This article, the first of two, summarises a study that explored the lived experiences of patients with leg ulcers and the impact of this condition on their quality of life. The study had four study phases; phases 1 and 2 employed qualitative methods and are reported here. Initially, unstructured interviews were held; these revealed significant issues for the patients including the dominance of pain, issues relating to exudate and odour, social isolation and psychological effects.
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Identifying wound infection can be challenging for clinicians, particularly in the chronic wound where infection may not always present itself as it does in acute wounds. The management of infected wounds can be complicated. Managing multiple symptoms and recognising these as being due to infection is not always straightforward and relies on the practitioner's knowledge and skills.
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Open access. Pressure injuries are problematic to health systems throughout the world, significantly harming over 7 million patients and adding extraordinary costs. The USA, for instance, experiences more than 2.5 million pressure injury cases per year which cause over 60 000 deaths—that is more than car accident fatalities in the USA—and cost the health system at least $9–$11 billion.1 The UK is no less affected by 700 000 cases per year that result in 27 000 deaths and cost the National Health Service (NHS) an estimated £1.4–£2.1 billion.2
Malnutrition and dehydration are risk factors for the development of pressure ulcers. This paper takes the advice of some dietitians and nutrition specialist nurses to identify their five top tips for eating well and drinking well to keep skin well.
Nutrition and hydration play a key role in keeping the skin healthy. The National Institute of Health and Care Excellence recognises deficiencies in diet as a risk for developing pressure ulcers and international guidance recommends using a nutritional screening tool to assess risk of malnutrition and other risk factors.
This guidance from the Chief Social Worker helps practitioners and managers across health and care organisations to provide caring and quick responses to people at risk of developing pressure ulcers.
It also offers a process for the clinical management of harm removal and reduction where ulcers occur, considering if an adult safeguarding response is necessary.
Emma Marsh organised a series of special events for 'Stop the pressure' week, an awareness campaign held in October 2017. Staff from the tissue viability team visited wards during the week to teach staff about how to protect patients from pressure ulcers and launch the '5 Moments for Pressure Ulcer Prevention' campaign. All of this was done on top of Emma's day job as a Tissue Viability Nurse.
Dextranomer and tripeptide copper gel seem to be the most effective topical agents for healing pressure ulcers; collagenase ointment also ranks highly. Researchers have not assessed the adverse event profiles of these interventions.
74 percent of our patients have reported benefitting from a new wound dressing project that now sees our nurses providing the dressings for wounds, rather than patients receiving them as prescriptions.
To the unfamiliar, it might not be obvious what the benefits of such an initiative might be, but according to Luxmi Mohamud, Clinical Service Lead Tissue Viability at our Trust, there’s now better wound outcomes for patients, and fewer wasted patient visits due to staff not having the appropriate dressings.
In this article, the vulnerability of the soft tissues of the heel to pressure ulcers (injuries) is explained from a biomechanical engineering perspective, and emerging technologies for protecting the heel, particularly low-friction garments, are reviewed.
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Prevention of pressure ulcers (PUs) in end-of-life care is often problematic because both PUs and interventions to prevent them can cause suffering. The primary aim of this study was to identify and describe the different ways in which nurses understood unavoidable PUs in late palliative care. A second aim was to explore the expediency of the different levels of understanding.
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React to Moisture’, a new interactive training resource that supports care home staff in preventing and managing moisture lesions (incontinence-related dermatitis), has been launched by the Trust.
Tissue Viability Specialist Nurses developed the resource, containing a training DVD, competencies, a patient leaflet and poster, with advice from the Specialist Continence Service. It aims to provide the knowledge and skills required for care home staff to feel confident in identifying, preventing and managing moisture lesions. Although primarily aimed at care homes, it is transferrable to any health care setting. [Includes contact details for health professionals interested in the pack]
The implications of recognizing property in our own excised body parts are vast and far reaching, involving ethical, legal and practical issues that cut across many aspects of modern social intercourse and legal regulation. Arguments both for and against such recognition are well rehearsed; enough has been written to fill a small library, or at least a large bookshelf. A significant portion of the work considers the role and impact of such recognition on human dignity. Indeed, given the special status accorded the human body, it is impossible to avoid human dignity and its interaction with the various choices presented by the adoption of a property model. However, reference to this general ethical value is of little assistance. Here, the ethical foundation of a property model is considered within the context of medical ethical four principles, namely autonomy, beneficence, non-maleficence and justice. If such a model promotes these principles, it can be ethically defended.
There is legal uncertainty and academic disagreement as to the legal status of biological material that has become separated from the person. This article sets out the two criteria upon which the assessment of the legal status of ‘separated biological material’ ought to be made. Any argument concerning the legal status of separated biological material needs to (i) assess which ownership entitlements in the material the law ought recognize and (ii) assess which set of legal rules ought to be used to protect these ownership entitlements. There are also limits to the way these two criteria ought to operate. First, the considerations that are necessary to justify an ownership entitlement in a body part vary between different types of ownership entitlements. Second, whether there is a necessary connection between recognizing an ownership entitlement and protecting the entitlement in a particular way also varies in terms of the type of ownership entitlement in question.
Biobanks are increasingly seen as new tools for medical research. Their main purpose is to collect, store, and distribute human body materials. These activities are regulated by legal instruments which are heterogeneous in source (national and international), and in form (binding and non-binding). We analyse these to underline the need for a new model of governance for modern biobanks. The protection initially ensured by respect for fundamental rights will need to focus on more interactions with society in order to ensure biobanks' sustainability. International regulation is more oriented on ethical principles and traces the limits of the uses of genetics, while European regulation is more concerned with the protection of fundamental rights and the elaboration of standards for biobanks' quality assurance. But is this protection adequate and sufficient? Do we need to move from the biomedical research analogy to new forms of legal protection, and governance systems which involve citizen
Standards should never come into question, but it's clear to this Government that NHS administrative costs can be streamlined. Estimates suggest that savings of over £180 million could be delivered by 2015 by reducing the number of NHS bodies, including arm's-length bodies. And that is why I set out proposals to change responsibility for regulating fertility treatment and human tissue last week. The UK-wide consultation will consider whether the responsibilities of the regulators - the Human Fertilisation and Embryology Authority (HFEA) and Human Tissue Authority (HTA) - should move to the Care Quality Commission (CQC) and the Health Research Authority (HRA).
R. Frotscher, und M. Staat. 4th International Conference on Computational and Mathematical Biomedical Engineering - CMBE2015, 29 June - 1 July 2015, Cachan (Paris), France, CMBE Zeta Computational Resources Ltd., Swansea, UK, (2015)
Maolood, Lu, Al-Salhi, resheedi, und Ince. IJIRIS:: International Journal of Innovative Research in Information Security, Volume V (Issue V):
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