School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, QC, Canada.
Int Wound J. 2024 Oct;21(10):e70064. doi: 10.1111/iwj.70064.
Chronic wounds are a growing concern due to aging populations, sedentary lifestyles and increasing rates of obesity and chronic diseases. The impact of such wounds is felt worldwide, posing a considerable clinical, environmental and socioeconomic challenge and impacting the quality of life. The increasing complexity of care requires a holistic approach, along with extensive knowledge and skills. The challenge experienced by health-care professionals is particularly significant for newly graduate nurses, who face a gap between theory and practice. Digital tools, such as mobile applications, can support wound care by facilitating more precise assessments, early treatment, complication prevention and better outcomes. They also aid in clinical decision-making and improve healthcare delivery in remote areas. Several mobile applications have emerged to enhance wound care. However, there are no applications dedicated to newly graduate nurses. The aim of this study was to co-create and evaluate an algorithm for the development of a wound care mobile application supporting clinical decisions for new graduate nurses. The development of this mobile application is envisioned to improve knowledge application and facilitate evidence-based practice. This study is part of a multiphase project that adopted a pragmatic epistemological approach, using the 'Knowledge-to-Action' conceptual model and Duchscher's Stages of Transition Theory. Following a scoping review, an expert consensus, and stakeholder meetings, this study was pursued through a sequential exploratory mixed methods design carried out in two phases. In the initial phase, 21 participants engaged in semi-structured focus groups to explore their needs regarding clinical decision support in wound care, explore their perceptions of the future mobile application's content and identify and categorize essential components. Through descriptive analysis, five overarching themes emerged, serving as guiding principles for conceptual data model development and refinement. These findings confirmed the significance of integrating a comprehensive glossary complemented by photos, ensuring compatibility between the mobile application and existing documentation systems, and providing quick access to information to avoid burdening work routines. Subsequently, the algorithm was created from the qualitative data collected. The second phase involved presenting an online SurveyMonkey® questionnaire to 34 participants who were not part of the initial phase to quantitatively measure the usability of this algorithm among future users. This phase revealed very positive feedback regarding the usability [score of 6.33 (±0.19) on a scale of 1-7], which reinforces its quality. The technology maturation process can now continue with the development of a prototype and subsequent validation in a laboratory setting.
慢性伤口是一个日益严重的问题,原因是人口老龄化、久坐不动的生活方式以及肥胖症和慢性病发病率的上升。这些伤口的影响在全球范围内都能感受到,给生活质量带来了相当大的临床、环境和社会经济挑战。由于护理的复杂性不断增加,因此需要采取整体方法,同时还需要广泛的知识和技能。这对新毕业的护士来说是一个特别大的挑战,他们面临着理论与实践之间的差距。移动应用等数字工具可以通过促进更精确的评估、早期治疗、预防并发症和更好的结果来支持伤口护理。它们还有助于临床决策,并改善偏远地区的医疗服务提供。已经出现了几种移动应用来增强伤口护理。然而,针对新毕业护士的应用程序还没有。本研究的目的是共同创建和评估一种算法,以开发一种支持新毕业护士临床决策的伤口护理移动应用程序。开发这种移动应用程序旨在提高知识应用并促进循证实践。这项研究是一个多阶段项目的一部分,该项目采用实用的认识论方法,使用“知识到行动”概念模型和 Duchscher 的过渡理论阶段。在进行范围审查、专家共识和利益相关者会议之后,本研究通过在两个阶段中进行顺序探索性混合方法设计来进行。在第一阶段,21 名参与者参加了半结构化焦点小组讨论,以探讨他们在伤口护理临床决策支持方面的需求,探讨他们对未来移动应用程序内容的看法,并确定和分类必要的组件。通过描述性分析,出现了五个总体主题,这些主题为概念数据模型的开发和完善提供了指导原则。这些发现证实了整合全面词汇表并辅以照片的重要性,确保移动应用程序与现有文档系统的兼容性,并提供快速访问信息以避免工作流程负担。随后,从收集的定性数据中创建了算法。第二阶段向不属于初始阶段的 34 名参与者在线发布了 SurveyMonkey®问卷,以定量衡量未来用户对该算法的可用性。这一阶段的反馈非常积极[在 1-7 的范围内评分为 6.33(±0.19)],这增强了其质量。现在可以继续进行技术成熟过程,开发原型并在实验室环境中进行验证。