Provincial Council for Maternal and Child Health, Toronto, Canada.
The Regional Municipality of York, Toronto, Canada.
Int Wound J. 2018 Aug;15(4):580-589. doi: 10.1111/iwj.12901. Epub 2018 Mar 30.
Optimal pressure injury (ulcer) management by the inter-professional team requires appropriate health care system and organisational resources, infrastructure, and policies. A systematic review was conducted on pressure injury care-related education and health care system-/organisation-level strategies. A search for relevant articles published between January 2006 and October 2014 was applied to 8 databases. Ultimately, 22 articles pertaining to education and training and 12 articles pertaining to health care system and organisation supports for pressure injury care were included in the systematic review. A lack of pressure injury assessment and management knowledge by health care professionals was an overriding theme in the education literature. Some of the methods preferred for pressure injury education among nurses and physicians included information technology (eg, e-learning) with technology support and the use of high-quality wound pictures. Although the evidence is scarce, the literature did highlight specific system- and organisation-level barriers and enablers that influence practice change, including inter-professional communication and human resource investments. In conclusion, (1) the current evidence on the education and system-level enablers, barriers, and strategies to optimise pressure injury best practices requires further investigation, and (2) multi-faceted, up-stream, evidence-based approaches for pressure injury care are essential to improve health care and patient-related outcomes.
多专业团队进行最佳压力性损伤(溃疡)管理需要适当的医疗保健系统和组织资源、基础设施和政策。对压力性损伤护理相关教育和医疗保健系统/组织层面策略进行了系统评价。在 8 个数据库中搜索了 2006 年 1 月至 2014 年 10 月发表的相关文章。最终,系统评价纳入了 22 篇关于教育和培训的文章和 12 篇关于压力性损伤护理的医疗保健系统和组织支持的文章。医疗保健专业人员缺乏压力性损伤评估和管理知识是教育文献中的一个主要主题。一些护士和医生喜欢的压力性损伤教育方法包括信息技术(如电子学习)和技术支持以及使用高质量的伤口图片。尽管证据很少,但文献确实强调了影响实践改变的具体系统和组织层面的障碍和促进因素,包括跨专业沟通和人力资源投资。总之,(1)目前关于优化压力性损伤最佳实践的教育和系统层面促进因素、障碍和策略的证据需要进一步研究,(2)多方面、上游、基于证据的压力性损伤护理方法对于改善医疗保健和患者相关结果至关重要。