Search

: A deep tissue pressure injury (DTPI) is a serious type of pressure injury that begins in the muscle closest to the bone and may not be visible in its early stages. Its hallmark is rapid deterioration despite the use of appropriate preventive interventions. In 2007, the National Pressure Ulcer Advisory Panel added suspected deep tissue injuries to the traditional classification system, and by 2010 DTPIs had accounted for about 9% of all pressure injuries and were for the first time more prevalent than stage 3 or 4 pressure injuries. On average, patients who develop these injuries are older and have a lower body mass index than patients who develop other pressure injuries. Most commonly, DTPIs appear on the skin over the coccyx or sacrum, the buttocks, and the heels. This article discusses the pathophysiology; risk factors; and assessment, prevention, and treatment of DTPIs, using a composite case to illustrate the progression of this serious type of pressure injury.

With the widespread use of health information technologies, there is a growing need to educate healthcare providers on the use of technological innovations. Appropriate health information technology education is critical to ensure quality documentation, patient privacy, and safe healthcare. One promising strategy for educating clinicians is the use of participatory e-learning based on the principles of Web 2.0. However, there is a lack of literature on the practical applications of this training strategy in clinical settings. In this article, we briefly review the theoretical background and published literature on distance education, or e-learning, of health information technology, focusing on electronic health records. Next, we describe one example of a theoretically grounded interactive educational intervention that was implemented to educate nurses on new elements incorporated into the existing electronic health record system. We discuss organizational factors facilitating nurses' in-service education and provide an example of software designed to create interactive e-learning presentations. We also evaluate the results of our educational project and make suggestions for future applications. In conclusion, we suggest four core principles that should guide the construction and implementation of distant education for healthcare practitioners.