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Experiencing bereavement as a child or young person (CYP) can have long-lasting effects. The societal and environmental burdens of the SARS-CoV-2 pandemic exacerbated the experience of loss and grief for many CYP, who were unable to access their usual the support networks. However, it is still unclear what is currently known and not known about the experiences of CYP bereaved during the SARS-CoV-2 pandemic. This review used the framework of Arksey and O'Malley and included five stages: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results. The methodological quality of the included studies was also assessed using the Critical Appraisal Skills Programme tool. The PRISMA framework was used for reporting the results. The electronic databases Medline, PsychINFO, CINAHL, and PubMed were searched for relevant articles. A total of three papers meeting the inclusion criteria were included in this review and two main themes identified: (1) support (which included sub-themes; social isolation and the impact on support; support from family and friends; wider support networks); (2) Emotional impact of bereavement during a pandemic. Access to support networks is crucial for CYP to understand and process their emotions relating to their bereavement experience. The pandemic meant that many usual support networks such as family and friends were inaccessible to CYP, who struggled to deal with their experience of grief during this time. Schools are a valuable support mechanism and can help CYP understand their emotions through open discussions about their bereavement. The limited empirical evidence currently available in this area of research demonstrates an important need to further understanding of the long-term impacts of dealing with pandemic-related loss in childhood [ABSTRACT FROM AUTHOR]

Background: A vast amount of wound care occurs in the community, but due to varying levels of knowledge and education, wound dressing selection and usage are not always optimal. Aim: This study aimed to investigate the effects of different forms of education alongside the introduction of a wound dressing on nurses' frequency of dressing changes in the home care setting. Method: We used three different approaches to explore the impact of wound care education undertaken across three district nursing teams. Semi-structured interviews with healthcare professionals explored the impact of education on nurses' clinical practice, decision making and confidence. Results: Reductions in overall wound dressing change frequency were observed in the group receiving the education package with training, compared with the control group. Dressing-specific education enabled staff to trust and feel confident about using the dressings, while wound care education enabled participants to apply new knowledge to their clinical practice. Discussion: This study highlights the importance of how education can provide valuable solutions to reducing unnecessary dressing changes, reducing nursing visits and dressing use and supporting healthcare professionals to feel more confident in their practice. Product-specific education and general wound care education combined can help to build confidence and support positive changes in practice. [ABSTRACT FROM AUTHOR]

Objective: This study assesses anonymous patient-level data on the use of sub-epidermal moisture (SEM) assessment technology as a tool in the prevention of pressure ulceration in at-risk hospital patients. Method: The relationship between technology-generated prompts for clinical action (patient turning, application of pressure redistributing equipment, heel protection or cream) and consequent clinical action was evaluated using data cross-tabulations (using data aggregated over multiple anatomical sites); in a multilevel model with patients clustered within wards, clustered in turn within hospitals, and controlling for additional patient- and institution-level factors; and using receiver operating characteristic (ROC) analyses of anatomy-specific data. The ability of the SEM assessment technology to detect deep and early-stage pressure ulcers/injuries on specific anatomical areas of a patient's body on admission, earlier than visual and tactile skin tissue assessments (STA), was assessed. Results: A total of 15,574 patient assessments ('cases') were reported on 1995 patients. Most incidences of nurse action were in response to a prompt from SEM assessments (4944/5494; 90.0%). An SEM delta (Δ)≥0.6 resulted in nurse action in 4944/13,071 cases (37.8%). The multilevel model revealed strong evidence that SEM Δ prompts were significantly associated with nurse action (p<0.001; adjusted odds ratio: 1.99). Conclusion: In this study, SEM assessment technology effectively prompted nurse action moreso than skin reddening diagnosed via trained clinician judgement and STAs. While baseline responses of nurses' actions remained low, with or without SEM Δ prompts, findings verified the 'clinical utility' of SEM assessment technology as an objective prompt for early clinical action over and above existing mechanisms. [ABSTRACT FROM AUTHOR]

