A study protocol for comparing the treatment of varicose tributaries either concomitantly with or separately from endovenous laser ablation of the incompetent saphenous trunk (the FinnTrunk Study). A multicenter parallel-group randomized controlled study.

BACKGROUND: Opinions on the treatment of varicose tributaries in relation to saphenous ablation in varicose disease vary. Moreover, the possible role of the tributaries regarding the recurrence of varicose disease remains unclear. The aim of the FinnTrunk study is to compare two different treatment strategies for varicose disease in a randomized setting. In group one, the initial treatment will entail endovenous laser ablation (EVLA) of the incompetent saphenous trunk without tributary treatment. In group two, the varicose tributaries will be treated with ultrasound-guided foam sclerotherapy (UGFS) concomitantly with truncal ablation. The primary outcome measure is the need for additional procedures during the follow-up. The secondary outcome measures are the cost of treatment and recurrence of varicose disease. METHODS: Consecutive patients with symptomatic varicose disease (CEAP clinical class C2-C3) will be screened for the study. Patients who fulfil the study criteria and give their informed consent will be scheduled for the procedure and randomized to either study group. Patients will be followed-up at 3 months, 1 year, 3 years, and 5 years. The post-procedure pain score based on a numeric rating scale (NRS) and also the use of analgesics, as well as possible procedure-related complications will be recorded at 3 months. Patient-reported outcome measures (PROMs) will be recorded at 1 year. Data pertaining to the additional treatment of varicose tributaries, the Aberdeen Varicose Vein Questionnaire (AVVQ), the Venous Clinical Severity Score (VCSS), and the health-related quality of life (EQ-5D-5L) will be collected at each follow-up visit. A duplex ultrasound (DUS) examination will be performed at each visit, and data on varicose tributaries and the need for additional treatment will be recorded. TRIAL REGISTRATION: Registered on ClinicalTrials.gov, ID NCT04774939.

Learning goals and content for wound care education in Finnish nursing education - A Delphi study.

BACKGROUND: Caring for patients with wounds requires diverse competences from nursing professionals. However, wound care education in undergraduate nursing education is often fragmented and lacks consistent learning goals and content. OBJECTIVES: To create learning goals and content for wound care education in Bachelor's level nursing education in Finland and to assess the consensus relating to these learning goals and content among wound care experts. DESIGN: A consensus-building approach using the Delphi technique. SETTINGS: A Delphi panel of wound care experts built on an online platform. PARTICIPANTS: The participants of the Delphi panel were registered nurses, authorised wound care nurses, nurse educators and physicians. METHODS: Learning goals and content for wound care education which had been formulated on the basis of previous focus-group interviews were presented to the Delphi panel. The data were collected in 2021 with two online Delphi rounds: 51 panellists participated in the first round and 36 in the second round. The data were analysed using statistical and qualitative analysis. RESULTS: Learning goals and content were divided into four competence areas: 1) Anatomy and physiology, 2) Care of chronic and acute wounds, 3) Wound management and care of a patient with a wound, 4) Values and attitudes. These competence areas comprised 26 learning goals and 29 pieces of content. The consensus between the panellists was high, at >90% in all competence areas. CONCLUSIONS: The basis of registered nurses' wound care competence is built during their undergraduate nursing studies. The results of this study can be used to standardise wound care education by implementing consistent learning goals and content in Bachelor's level nursing education.

A systematic and psychometric review of tests measuring nurses' wound care knowledge.

Wound care is an important realm of nurses' clinical responsibilities, and a broad knowledge and range of skills are needed to perform efficient and safe patient care. Nurses' knowledge on this matter can be measured using knowledge tests. This study aims to identify, define, and analyse the knowledge tests developed for the measurement of nurses' wound care knowledge, and to evaluate the psychometric properties of the tests. This study was a systematic literature review. A total of 52 studies and 18 instruments were found. Of the 18 instruments, only 5 had been used more than once and were successful in a psychometric evaluation. These five instruments were analysed on the basis of their psychometric properties by using Zwakhalen et al.'s (2006) psychometric testing framework. According to the analysis, the Pressure Ulcer Knowledge Test (PUKT) and the Pressure Ulcer Knowledge Assessment Tool (PUKAT) were the most valid and reliable instruments for measuring nurses' wound care knowledge. Most of the instruments identified and analysed focused on pressure ulcers, indicating that future instruments could focus more on other types of wounds or on wound care in general in order to receive a broader understanding of nurses' wound care knowledge.

