Conectar
There are estimated to be 3.4 million patients in the UK living after a diagnosis of cancer. We know very little about their quality of life or healthcare usage. Patient-reported outcome measures (PROMs) are tools which help to translate a patient’s quality of life into measurable categories, but how to do this at scale remains underexplored. The study employs a randomised design to assess different engagement strategies for optimising participation, data linkage and questionnaire completion in Northwest London and then nationally, with appropriate research approvals.
We have designed and implemented an online, patient-completed, randomised observational trial. We will pilot it in Northwest London before national roll-out, using initially the General Practice (GP) record of a cancer diagnosis and then exploring the use of social media. The primary objective is to explore the feasibility of recruiting participants via self-identification or contact from the primary care research network and obtaining consent to link participants’ PROMs responses to their cancer registry records. Data collection occurs through a secure platform, with participants directly responsible for data entry. There is no formal target sample size because this is a feasibility study, and we want to explore how many patients we can recruit. Analyses will be conducted using descriptive statistics, repeated measures multilevel modelling and machine learning techniques. If a substantial difference in responses between randomisation arms is detected, ineffective strategies will be removed. If no clear difference is observed, recruitment will continue with periodic reviews based on response rates and data completeness.
The Study Coordination Centre has obtained approval from the London—Surrey Research Ethics Committee and Health Research Authority. We will publish and disseminate the results in local, national and international meetings, in peer-reviewed journals, on social media and on websites.
It has been registered under ‘Investigating Digital Outcomes for Cancer Survivors in the Community’ (NCT06095024).
NCT06095024: Investigating Digital Outcomes for Cancer Survivors in the Community.
To describe the development and implementation of evidence-based teaching strategies for assessing and classifying pressure injuries in older nursing home individuals ≥ 60 years old with darker skin tones.
Pressure injury assessment learning interventions based on pre- and post-test assessments.
The learning interventions were developed by experts in pressure injury education and were based on empirical evidence, international clinical practice guidelines, and underpinned by social constructivism theory and the integrated interactive teaching model. The teaching strategy was developed to educate research assistants in the assessment of pressure injuries in darker skin tone individuals. The content included requisite knowledge and skills for pressure injury assessment and classification in darker skinned individuals. Using evidence-based teaching strategies, the content was delivered through face-to-face lectures, small group discussions, and practical application sessions delivered using classroom and practical-based activities. Photographic images were used to assess their knowledge and skills in classifying pressure injuries. Four Bachelor of Nursing-qualified registered nurses in Sri Lanka were recruited as research assistants using the new education resource. Using scores from 1 to 20 points, mastery of the theory and practice components was assessed.
The mean pre-test score was 9 ± 1.6 (95% confidence interval 6.4–11.6), demonstrating that assessment and classification of pressure injury knowledge were lacking. The mean post-test score was 16 ± 0.8 (95% confidence interval 14.7–17.3) indicating an improvement in the participants' ability to assess and staging pressure injuries.
Early pressure injury detection among older individuals with darker skin tones is challenging. This evidence-based teaching approach can be used to educate clinical nurses and research assistants in assessing pressure injuries in individuals with darker skin tones.
This study contributes to the body of knowledge by improving the early detection and accurate classification of pressure injuries in older nursing home residents with darker skin tones, addressing a significant gap in current nursing practice.
To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes.
Pressure injury prevalence and incidence are indicators of safety and quality of care. A significant portion of the global population has a skin color dominated by the presence of melanin. Yet, the number of nursing home residents with darker skin tones who develop pressure injuries in nursing homes is relatively unknown.
Prospective multisite cohort study conducted in nine nursing homes in Sri Lanka. The sample comprised 210 residents aged ≥60 years old.
Semi structured observations and chart audits were used to gather data from July to October 2023. Head-to-toe visual skin assessment to check for nursing home- acquired pressure injuries, Braden pressure injury risk scale and Fitzpatrick skin tone assessments were conducted on all recruited residents at baseline. All recruited residents were followed-up weekly for 12 weeks until detection of a new pressure injury, death, discharge, or transfer.
Pressure injury point prevalence at baseline was 8.1% (17/210). Cumulative incidence was 17.1% (36/210). Incidence density was 15.8 per 1000 resident weeks. Most nursing home-acquired pressure injuries were located on the ankle at baseline (29.4%; 5/17) and in the follow-up period (27.8%; 10/36). Stage I pressure injuries were most common: 58.8% (10/17) and 44.4% (16/36) at baseline and during follow-up respectively.
About one in six nursing home residents developed a new pressure injury over the 12-week follow-up period. Despite staff and resource constraints, there remains a need to focus on the prevention of pressure injuries in Sri Lankan nursing homes.
Studies on the burden of pressure injuries among darker skin tone nursing home residents are lacking and the current evidence available are predominantly from Western countries. The findings of this study highlight the need of targeted preventive measures for nursing home residents with darker skin tones.
To present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients.
A systematic review and meta-analysis.
This study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources.
The studies were meta-analysed using JAMOVI 1.6.15 software. A random-effects model was used to identify the global prevalence of adverse events, confidence intervals and the heterogeneity data. Risk of bias was assessed using the Joanna Briggs Institute tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Of the 7904 studies identified, 169 were included for full reading, and 10 were included in the review. The most prevalent adverse events were pressure injuries (59%), haemodynamic instability (23%), death (17%) and device loss or traction (9%).
The most prevalent adverse events in mechanically ventilated pronated patients with COVID-19 are pressure injuries, presence of haemodynamic instability, death and device loss or traction.
The evidence identified in this review can help improve the quality and safety of patient care by helping to design care protocols to avoid the development of adverse events that can cause permanent sequelae in these patients.
This systematic review addressed the adverse events related to prone position in intubated adult COVID-19 patients. We identified that the most prevalent adverse events in these patients were pressure injuries, haemodynamic instability, device loss or traction and death. The results of this review may influence the clinical practice of nurses who work in intensive care units and, consequently, the nursing care provided not only to COVID-19 patients but for all intubated patients due to other reasons in intensive care units.
This systematic review adhered to the PRISMA reporting guideline.
As this is a systematic review, we analysed data from primary studies conducted by many researchers. Thus, there was no patient or public contribution in this review.
FreshRSS 