Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study
- Authors: Barker, Anna , Kamar, Jeannette , Tyndall, Tamara , White, Lyn , Hutchinson, Anastasia , Klopfer, Nicole , Weller, Carolina
- Date: 2012
- Type: Text , Journal article
- Relation: International Wound Journal Vol. 10, no. 3 (June 2012), p. 313-320
- Full Text: false
- Reviewed:
- Description: Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12 center dot 6% (2 years preprogramme implementation) to 2 center dot 6% (6 years postprogramme implementation) (P < 0 center dot 001). Audits between 2003 and 2011 of 4368 patient medical records identified compliance with pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital.
Recommendations for the prevention of deaths among nursing home residents with unexplained absences
- Authors: Woolford, Marta , Bugeja, Lyndal , Weller, Carolina , Boag, Jane , Willoughby, Melissa , Ibrahim, Joseph
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Older People Nursing Vol. 14, no. 3 (2019), p.
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- Description: Objectives: Unexplained absences (UAs) contribute to the mortality and morbidity rates in the nursing home (NH) population. Valuing expert professional knowledge and skills is central to the achievement of improved care in NHs. This study developed and prioritised recommendations to prevent deaths of NH residents (NHRs) with UAs. Methods: Two expert consultation forums using the modified nominal group technique to develop recommendations were conducted, followed by an online survey to prioritise the most important recommendations for implementation. A framework applying the temporal dimension (“pre-event,” “event” and “post-event”) of an internationally accepted injury prevention framework, Haddon's Matrix, was applied to the recommendations. Participants were purposively sampled and identified via aged care organisations; and were selected based on their experience in aged care practice, policy, research, elder rights, seniors' law, or missing persons search and rescue (SAR). Results: Forum one comprised six, and forum two comprised nine experts from mixed disciplines. Seven participants completed the online survey. Twenty recommendations to prevent future injury and death were developed, five of which were prioritised for implementation in the aged care sector. In order of priority, these include: universal UA definition; mandated SAR plan, early assessment of NHRs; unmet needs behavioural assessments; and participation in decision-making. Conclusions: The recommendations cover the broad spectrum of complex issues raised in managing unexplained absences, and are a vital first step towards informing care providers, governments and SAR teams about how to prevent injury and death of NHRs in residents with UAs. Future research should explore how to translate and evaluate the recommendations into practice. © 2019 John Wiley & Sons Ltd
Maternal mental health and partner-delivered massage : a pilot study
- Authors: Hall, Helen , Munk, Niki , Carr, Bethany , Fogarty, Sarah , Cant, Robyn , Holton, Sara , Weller, Carolina , Lauche, Romy
- Date: 2021
- Type: Text , Journal article
- Relation: Women and Birth Vol. 34, no. 3 (2021), p. e237-e247
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- Description: Background: Anxiety and depression affects many pregnant women. Massage may be beneficial for supporting mental wellbeing during this time. The aim of this study was to assess the feasibility and acceptability of a partner-delivered relaxation massage program for pregnant women, and its impact on symptoms of antenatal anxiety, stress and depression. Methods: A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with self-directed stress management (control). Women attended an initial workshop at 28–32 weeks gestation followed by completion of a self-directed massage or stress management program. Qualitative data about the feasibility and acceptability (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Birth outcomes were collected at the post- birth interview. Results: A total of 14 women/partner dyads in the massage group and 13 women in the self-directed stress management group, attended the initial workshops. When interviewed, participants from both groups reported that the programs were feasible and acceptable. Women's mean scores on all subscales of the DASS-21significantly decreased over time in both the intervention and the control group. Conclusion: Pregnant women found the partner-delivered massage program to be feasible and acceptable. Both programs decreased women's symptoms of anxiety, depression and stress with no significant differences identified between the two groups. An adequately powered experimental study with a large representative sample is needed to determine whether partner-delivered relaxation massage reduces pregnant women's symptoms of anxiety, depression and stress. © 2020 Australian College of Midwives
The effectiveness of massage for reducing pregnant women's anxiety and depression; systematic review and meta-analysis
- Authors: Hall, Helen , Cant, Robyn , Munk, Niki , Carr, Bethany , Tremayne, Anne , Weller, Carolina , Fogarty, Sarah , Lauche, Romy
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Midwifery Vol. 90, no. (2020), p.
- Full Text: false
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- Description: Objective: To critically appraise and synthesize the best available evidence on the effectiveness of massage to reduce antenatal women's anxiety and/ or depression. Design: Systematic review with meta-analysis Participants, interventions: Pregnant women over the age of 18 years who receive massage interventions. Measurements and findings: Eight studies were included in the review; seven were randomized controlled trials. Data were collected via pregnant women's self-reported ratings of anxiety or depression using validated tools. Meta-analysis of four studies revealed a moderate effect of massage therapy on women's depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (MD = -5.95, 95%CI = -8.11 to -3.80, I2 = 0%) compared with usual care. A moderate effect of massage interventions on women's anxiety were also found based on five studies using various measures (SMD = -0.59, 95%CI = -1.06 to -0.12, I2 = 75%) when compared with usual care. However, none of the trials had a low risk of bias. Key conclusions: Non-pharmacologic treatments for mental health symptoms are an important option for women to use during pregnancy. As shown in meta-analysed data, massage therapy might be more effective in reducing pregnant women's anxiety and depression than usual care, although the current results may be prone to bias. Further high-quality research is required to fully evaluate the impact of massage therapy on pregnant women's mental health symptoms in the immediate and also longer term. Implications for practice: Massage therapy may be an acceptable and feasible approach for pregnant women to employ to reduce their anxiety and depressive symptoms. More research evidence examining the safety and effectiveness of massage is required before practice recommendations can be made. © 2020 Elsevier Ltd