Diabetes is a condition that can lead to foot ulcers that often progress to amputation of a limb. Providing patients with education about foot care is crucial because it can help to prevent or minimize the incidence of foot ulcer development and amputation of a limb. Foot care education as a strategy not only empowers patients with proper foot care knowledge and skill to support and motivate self-care but can also enhance the partnership between the provider and patient. The purpose of this quality improvement project was the implementation of a sustainable evidence-based foot care program for adult patients with diabetes as a routine organizational protocol for quality improvement in diabetic care in a primary care clinic. The question for this project was: How does the implementation of an evidence-based diabetic foot care protocol impact the health outcomes of diabetic patients in a primary care clinic? Orem’s self-care deficit nursing theory and the logic model for evidence-based practice were used to guide this DNP project. The research method for the quality improvement project was a review of the literature. The participants were staff and adults with diabetes at the primary care clinic. The results of the chart review showed that 80% of the charts included documented foot assessments and patient education, which was an improvement when compared to 40% pre-implementation of the foot care program. The program has improved the foot health knowledge and skills of clinicians and people with diabetes and has also helped to reduce the burden of healthcare costs related to the lower incidence of hospitalization for the treatment of wounds and amputation associated with complications of diabetes.

Background: Wounds have existed at all times and have always been feared because of the risk of infection leading to prolonged bed rest, and risk of complications such as amputation and even in some cases death. Pressure ulcers are included in the group of secondary healing wounds, which means that they heal from the inside only after that the wound is filled by granulation tissue. As a nurse one of the main work assignments is to promote health and care by showing professional liability to meet the patient's needs. In this study, the focus will be to describe the challenges for nurses in Tanzania in preventing and early detection of pressure ulcers. Aim: To describe the challenges for nurses in Tanzania in preventing and early detection of pressure ulcers Method: A descriptive qualitative design was chosen for this study as the aim was to explore nurses’ experiences of preventing and early detection of pressure ulcers. A qualitative design is most suitable when the researcher seeks to understand the phenomenon under study. Results: There were indeed challenges for the nurses in preventing and early detect pressure ulcers. The findings could be divided into three sub-themes: a) Structural challenges and varying educational level among health care personnel, b) Insufficient resources – challenges and strategies, and c) Patients unable to pay for health care Discussion: The discussion addressed that education is one of the main strategies for preventing pressure ulcers and is not always a financial issue. Understaffed wards and patients that are not able to pay for healthcare are factors that are ongoing issues at a hospital financed by the government. It also addresses the frustration some nurses expressed towards the problem and often felt helpless concerning patients health.

This investigation attempted to determine the relationship of the site of contact ulcers and subject’s handedness. Literature concerned with contact ulcers has indicated that cerebral dominance tends to determine the site of the lesion. Four research questions were posed, two questions were presented in the form of the null hypothesis. The questions were: (1) Is the proportion of right-handed subjects with left-sided ulcers equal to the proportion of left-handed subjects with left-sided ulcers? (2) Is the proportion of right-handed subjects with right-sided ulcers equal to the proportion of left-handed subjects with right-sided ulcers? (3) Will the site of contact ulcers be able to be predicted from subject’s handedness? And (4) Is there a significant relationship between the factors of age, sex and occupation of the sample studied and the occurrence of contact ulcers?

No description available.

