Kuhnke Janet L, Keast David, Rosenthal Sue, Evans Robyn Jones
Assistant Professor, Nurse Specialist, Ostomy, Wound and Continence, Cape Breton University, Nursing, Grand Lake Road, Sydney, Canada.
Wound Care Research Leader, Parkwood Institute Research, Parkwood Institute, London, Ontario.
J Wound Care. 2019 Jul 1;28(Sup7):S4-S13. doi: 10.12968/jowc.2019.28.Sup7.S4.
This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes.
A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes.
A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers.
Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.
本研究探讨了卫生专业人员对以患者为中心的伤口管理及结果的障碍和解决方案的看法。
采用定性描述性研究设计。参与者包括伤口护理服务中的医疗保健管理人员、临床负责人、护士和相关卫生人员。在一系列学习研讨会上向参与者发放开放式调查问卷,并对数据进行分析以确定主要主题。
共有261名参与者,回收了194份调查问卷(回复率:74%)。通过分析得出了五个主题:患者/家属伤口相关教育;卫生专业人员伤口相关教育;循证伤口护理的实施以及循证伤口信息在不同专业和环境中的传播;团队合作以及团队内部的尊重沟通;管理人员、负责人和政策制定者通过协作团队对伤口护理给予更高的重视和优先级。
研究结果表明,需要进行持续的全系统教育,以改善四种伤口类型(下肢静脉溃疡、糖尿病足溃疡、压疮和手术伤口)的预防、评估、治疗和管理。卫生专业人员致力于提供伤口护理的最佳实践。参与者认为,有效的以患者为中心的循证伤口护理需要一个有明确任务的医疗保健系统,以确保伤口护理成为优先事项。管理人员和临床负责人对伤口护理的高度重视可以改变现有系统。此外,有效且广泛地传播循证实践信息对于患者取得积极结果至关重要。开展教育并让团队致力于进行一致且尊重的沟通将改善护理服务。