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Pressure injuries are a significant health concern in all clinical settings. The current body of research on pressure injuries reported in the literature presents primarily low level evidence. The purpose of the current study was to identify and prioritize pressure injury research issues. The approach entailed evidence scoping and implementing a formal consensus process using a modified nominal group technique based on the Research and Development/University of California at Los Angeles appropriateness method. Sixteen Australian pressure injury experts participated in five consensus voting rounds in May to June 2015. From 60 initial research issues, the experts reached agreement that 26 issues are a priority for future pressure injury research. The highest priorities were strategies to assess skin and tissues, appropriate outcome measures for indicators of pressure injury healing and recurrence, heel pressure off-loading and shear reduction strategies, economic cost of pressure injuries and their management and effectiveness of skin moisturizers and barrier products. Developing a prioritized research agenda, informed by clinical and academic pressure injury experts, can assist in reducing the burden of pressure injuries by identifying topics of the highest need for further research. A web-based nominal group voting process was successful in engaging expert decision-making and has wide-reaching international appeal in facilitating cost-effective consensus methodologies. The priority list generated from this research is currently used in Australia to inform government investment in pressure injury research.

https://journals.cambridgemedia.com.au/application/files/3616/0498/7140/2302_03.pdf Informit DOI: https://search.informit.org/doi/10.3316/informit.308994692790462

Aim: To identify organisational characteristics and practices that promote or inhibit the recognition of sexuality in the care of older people in health and aged care settings. Background: Sexuality in old age is poorly understood by health professionals and rarely addressed in care planning and delivery. Nurse managers are ideally placed to lead organisations in promoting a culture of acceptance that enables the expression of sexuality. Evaluation: A search for research/expert opinion papers published from January 2004 to February 2017 was undertaken. Two reviewers performed data extraction and appraisal of 34 included studies using Joanna Briggs Institute tools. The primarily qualitative research was analysed to identify 152 findings that were organised into 22 categories and combined into four syntheses. Key issue(s): An organisation's philosophies frame the way older people's sexuality is perceived. Cultivating a culture and environment of acceptance, engagement and knowledge and delivering care in a way that promotes opportunity for safe and private expression of sexuality are key enabling factors. Conclusion(s): Organisations and nurse leaders can support and facilitate older adults��� expression of their sexuality through the review and development of philosophies, policies, procedures, staff attitudes and knowledge and the creation of a conducive environment. Implications for Nursing Management: Nurse managers play a pivotal role in developing a sexuality-positive organisational ethos by ensuring policies, care practices, the environment and amenities are supportive of the expression of sexuality and by role modelling attitudes of respect and inclusivity.

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Background: Relational aspects of primary care are important, but we have no standard measure for assessment. The 'working alliance' incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients. Objective: To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor-patient relationship and discriminant validity with measures of social desirability. Methods: Two rounds of online survey feedback from 55 GPs and 47 patients were used to adapt the WAI-SF - the WAI-GP. The tool was then completed by 142 patients in waiting rooms after seeing their GP and by 16 GPs at the end of their session. Concurrent validity with measures of shared decision-making and patient-doctor depth of relationship was determined using Spearman Rho correlations. Patients also completed two social desirability surveys, and discriminant validity with WAI-GP was assessed. Results: Following feedback, the survey was re-worded to remove phrases that were perceived as judgmental or irrelevant. The patient measure of the WAI-GP was strongly correlated with Dyadic OPTION (rho = 0.705, P = 0.0001) and Patient-Doctor Depth of Relationship scale (rho = 0.591, P = 0.0001) and not with measures of social desirability. Conclusion: The psychometric properties of the WAI-GP support its use for measuring GP-patient alliance. Possibilities for use include assessing the influence of therapeutic alliance on the effectiveness of interventions.

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This article reports on a systematic review of the strategies, practices, and organizational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Research evidence points to the need to address power and control issues, communication, and collaborative approaches to care. Interventions designed to promote family-staff relationships are more likely to achieve maximum benefit when implemented with accompanying information sharing, education, and managerial support.