Trycksår är en komplikation hos patienter med höftfraktur som ofta tillskrivs sängläge men som kan uppstå vid olika långvariga inaktivitet och belastningstillstånd. Syftet med denna litteraturstudie var att undersöka eventuellt sambandet mellan nutrition och förebyggandet av trycksår hos patienter över 65 år med genomgången höftfraktur. En systematisk databassökning har skett i Pubmed och Cinahl. Denna studie genomfördes för att söka relevanta vetenskapliga artiklar och sju artiklar selekterades. Författarna fann att olika näringsämnen framförallt serumalbumin, arginin, zink, vitamin C kan påverka sårläkningsprocessen. Det visade att lågt serumalbumin och arginin kan leda till viktminskning, detta är en viktig riskfaktor som kan öka komplikationer hos äldre patienter. Serumalbumins betydelse hos patienter med trycksår är viktigt. / Pressure ulcers are a complication in patients with hip fracture often attributed to bed rest, but that can arise in various long-standing idle and load conditions. The purpose of this study was to investigate the possible relationship between nutrition and the prevention of pressure ulcers in patients over 65 with a hip fracture. A systematic database search has taken place in Pubmed and Cinahl. This study was conducted to find relevant scientific papers and seven articles were selected. The authors found that certain nutrients, particularly serum albumin, arginine, zinc, vitamin C can affect the wound healing process. It showed that low serum albumin and arginine are can lead to weight loss, this is an important risk factor that may increase complications in elderly patients. Serumalbumins significance in patients with pressure ulcers is important.

Perifer vaskulär insufficiens innebär arteriell och/eller venös cirkulationssvikt i nedre extremiteter, vilket kan förorsaka bensår. Vaskulär insufficiens i benen är ett ökande hälsoproblem som ofta är ett mycket smärtsamt tillstånd och kan ha stora konsekvenser för den drabbade i dennes dagliga liv. Litteraturöversikt valdes som metod för att besvara syftet; att beskriva forskning om patienters upplevelser av hur perifer vaskulär insufficiens i de nedre extremiteterna påverkar det dagliga livet. Detta utifrån Carnevalis omvårdnadsteori om dagligt liv funktionellt hälsotillstånd. Stora inskränkningar i dagligt liv på grund av sjukdomen identifierades i litteraturen. Smärtan spelade en central roll i flertalet begränsningar respondenterna mötte. Den sänkte deras mobilitet, vilket medförde social isolering och begränsningar i vardagliga aktiviteter och förändrad självbild. Smärtan orsakade även sömnrubbningar och förändrade sinnesstämningar. Flera respondenter upplevde rädslor, de med arteriell insufficiens för amputation och för tidig död, och de med venös insufficiens för situationer som kunde medföra nya sår. Ett annat återkommande fynd var brist på kunskap, smärtlindring och brister i relationen med vårdpersonal. / Peripheral vascular insufficiency entails arterial and / or venous circulatory failure in the lower extremities, which can cause ulcers. Vascular insufficiency in the legs is an increasing health problem which often is a very painful condition and can have a major impact on the patient's daily life. Literature review was chosen as a method to answer the study aim; to describe research on patients' experiences of peripheral vascular insufficiency in the lower limbs and how it affects everyday life. This according to Carnevali’s theory on daily life functional health status. Major limitations in daily life because of the disease were identified in the literature. The pain was a central part of the restrictions all respondents met. It lowered mobility, leading to social isolation, limitations in activities in daily life and change in self-image. The pain also caused sleep disorders and altered moods. Several respondents experienced fears, those with arterial insufficiency of amputation and premature death, and those with venous insufficiency of situations that could cause new ulcers. Another frequent finding was a lack of knowledge, pain relief and trustful relationships with health professionals.

No description available.

No description available.

