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Objective: After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: present evidence-based guideline recommendations; incorporate search capacities and functionality to facilitate easy access to clinical guidance; provide accessibility in multiple languages; and to be available worldwide at a reasonable price, including opportunities for free access in low-resource countries. This paper describes the development, dissemination and formative evaluation of a mobile app providing evidence-based recommendations for pressure injury prevention, assessment/classification, and treatment at the point of care. Method: An evaluation tool was designed based on a framework developed by Nouri et al. and made available to all app subscribers. Results: The InterPIP App is currently available in 11 languages and had been downloaded 3616 times by February 2022 in 78 countries. A total of 62 individuals responded to the survey of end-users. In this formal evaluation of user experiences, the app was rated positively on criteria of: information/content; usability; design; functionality; ethics; and security/privacy (median=4 on a 1–5 Likert scale). Overall perceived value was ranked lower with a median of three. Users provided suggestions for ongoing app enhancement. Conclusion: The InterPIP App offers a unique opportunity to bring evidence-based guidance to the point of care. Formal evaluation of end-user experiences identified opportunities for quality improvement, and informed plans for future development and evaluation. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to establish an international, interorganisational consensus on wound infection terminology. Methods: This project consisted of definition scoping and a Delphi process to produce a consensus glossary for 18 wound infection terms. Recent guidelines/consensus documents were reviewed to identify 2–4 definitions for each term. An online consensus process was undertaken using the RAND Appropriateness Method, a consensus method for panels to reach agreement. International wound organisations nominated experts to participate, from whom 21 participants were selected to represent different organisations, geographic regions and disciplines. In the first consensus round, each term was presented alongside 2–3 definitions and participants nominated their preferred definition, with the majority vote used to select a baseline definition. The consensus process then proceeded, with participants using a 9-point Likert scale to score their level of agreement or disagreement with the definition for each term. Participants also provided a justification outlining the reason behind their rating. At the end of each round, an index was calculated to provide a quantitative evaluation indicating whether agreement or disagreement had been reached. Results: Reasoning statements were summarised and the definitions were adjusted to incorporate concepts identified by participants. The adjusted definition was presented in the next consensus round, together with the reasoning statements. Terms for which a final definition was not achieved in three consensus rounds were finalised with preferential voting using 2–3 definitions that had reached consensus. Project progress and significance: The project generated a glossary of wound infection terms, endorsed through participation of 15 international organisations, for dissemination of guidelines and clinical decision-making/teaching tools. [ABSTRACT FROM AUTHOR]

Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII–WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted. [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]

Objective: To achieve international consensus relating to clinical indicators for a chronic wound, wound infection and biofilm presence to inform the development of international clinical guidance for assessing and managing wound infection. Method: An online Delphi consensus process of international key opinion leaders in infection was undertaken. A literature search underpinned the development of issue statements related to terminology, emerging topics and debate in the field of wound infection. Experts participated in three rounds of consensus voting, sharing their opinions and indicating their level of agreement with the issue statements. Votes were calculated using web-based software that implements a nominal group voting methodology previously published by Research and Development/University of California at Los Angeles. Results: A total of 14 experts took part in the development process. Consensus was reached on clinical indicators of wound chronicity, wound infection and biofilm presence. Agreement was also reached that the term 'critical colonisation' should no longer be used to refer to a stage in the wound infection continuum. Conclusion: Outcomes from the consensus process were used to inform the development of international, evidence-informed guidance on the assessment and treatment of wound infection to promote improved outcomes for people with wounds. [ABSTRACT FROM AUTHOR]

Aim A discussion of the methodology used to develop the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. (2014). Background International experts representing National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance developed the second edition of this clinical guideline. Design Discussion paper - methodology. Data sources A comprehensive search for papers published up to July 2013 was conducted in 11 databases and identified 4286 studies. After critical appraisal, 356 studies were included and assigned a level of evidence. Implications for Nursing Guideline recommendations provide guidance on best practice in pressure ulcer prevention and treatment. Understanding the development process of a guideline increases the meaningfulness of recommendations to clinicians. Findings Five hundred and seventy five recommendations arose from the research and its interpretation. The body of evidence supporting each recommendation was assigned a strength of evidence. A strength of recommendation was assigned to recommendation statements using the GRADE system. Recommendations are primarily supported by a body of evidence rated as C (87% of recommendations), representing low quality and/or indirect evidence (30%) and expert opinion (57%). Two hundred and forty seven recommendations (43%) received a strong recommendation ('Do it'). Conclusion Recommendations were developed with consideration to research of the highest methodological quality evidence and studies that add to clinical insight and provide guidance for areas of care where minimal research has been conducted. Recommendations in the guideline reflect best practice and should be implemented with consideration to local context and resources and the individual's preferences and needs. [ABSTRACT FROM AUTHOR]

Background: Primary health care requires new approaches to assist patients with overweight and obesity. This is a particular concern for patients with limited access to specialist or allied health services due to financial cost or location. The Change Program is a toolkit that provides a structured approach for GPs working with patients on weight management.Objective: To assess the acceptability and feasibility of a GP-delivered weight management programme.Methods: A feasibility trial in five Australian general practices with 12 GPs and 23 patients. Mixed methods were used to assess the objective through participant interviews, online surveys and the NOrmalization MeAsure Development (NoMAD) tool based on Normalization Process Theory. Content analysis of interviews is presented alongside Likert scales, free text and the NoMAD tool.Results: The Change Program was acceptable to most GPs and patients. It was best suited to patient-GP dyads where the patient felt a strong preference for GP involvement. Patients' main concerns were the time and possible cost associated with the programme if run outside a research setting. For sustainable implementation, it would have been preferable to recruit a whole practice rather than single GPs to enable activation of systems to support the programme.Conclusion: A GP-delivered weight management programme is feasible and acceptable for patients with obesity in Australian primary health care. The addition of this structured toolkit to support GPs is particularly important for patients with a strong preference for GP involvement or who are unable to access other resources due to cost or location. [ABSTRACT FROM AUTHOR]

It is important to develop an individualised plan of care for people at the end of life to prevent pressure ulcers, and to treat them if they do occur. This article discusses patient and risk assessment, prevention and care for pressure ulcers for the palliative care patient and the recommendations given in the palliative care section of the Prevention and Treatment o f Pressure Ulcers: Clinical Practice Guideline (National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance, 2014). [ABSTRACT FROM AUTHOR]