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The International Wound Infection Institute (IWII) is an organisation of volunteer interdisciplinary health professionals dedicated to advancing and improving practice relating to prevention and control of wound infection. This includes acute wounds (surgical, traumatic and burns) and chronic wounds of all types, although principally chronic wounds of venous, arterial, diabetic and pressure aetiologies.\ud Wound infection is a common complication of wounds. It leads to delays in wound healing and increases the risk of loss of limb and life. Implementation of effective strategies to prevent, diagnose and manage, is important in reducing mortality and morbidity rates associated with wound infection.\ud This second edition of Wound Infection in Clinical Practice is an update of the first edition published in 2008 by the World Union of Wound Healing Societies (WUWHS). The original document was authored by leading experts in wound management and endorsed by the WUWHS. The intent of this edition is to provide a practical, updated resource that is easy-to-use and understand.\ud For this edition, the IWII collaborative team has undertaken a comprehensive review of contemporary literature, including systematic reviews and meta-analyses when available.\ud In addition, the team conducted a formal Delphi process to reach consensus on wound infection issues for which scientific research is minimal or lacking. This rigorous process provides an update on the science and expert opinion regarding prevention, diagnosis and control of wound infection. This edition outlines new definitions relevant to wound infection, presents new paradigms and advancements in the management and diagnosis of a wound infection, and highlights controversial areas of discussion.

Aviso de responsabilidade: Este guia de consulta rápida foi desenvolvido pelo National Pressure Ulcer Advisory Panel, pelo European Pressure Ulcer Advisory Panel e pela Pan Pacific Pressure Injury Alliance. Apresenta uma análise e avaliação abrangentes da melhor evidência disponível no momento da pesquisa da literatura relacionada com avaliação, diagnóstico, prevenção e tratamento das úlceras por pressão. As presentes recomendações apresentam orientações gerais para uma prática clínica adequada e devem ser implementadas por profissionais de saúde qualificados e sujeitas ao seu juízo clínico de cada situação tendo em conta as preferências individuais de cada doente e os recursos disponíveis. O guia deve ser implementado de forma culturalmente consciente e respeitosa de acordo com os princípios de proteção, participação e parceria. Prefácio: Este Guia de Consulta Rápida sumariza as recomendações e os excertos da evidência disponível sobre a prevenção e o tratamento das úlceras por pressão. A versão mais abrangente, Diretrizes da Prática Clínica, fornece uma análise detalhada e discussão da investigação existente, uma avaliação crítica dos pressupostos e conhecimentos da área e uma descrição da metodologia utilizada no desenvolvimento das diretrizes. Este Guia de Consulta Rápida destina-se a profissionais de saúde ocupados que necessitam de efetuar uma consulta rápida para prestarem cuidados em ambientes clínicos. Os utilizadores não devem usar excertos do Guia de Consulta Rápida de forma isolada. A primeira edição deste Guia foi desenvolvida ao longo de quatro anos de colaboração entre o National Pressure Ulcer Advisory Panel (NPUAP) e o European Pressure Ulcer Advisory Panel (EPUAP). Nesta segunda edição do Guia, a Pan Pacific Pressure Injury Alliance (PPPIA) juntou-se ao NPUAP e ao EPUAP. O objetivo desta colaboração internacional foi o de desenvolver recomendações baseadas em evidência para a prevenção e tratamento das úlceras por pressão que possam ser usadas por profissionais de saúde em todo o mundo. Foi utilizada uma metodologia científica específica para identificar e avaliar de forma crítica a investigação disponível. Na ausência de evidência definitiva, recorreu-se à opinião de peritos (muitas vezes fundamentada em evidência indireta e outras diretrizes) com vista à formulação de recomendações. As versões preliminares das recomendações e a evidência disponível foram disponibilizadas a 986 stakeholders convidados (pessoas individuais e organizações) em todo o mundo. A versão final do Guia baseia-se na investigação existente e na sabedoria acumulada do NPUAP, do EPUAP, da PPPIA e de parceiros internacionais. Nesta edição do Guia, a força de cada recomendação foi avaliada através de um processo de votação consensual (GRADE). A força da recomendação identifica a importância da recomendação com base no respetivo potencial para melhorar os resultados dos doentes. Indica também ao profissional de saúde o grau de confiança que poderá ter na recomendação para saber se esta será mais benéfica do que prejudicial. Pode ainda ser utilizada para auxiliar na priorização de intervenções relacionadas com úlceras por pressão. info:eu-repo/semantics/publishedVersion