Congruence between perceived and theoretical knowledge before and after an internet-based continuing education program about venous leg ulcer nursing care.

BACKGROUND: Previous research has revealed nurses' knowledge gaps in venous leg ulcer (VLU) nursing care, and continuing education is needed. The closer nurses' perceived knowledge is to their evidence-based theoretical knowledge, the better possibilities they have to conduct evidence-based VLU nursing care. OBJECTIVES: To assess the congruence between nurses' perceived and theoretical knowledge about VLU nursing care before and after an internet-based education about VLU nursing care (eVLU). DESIGN: Quasi-experimental study with intervention and comparison groups and pre- and post-measurements. SETTING: Home health care in two Finnish municipalities. PARTICIPANTS: Nurses (n = 946) working in home health care were invited to participate. In the intervention group, 239 nurses and 229 nurses in the comparison group met the inclusion criteria, and they were all recruited to the study. METHOD: Nurses were divided into intervention and comparison groups with lottery between the municipalities. Nurses in both groups took care of patients with VLU according to their organizations' instructions. In addition to this, nurses in the intervention group received a 6-week eVLU while those in the comparison group did not. Data were collected with a questionnaire about perceived and theoretical knowledge before education, at six weeks, and at 10 weeks. The percentages of congruence were calculated at every measurement point, and the McNemar test was used to detect statistical significance of changes between measurements. RESULTS: The increase of congruence was more often statistically significant in the intervention group than in the comparison group. CONCLUSION: The results support the hypothesis that the congruence between perceived and theoretical knowledge will be higher among nurses receiving eVLU. Because of the low participation and drop-outs, the results should be interpreted with caution.

Internet-based learning programme to increase nurses' knowledge level about venous leg ulcer care in home health care.

AIMS AND OBJECTIVES: To test the effectiveness of an Internet-based education programme about venous leg ulcer nursing care on perceived and theoretical knowledge levels and attitudes among nurses working in home health care. BACKGROUND: Nurses have been shown to have knowledge gaps in venous leg ulcer nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment. DESIGN: Quasi-experimental study with pre- and postmeasurements and nonequivalent intervention and comparison groups. METHOD: Nurses (n = 946) in home health care in two Finnish municipalities were invited to participate in the study and divided into intervention and comparison groups. The intervention group received education programme about venous leg ulcer nursing care, while the comparison group did not. Data were collected at baseline, at six weeks and at 10 weeks to test the hypotheses: nurses using education programme about venous leg ulcer nursing care will have higher level of knowledge and more positive attitudes than those not using education programme about venous leg ulcer nursing care. An analysis of variance and mixed models with repeated measures were used to test differences in knowledge and attitudes between and within the groups. RESULTS: There were statistically significant increases in knowledge levels in the intervention group from baseline to the first and second follow-up measurements. In the comparison group, the knowledge levels remained unchanged during the study. Attitude levels remained unchanged in both groups. CONCLUSION: Nurses' perceived and theoretical knowledge levels of venous leg ulcer nursing care can be increased with Internet-based education. However, this increase in knowledge levels is short-lived, which emphasises the need for continuous education. RELEVANCE TO CLINICAL PRACTICE: Internet-based education about venous leg ulcer nursing care is recommended for home healthcare nurses. Education programme about venous leg ulcer nursing care provides flexible method for nurses' learning with feasible and cost-effective access to evidence-based education. Education programme about venous leg ulcer nursing care material can be used in all nursing environments where Internet is available.

Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

AIM: To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. BACKGROUND: The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. DESIGN: Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. METHODS: During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. DISCUSSION: Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300.