Background: Wound care is a significant financial burden in healthcare and the cost of wound dressings are reported as explicit expenditures. However, there are many financial aspects associated with wound dressings that are less understood, but play an important role in understanding how to manage the wound care burden. Aim: This study explored the real-world costs of wound dressings for the management of acute and chronic wounds. Methods: A round table discussion with 6 healthcare professionals with expertise in wound care was undertaken. Results: Thematic analysis identified four main themes (supported by eight sub-themes); holistic wound management; wound dressing expenditure; specialists and generalists in wound care; and patient factors. Discussion: The real-world cost of managing wounds encompasses a variety of factors that are frequently underrepresented. A holistic approach is essential for patient health and wellbeing and managing patient expectations of wound healing. While wound dressing costs should be considered, the focus should be on choosing the right product for each patient. Simplifying the number of products available to clinicians is an important aspect of supporting individuals to treat and manage patients in their care. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of sub-epidermal moisture (SEM) assessment technology as an adjunct to visual assessment to reduce pressure ulcer (PU) incidence alongside standard PU care pathways. Method: Data were obtained from wards located within 28 institutions in the UK, Canada, Belgium, Spain and Ireland. At each ward, the proportion of patients scanned who were observed to have one or more PUs of Category 2 or above during a pre-Pressure Ulcer Reduction Programme (PURP) implementation period starting between November 2017 and July 2018 was recorded. The proportion of patients scanned who were observed to have one or more PUs of Category 2 or above during a post-PURP implementation period starting between November 2018 and July 2019 was also recorded. A meta-analysis was conducted on the data using wards as the unit of analysis, to facilitate overall estimate of the PURP. A sensitivity study was also conducted to assess the sensitivity of results to data from specific institutions. Results: A synthesised estimate of the overall relative risk (RR) was calculated to be 0.38 (95% confidence interval 0.26 to 0.56). Hence the risk of PU in the post-PURP cohort was about one-third that of the corresponding risk in the pre-PURP cohort. The sensitivity analysis revealed no evidence that any individual ward exerted excessive influence on the findings. Conclusion: The analysis has revealed strong evidence that implementation of the PURP was associated with reduction in incidence of Category 2 or above PUs across a wide range of clinical settings. [ABSTRACT FROM AUTHOR]

'The SARS-Cov-2 (COVID-19) pandemic saw the introduction of safety measures such as social distancing, isolation and shielding. This has facilitated health care services transformation, particularly in tissue viability services, where a decrease in community nursing visits, limited outpatient appointments and few face-to-face GP appointments have increased the need for patients to be actively involved in their own care. Such a shift has contributed towards patients and health professionals (HCP) sharing treatment and care responsibilities to maintain the patients' health. This shift brings about its own challenges, with patients requiring a degree of knowledge and skills of wound care to be able to confidently manage their wounds. The terms self-care, shared care and supported self-management are often used to refer to patient involvement in their treatment and care but a lack of consensus around the extent of patient involvement and an absence of strategic guidelines for shared or self-management of lower limb wounds contributes towards difficulties in understanding the extent of patient involvement. This paper provides a narrative review of current literature focused on shared, self or supported self-management practices and perceptions in the management of lower limb wounds. [ABSTRACT FROM AUTHOR]

Objective: Episodes of inpatient care-related pressure ulcers (PU) lead to deleterious effects on patient quality of life, and additional costs associated with wound dressings, staff visits and hospitalisation. Accurate prediction of future incidence may be helpful in defining strategies for benchmarking and resource management. Observations of category 2 or above PUs during episodes of care at an NHS Foundation Trust were recorded monthly from 2010 to 2020. Trust-specific interventions designed to reduce PU incidence, such as procurement of specialised staff and equipment, were also recorded. This study aimed to investigate the historical pattern of PU incidence in the Trust to assess intervention effectiveness in reducing PU incidence, and to use historical data to derive estimates of future incidence. Method: Time-series analysis was conducted on monthly PU incidence data to quantify underlying trends, seasonality and effect of interventions, and to derive a suitable model to predict future incidence levels. Results: Mean monthly PU incidence gradually reduced from 20.3 during 2012 to 5.08 during 2019; with a negative linear trend in the presence of concurrent seasonal effects. There was limited evidence that implementation of specific interventions was associated with raised rates of reduction; however, incidence reductions during intervention periods continued from lower baselines. Best estimate predictions revealed that incidence is likely to stay at current levels or below for the foreseeable future. Conclusion: Past data can be used to model future episodes of inpatient care PU occurrence. Interventions may be effective in reducing PU incidence rates. [ABSTRACT FROM AUTHOR]

Objective: The aim of this systematic review was to examine the associations and relationship between commonly cited risk factors and the pathology of pressure ulcer (PU) development. Method: Using systematic review methodology, original research studies, prospective design and human studies written in English were included. The search was conducted in March 2018, using Ovid, Ovid EMBASE and CINAHL databases. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the evidence-based librarianship critical appraisal. Results: A total of 382 records were identified, of which five met the inclusion criteria. The studies were conducted between 1994 and 2017. Most studies were conducted in hospital and geriatric wards. The mean sample size was 96±145.7 participants. Ischaemia, recovery of blood flow and pathological impact of pressure and shear was mainly found as the cited risk factor and PU aetiology. Conclusion: This review systematically analysed five papers exploring the relationship between risk factors for PU development and aetiology. It identified many risk factors and underlying pathological mechanisms that interact in the development of PU including ischaemia, stress, recovery of blood flow, tissue hypoxia and the pathological impact of pressure and shear. There are several pathways in which these pathological mechanisms contribute to PU development and identifying these could establish potential ways of preventing or treating the development of PU for patients. [ABSTRACT FROM AUTHOR]