enrolled in this study. In the group using Aquacel Ag with Vaseline gauze, the visual analog scale score was significantly less than that of the SSD group (P = .02). Labor costs were significantly lower in the Aquacel Ag with Vaseline gauze group (P < .01). Commencement of specific dressing to 95% re-epithelialization (P = .09) and time spent in the second dressing change (P = .05) had no statistical significance between the 2 groups. CONCLUSIONS: This study showed that Aquacel Ag with Vaseline gauze decreased pain and labor costs but did not shorten wound healing time. Thus, Aquacel Ag with Vaseline gauze can be an efficient method for treating TEN wounds.