Search

Background: General practitioners (GPs) have played an integral role in Australia's coronavirus disease 2019 (COVID-19) pandemic response. However, little is known about how GPs themselves have been impacted by the COVID-19 pandemic. This study aimed to increase our understanding of the experiences of GPs working during the COVID-19 pandemic. Methods: A qualitative study was conducted using semi-structured interviews. Using purposive sampling, 15 GPs from South-Eastern Australia were asked to reflect on their experiences during the first year of the COVID-19 pandemic. Interview transcripts underwent thematic analysis. Results: Five main themes were identified: fear of infection; uncertainty and information overload; impacts on the government–GP relationship; impacts on the patient–doctor relationship; and teamwork within practices and among GPs. Conclusions: The 15 GPs interviewed in this study provided valuable insights into their experiences working during the first year of the COVID-19 pandemic. From these insights, four recommendations propose what could be done to help support GPs to respond to a pandemic while continuing to deliver primary health care. Although general practitioners (GPs) have played a crucial role in Australia's COVID-19 pandemic response, few studies have explored the impact of the COVID-19 pandemic on GPs themselves. In this qualitative study, 15 GPs from South-Eastern Australia were asked to reflect on their experiences working during the first year of the COVID-19 pandemic in semi-structured interviews. Their reflections enhance our understanding of the experience of GPs working during the COVID-19 pandemic and may help guide future research and work to support GPs. [ABSTRACT FROM AUTHOR]

In 2019, the third and updated edition of the Clinical Practice Guideline (CPG) on Prevention and Treatment of Pressure Ulcers/Injuries has been published. In addition to this most up‐to‐date evidence‐based guidance for clinicians, related topics such as pressure ulcers (PUs)/pressure injuries (PIs) aetiology, classification, and future research needs were considered by the teams of experts. To elaborate on these topics, this is the third paper of a series of the CPG articles, which summarises the latest understanding of the aetiology of PUs/PIs with a special focus on the effects of soft tissue deformation. Sustained deformations of soft tissues cause initial cell death and tissue damage that ultimately may result in the formation of PUs/PIs. High tissue deformations result in cell damage on a microscopic level within just a few minutes, although it may take hours of sustained loading for the damage to become clinically visible. Superficial skin damage seems to be primarily caused by excessive shear strain/stress exposures, deeper PUs/PIs predominantly result from high pressures in combination with shear at the surface over bony prominences, or under stiff medical devices. Therefore, primary PU/PI prevention should aim for minimising deformations by either reducing the peak strain/stress values in tissues or decreasing the exposure time. [ABSTRACT FROM AUTHOR]

Aim: Evidence based wound practice (EBWP) is a process by which health professionals make clinical decisions informed by evidence, patient preferences, and their clinical experience. There is a large body of wound care evidence to support clinical decisions; however, this evidence is often poorly translated into practice. The aim of this project was to explore facilitators and barriers to implementing evidence based wound practice across clinical settings. Method: The project used a phenomenological framework to explore the experiences of wound professionals related to facilitators and barriers to EBWP across clinical settings. The goal was to determine perceived or actual benefits of EBWP by clinicians. Data was collected using semi-structured interviews with 12 clinicians from a range of wound-related settings that were recorded and transcribed. Interviews were analysed using a four-stage process of comprehending, synthesising, theorising and recontextualising to identify key themes. Results / Discussion: Identified themes addressed system factors, organisation factors and individual experiences that influenced the translation of evidence into practice in different clinical settings. Access to education, opportunities for collaboration and perceived ability to influence practice were all factors that influenced a wound professional's translation of evidence into practice. At the individual level, length of experience appeared to influence both confidence and ability to influence clinical practice in different wound care contexts. Conclusion: Through the understanding of factors influencing the process of translating evidence to practice, peak bodies, organisations and individual wound professionals can work on strategies to overcome barriers and capitalise on facilitators. [ABSTRACT FROM AUTHOR]

Objectives: Extensive preparatory work is undertaken by Guideline Governance Groups (GGGs) before critical appraisal of literature for an evidence-based guideline. The aim of this paper is to provide overview of preparation for the next edition of Clinical Practice Guideline for the Prevention and Management of Venous Leg Ulcers (working title) being developed by Hong Kong Enterostomal Therapists Association, New Zealand Wound Care Society, Wounds Australia and the Wound Healing Society of Singapore. Methods: Scoping of venous leg ulcer (VLU) literature published 2016-2022 was undertaken to identify quantity and level of new evidence. A stakeholder survey is being undertaken (currently under consideration by ethics committees in Australia and NZ). The survey will open for patients, caregivers, health professionals and other stakeholders in July 2022. The survey measures priority stakeholders place on clinical topics from previous guideline editions, as well as importance stakeholders place on clinical outcomes from VLU interventions. Results: Using the guideline search strategy, 12,711 potentially relevant publications were identified, with screening identifying 3,132 of these publications as eligible for further consideration. These publications are being screened against the inclusion criteria and Results: will be presented. The stakeholder survey results, which will inform development of clinical questions explored in the guideline, are anticipated by September 2022. Conclusions: Contemporary guideline development processes require extensive background preparation. Scoping the literature allows GGGs to develop a strong understanding of the volume and quality of relevant new literature. Collecting stakeholder feedback allows GGGs to develop clinical questions, content and resources of relevance to stakeholders. [ABSTRACT FROM AUTHOR]

Objective: The aim of 2022 IWII consensus document update was to provide an accessible and useful clinical resource incorporating the latest evidence and current best practice for wound infection and prevention Method: A systematic review of the literature was undertaken to identify research published since 2016. A modified Delphi process was used for definitions within the document. Grading of evidence for clinical effectiveness of wound infection interventions for topical antimicrobial treatments was guided by the PICO approach. Evidence sources were critically appraised using tools recommended by GRADE. Ranking was labelled as high, moderate or low certainty. The document was peer reviewed by leading experts in wound management/ infection. Outcome: The 2022 Wound Infection in Clinical Practice document consists of 15 sections of contemporary wound infection practice, methodology, References: and a glossary. Extensive work has been conducted to update the 2022 IWII-WIC Management Guide and provides a one-page visual tool for wound infection and biofilm management to promote ease of use and accessibility for clinicians Results: The entire document has been published on the International Wound Infection Institute website but additional pdf versions of the WIC and Management Guide are also free to download. One version is the entire diagram, another is just the WIC and the third is the BBWC diagram of the step down / step up care. Conclusion: The focus of this presentation would be on the updated WIC and Management Guide. [ABSTRACT FROM AUTHOR]