Aim Wound infection is a life-threatening complication of pressure injuries (PIs) and is not yet completely preventable. This study aims to explore the dissemination of microbiota between PIs and hospital beds using a culture-independent methodology. This serves as the first step towards developing a new intervention to prevent wound infection.

Methods A cross-sectional study was conducted at a long-term care hospital on patients aged >65 years with PIs. The microbiota of wounds, skin and beds were identified using 16S ribosomal RNA (rRNA) gene sequencing analysis. Zero-radius operational taxonomic units (zOTUs) were used for confirming dissemination which indicates bacteria possessing identical sequences within the V3–V4 region of the 16S rRNA gene.

Results Ten PIs were analysed in this study. All individuals had zOTUs common to samples from their wound, skin and bed (median: 194, interquartile range [IQR]: 121–320). Furthermore, the bed samples were classified into the same clusters as the wound samples from eight sites.

Conclusion Our study is the first to quantitatively show the dissemination of microbiota between PIs and patients’ beds using culture-independent analysis. Preventing the dissemination of bacteria to beds may be an effective therapeutic strategy for the prevention of wound infection.

Aims Reduce pressure injuries (PIs) in residents of a high level care facility by increasing staff knowledge and skills through clinical support and a skin integrity education package.

Method This project was a quality improvement (QI) activity and data were de-identified and reported in aggregate. Pre- and post-implementation data included staff knowledge testing and PI prevalence and severity.

Results Pre-implementation data indicated that staff knowledge was very limited, skin inspections and PI risk assessment were not performed, and use of pressure redistribution devices was low, with point prevalence at 64% of mainly severe PIs. Despite ongoing external clinical and project support, compliance with project elements was deficient. Post-implementation knowledge change was unable to be measured, but skin inspections improved. PI point prevalence reduced to 33% and suspected deep tissue injuries (SDTI) were eliminated.

Conclusion Change in knowledge could not be measured as staff did not complete post-implementation tests. Although documentation of daily skin inspections were inconsistent, awareness of this requirement may be linked to the significant reduction in the prevalence and severity of PIs. There is an urgent need to engage residential care staff in risk assessment and the implementation of strategies to reduce skin injuries.

What is already known

• PIs are common in residential aged care facilities.
• There is a lack of skin integrity knowledge in residential aged care staff and education is often inadequate.
• Appropriate use of pressure redistribution equipment reduces the risk of PIs.

What this manuscript contributes

• Use of appropriate pressure redistribution equipment alone may not reduce the risk of PIs.
• Pressure redistribution equipment may be under-utilised in residential aged care facilities.
• Even when provided with support and education, other barriers prevent residential aged care staff from implementing PI prevention strategies.
• Regular skin inspection may have a positive impact on the incidence and severity of PIs.

Aims Epidermolysis Bullosa (EB) is a rare genetic disorder characterised by recurrent skin blistering. Wound care and nursing are critical to everyday lives of EB patients. The aim of this review was to identify the support needs of parents of a child with EB and to assess the impact EB has on the family unit, irrespective of subtype of condition severity.

Methods We conducted a scoping review comprising 11 studies (2005–2021) to examine the research literature related to the support needs of parents with a child with EB, and the impact on family unit wellbeing.

Results Most common needs identified were emotional needs, followed by practical needs, social needs and physical needs. Many parents also reported a lack of informational and psychological support. Common findings included emotional stress, lack of respite and physical strain on caring responsibility, financial stress, guilt and impact on relationships and family unit.

Conclusions Few studies exist that explore the support needs of parents of a child with EB. More attention should be paid to the support needs of parents to provide adequate care to those diagnosed with EB as well as their families.

Background Adults with venous leg ulcers (VLUs) are less likely to be physically active and show greater sleep disturbances than the general population. Limited evidence suggests these issues contribute to VLU healing delays.

Objectives The primary objective is to determine if physical activity (PA) and sleep levels are associated with VLU healing. The secondary objectives are to: 1) evaluate the feasibility and acceptability of a wrist-worn accelerometer device, wActiSleep-BT device wear (ActiGraph); 2) evaluate the utility of self-reported PA instruments to measure PA for people with VLU; and 3) determine whether PA and sleep levels are associated with i) delayed healing, ii) self-reported quality of life (QoL) and/or iii) self-reported VLU pain.

Design and method This prospective observational cohort pilot study aims to recruit 30 adults with VLUs from three hospital-based outpatient wound clinics in Melbourne, Australia. PA and sleep levels will be measured using the wActiSleep-BT device. VLU healing data will be collected from medical records. Patients’ self-reported outcomes will be collected using questionnaires.

Discussion Findings will provide insight into the relationship between PA and sleep with healing, QoL and pain, and determine the feasibility and acceptability of the wActiSleep-BT device. Findings will also inform the potential utility of self-reported instruments in estimating PA level in people with VLUs.

Contribution of the paper statements

What is already known about the topic?

• VLUs are a common and costly problem.
• Adults with VLUs are more likely to be inactive.
• Sleep disturbances are more common in adults with VLUs than the general population.
• Increased PA may improve wound healing outcomes for adults with VLUs.

What this paper adds

• An objective evaluation of the level of PA and sleep by adults with VLUs.
• The relationship between PA, sleep, VLU healing, as well as QoL and pain.
• The validation of self-reported instruments for assessing PA level.
• A feasibility assessment of the wActiSleep-BT device to examine levels of PA and sleep in adults with VLUs.
• An acceptability assessment of wearing the wActiSleep-BT device by adults with VLUs.

Objectives The primary objective is to identify instruments used to measure quality of life (QoL) in studies of people with active venous leg ulcers (VLUs). The secondary objective is to map the qualities of each instrument to make recommendations for clinical practice and future research.

Introduction VLUs have a negative impact on patients’ QoL. Prolonged healing and frequent recurrence leads to pain, prolonged disability and psychosocial morbidity. Accurate measurement of QoL can optimise the evaluation of VLU treatments and guide clinician and patient decision-making.

Inclusion criteria Studies that reported QoL in patients with active VLUs.

Methods This review will identify studies indexed in CINAHL, Ovid MEDLINE, Ovid Emcare and ProQuest from January 2000 to December 2020. Methodological quality will be assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) Risk of Bias checklist. A narrative synthesis of general information, methodology and measurement properties of the QoL instruments will be presented. If possible, a random effects meta-analysis will be conducted where appropriate.

What is already known on the topic:

• VLUs are the most common chronic lower limb wound managed in primary care in Australia and their prevalence is predicted to increase.
• Multicomponent compression therapy is recommended to improve healing and reduce the recurrence of VLUs.
• VLUs have a negative impact on patient QoL.
• There are many generic and condition-specific QoL instruments used in VLU studies.

What this study contributes

• This study will identify which instruments report QoL in people with active VLUs.
• This study will map QoL measurement properties, identify the qualities of each tool and make recommendations for clinical practice and future research.