Moore Zena, Dowsett Caroline, Smith Glenn, Atkin Leanne, Bain Michael, Lahmann Nils A, Schultz Gregory S, Swanson Terry, Vowden Peter, Weir Dot, Zmuda Ann, Jaimes Henry
Professor and Head, School of Nursing and Midwifery. Director, Skin Wounds and Trauma Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.
East London NHS Foundation Trust, London, UK.
J Wound Care. 2019 Mar 3;28(3):154-161. doi: 10.12968/jowc.2019.28.3.154.
Despite the understanding that wounds are a common problem affecting the individual, the health service and society as a whole, there continues to be a lack of a systematic, structured, evidence-based approach to wound management. The TIME principle was first published in 2003, and has since been integrated by many into clinical practice and research. However, this tool has been criticised for its tendency to focus mainly on the wound rather than on the wider issues that the patient is presenting with. At an expert meeting held in London in 2018, this conundrum was addressed and the TIME clinical decision support tool (CDST) was elaborated upon. This article introduces the TIME CDST, explains why it is required and describes how its use is likely to benefit patients, clinicians and health-service organisations. It also explores the framework in detail, and shows why this simple and accessible framework is robust enough to facilitate consistency in the delivery of wound care and better patient outcomes. Finally, it outlines the next steps for the rollout, use and evaluation of the impact of the TIME CDST.
尽管人们认识到伤口是影响个人、医疗服务乃至整个社会的常见问题,但在伤口管理方面,仍然缺乏一种系统、结构化且基于证据的方法。TIME原则于2003年首次发表,此后已被许多人纳入临床实践和研究。然而,该工具因倾向于主要关注伤口本身,而非患者所呈现的更广泛问题而受到批评。在2018年于伦敦举行的一次专家会议上,解决了这一难题,并详细阐述了TIME临床决策支持工具(CDST)。本文介绍了TIME CDST,解释了其必要性,并描述了其使用可能如何使患者、临床医生和医疗服务组织受益。它还详细探讨了该框架,并说明了为何这个简单且易于使用的框架足够强大,能够促进伤口护理提供的一致性并带来更好的患者治疗效果。最后,它概述了TIME CDST推广、使用和评估其影响的后续步骤。