Bakgrund: Tidigare forskning visar att patienter med trycksår har olika upplevelser av att leva med trycksår, vårdas med trycksår och faktorer som påverkar patienters delaktighet i det förebyggande och vårdandet av trycksår. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att vårda patienter med trycksår. Metod: En allmän litteraturöversikt där åtta kvalitativa artiklar och fyra kvantitativa artiklar analyserades. Resultat: I resultatet framkom det att sjuksköterskor upplevde brist på resurser, hög arbetsbelastning och tidsbrist som verkar som ett hinder i vårdandet av patienter med trycksår. Bristande kompetens var även befintlig bland sjuksköterskor och patienter vilket även påvisades som ett hinder i vårdandet. Bristande samarbete bland sjuksköterskor och patienter resulterade i en bristfällig följsamhet hos en del patienter vilket även påverkade vårdandet av patienter negativt. Slutligen påvisades även en emotionell påverkan hos en del sjuksköterskor i vårdandet av patienter med trycksår. Slutsats: Det framkom att sjuksköterskor upplevde flertal hinder i vårdandet av patienter med trycksår, i och med detta bör riktlinjer, arbetsförhållanden och utbildning kring vården relaterad till trycksår ses över för att möta dessa hinder och säkerställa en mer patientsäker vård. / Background: Previous research shows that patients with pressure ulcers have different experiences of living with pressure ulcers, being cared for with pressure ulcers and factors that affect patients' participation in the prevention and care of pressure ulcers. Aim: The aim of this study is to describe nurses’ experiences with caring for patients with pressure ulcers. Method: A general literature review where eight qualitative articles and four quantitative articles were analyzed. Results: The results showed that nurses experience a high workload and a lack of time and resources that acts as an obstacle in the care of patients with pressure ulcers. A lack of competence and knowledge was also existing among nurses and patients, which was also shown as an obstacle in caring of patients with pressure ulcers. Lack of cooperation among nurses and patients resulted in a lack of adherence among some patients, which also negatively affected the care of the patients. Finally, an emotional impact was also demonstrated by some nurses in the care of patients with pressure ulcers. Conclusions: It transpired that nurses experience several obstacles in the care of patients with pressure ulcers and as a result, guidelines, working conditions and education regarding pressure ulcer care should be reviewed to meet these obstacles and ensure more patient-safe care.

Bakgrund: Trycksår definieras som ett sår orsakat av ett konstant tryck mot hudytan och som resulterar i skada av hud och underliggande vävnad. Sjuksköterskors kunskap om förebyggande faktorer är av vikt för att kunna utföra riskbedömningar och förebygga uppkomsten av trycksår. Syfte: Syftet var att beskriva sjuksköterskors omvårdnadsåtgärder som förebygger uppkomsten av trycksår. Metod: Studien gjordes som en allmän litteraturstudie med två kvantitativa och sex kvalitativa vetenskapliga artiklar som granskades med en innehållsanalys. Resultat: Innehållsanalysen frambringande sex olika teman: Kunskap och kontinuerlig utbildning, riskbedömning av patient, mobilisering och positionering av patient, resurser och tillgänglig utrustning, kommunikation och samarbete i team, patient och anhörigbildning. Konklusion: Sjuksköterskor behöver kontinuerligt utveckla sin kompetens inom evidensbaserade trycksårsförebyggande omvårdnadsåtgärder för att kunna vara steget före i vården i allmänhet. Det krävs ett multidisciplinärt och tvärprofessionellt samarbete tillsammans med tydlig kommunikation samt patient och anhörigutbildning för att tillhandahålla en god trycksårsförebyggande omvårdnad av hög kvalitet. / Background: A pressure ulcer is defined as a wound caused by constant pressure against the skin's surface and resulting in damage to the skin and underlying tissue. Nurses' knowledge of preventive factors is of importance to be able to carry out risk assessments and prevent the occurrence of pressure ulcers. Purpose: The purpose was to describe nurses' nursing measures that prevent the occurrence of pressure ulcers. Method: The study was conducted as a general literature study with two quantitative and six qualitative scientific articles that were reviewed with a content analysis. Results: The content analysis produced six different themes: Knowledge and continuous education, patient risk assessment, patient mobilization and positioning, resources and available equipment, communication and collaboration in teams, patient and family education. Conclusion: Nurses needs to continuously develop competence in evidence-based pressure ulcer prevention nursing measures in order to be one step ahead in care in general. A multidisciplinary and interprofessional collaboration together with clear communication and patient and relative education is required to provide good pressure ulcer prevention care of high quality.