Biomedical subjects
Publications and source records attributed to C Dealey.
There is increasing interest in measuring the prevalence and incidence of pressure sores. These terms are often poorly understood and sometimes used interchangeably, although they refer to different forms of data collection. This article seeks to clarify the differences between them.
This article describes the actions of hydrocolloid dressings and the type of wounds for which they are most suitable. The range of hydrocolloid products is reviewed along with their individual advantages and disadvantages.
This article is the first in a monthly series which will address some of the common problems in wound care. Each article will discuss the nature of the problem and suggest appropriate management strategies.
Clinical guidelines are systematically developed statements to assist health-care professionals in decision-making and should be viewed as a means of improving clinical effectiveness. The NHS Executive wishes to encourage their development and use. To this end it has commissioned a number of clinical guidelines. As these will be used in a number of health-care settings, the need for multiagency and multiprofessional care is recognized. The main themes of the guidelines are that care should be patient focused, clinically useful and multidisciplinary. This article introduces a monthly series in the British Journal of Nursing examining the national clinical guidelines for pressure sore prevention and management.
The final article in this series examining the draft national clinical guidelines for pressure sore prevention and management considers continuous quality improvement. Different professions use different terminologies to describe quality assurance: nurses link it to 'standard setting' whereas the medical profession uses the term 'medical audit'. This article discusses the concepts of quality and audit in relation to pressure sores and their prevention. In particular, it addresses the importance of scientific rigour and multidisciplinary team working and management involvement.
In tissue viability, as in other aspects of health care, there is increasing recognition of the need for healthcare interventions to be supported by good research evidence. The randomized controlled trial (RCT) is considered to provide the most accurate evidence of effectiveness. This article discusses some of the problems that arise when researchers attempt to obtain the relevant evidence. They include funding, sample selection, sample size, recruitment of patients, and mortality and attrition rates. These points are illustrated by means of a case study. In this study an RCT was undertaken to compare two dressings for the management of pressure sores. Problems arose with recruitment of patients to the study. Relevant issues associated with this are discussed and recommendations for future recruitment are presented.
The majority of patients with leg ulceration are cared for in the community. There is insufficient evidence of the numbers of these patients who are being cared for in acute hospitals. This study sought to identify the size of the problem in one acute trust by means of a point prevalence survey. From a study population of 931 patients, 17 had leg ulcers, giving a prevalence of 1.8%. Out of 52 wards and units, staff on 44 (84.6%) said that patients with leg ulcers were admitted on occasion. In the case of 19 (36.5%) wards and units this was as infrequently as one or two patients a year. The results of this survey have considerable implications for ensuring that all patients receive optimum care.
Trusts have to face a number of challenges in the provision of accident and emergency (A&E) services. One suggested way forward is to introduce the emergency nurse practitioner (ENP) role into A&E. However, this is not without controversy. Thus, this review has been undertaken in order to identify and assess any available evidence. A total of nine studies met the inclusion criteria. The studies fell into a number of categories, e.g. overall evaluation of the role, the use of radiography, and patient satisfaction. Several studies monitored transit times though A&E and there was some limited cost-benefit analysis. Overall, there was little difference found between the performance of ENPs in comparison with that of senior house officers (SHOs). The studies available for review are of poor quality, which limits the conclusions that can be made. At best, it would be reasonable to state that there is no evidence to demonstrate that ENPs are better or worse than SHOs in seeing, treating and discharging patients with minor injuries in A&E.
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This article describes a two-year project to develop resources for the improvement of leg ulcer management. It was felt that an audit tool and complementary resources, such as a resource pack and implementation guide, could help practitioners to implement clinical guidelines on leg ulcer management in practice. The audit results from the pilot project are briefly described and discussed in terms of informing future work.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.