Wound Practice and Research

This study assessed the effects of high compression bandages and Unna’s boots on health-related quality of life for venous leg ulcer treatment. A randomised clinical trial was conducted with 56 patients across 22 primary healthcare services in Brazil, between 2020 and 2023. Participants were randomly assigned to receive high compression bandages (Group A) or Unna’s boots (Group B). Health-related quality of life was assessed by the six-dimensional Health State Short Form questionnaire at baseline and follow-up (venous leg ulcer healing or at 26 weeks). Descriptive analyses, and t-tests were performed. The average score change was 0.093 (±0.09) (p<0.001) in Group A and 0.06 (±0.1) (p=0.007) for Group B, with no difference between groups (p=0.218). For healed ulcers, Group A experienced an increase of 0.109 (±0.084) (p<0.001) and Group B 0.113 (±0.115) (p<0.01), with no difference between groups (p=0.914). For unhealed ulcers, the increases were 0.058 (±0.098) (p=0.09) in Group A and 0.028 (±0.078) (p=0.182) in Group B, with no difference between groups (p=0.441). Both treatments significantly improved participants’ health-related quality of life, with no significant differences between groups, suggesting that both interventions effectively enhance quality of life.

Aim This scoping review aims to map current literature relating to the role of empathy in the provision of wound care and its potential benefits to health professionals and patients. It seeks to provide a comprehensive overview of how empathy may influence the patient/clinician dynamic, patient wellbeing, patient engagement, adherence, pain management and treatment outcomes, including wound healing. Barriers to providing empathetic care will also be considered.

Method Following the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines, this review will map existing literature on empathy in wound care. We will search the following electronic databases: MEDLINE, CINAHL, Embase, Scopus & APA PsycINFO, using an agreed search strategy co-designed with a specialist university librarian. Data from included studies will be extracted thematically using a standardised form. Potential themes include the role of empathy on the patient-clinician relationship, the influence of empathy in wound care and the barriers healthcare providers face in delivering empathetic care and how these challenges affect both emotional and clinical aspects of patient care. A narrative synthesis will summarise the findings.

Discussion This review will assist healthcare professionals and policymakers better understand the role and potential impact of empathy in wound care. By highlighting the importance of empathetic, person-centred approaches, it may encourage the inclusion of these aspects in guiding the development of wound care strategies and health professionals’ education. Furthermore, this review will identify existing research gaps, promoting further studies into how empathy can be effectively integrated into clinical practice to enhance person centred care.

Aims Antimicrobial stewardship (AMS) describes a preventative approach to antimicrobial resistance (AMR). Evidence suggests that nursing knowledge and perceptions of their role in AMS inhibits their involvement in antimicrobial stewardship programmes (ASPs). This systematic review aimed to determine the knowledge and perceptions of nurses regarding AMS.

Methods A systematic search of publications using MEDLINE, CINAHL, and Cochrane databases was conducted and a narrative synthesis undertaken. The study protocol was registered prospectively in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42024524162.

Results This review included seven studies. Limited levels of nurses’ knowledge about AMS were significant in all studies, contributing to a lack of nurse engagement and involvement in AMS interventions. An inability to implement AMS protocols in clinical practice was often the result of inadequate knowledge of policies and procedures. Barriers to nurse involvement in AMS included training and education, competing priorities and organisational boundaries.

Conclusion Nurses have a vital role in ASPs and empowering them to challenge inappropriate prescribing practices or antibiotic therapy can contribute towards their success. Future studies should focus on developing targeted educational interventions, enhancing interprofessional collaboration, and exploring the impact of cultural and institutional differences to optimize the role of nurse in ASPs.

The primary aim of this case study was to assess the clinical presentation, diagnostic challenges, and management strategies for a head haematoma. Understanding these factors, can enhance a health provider’s approach to treatment, and management and improve patient outcome. A comprehensive analysis was conducted of the patient who presented with a head haematoma following a fall. The implementation of a conservative management approach was conducted with close monitoring and follow-up appointments. In conclusion, this case study highlighted the importance of a systematic approach to diagnosing and managing a head haematoma.

Objective The aim of this narrative review is to examine the historical evolution of antimicrobial treatments, the rise of antimicrobial resistance (AMR) and the implementation of antimicrobial stewardship (AMS) over time. It explores whether AMR remains a concern in wound care, the development of new antibiotics and alternative antimicrobial therapies, and the benefits observed following AMS initiatives.

Materials and methods The Medline (PubMed) electronic literature database was searched for the relevant studies. The search revealed 2940 potential articles, screening for relevance identified 203 articles, which were reviewed.

Results Despite the emergence of AMS strategies, our review found that AMR remains a significant issue with regard to wound care and healthcare more generally. AMR is an increasing problem with resistance being widespread and being seen in non-antibiotic antimicrobials, such as silver. The identification of new antibiotics is lacking and, despite the development of newer treatments with current antibiotics (including combination therapies), there is a strong push for new, non-antibiotic therapies, such as photodynamic therapy and phage therapy.

Conclusion Alongside the development of new treatments, updating current AMS procedures and enhancing their implementation (resulting in a reduction in antimicrobial use) are identified as important areas in the battle against AMR. In addition, the implementation of AMS procedures corresponded with a decrease in levels of antimicrobial resistant microorganisms. As well as reducing levels of resistant microorganisms, this review revealed additional benefits of the introduction of AMS procedures, including a reduction in costs (surgical antibiotic prophylaxis costs), and a reduction in patient morbidity and mortality.