[Prevalence and influencing factors of chronic wounds among clients of home care services in Germany]

The process of clinical decision-making in chronic wound care: A scenario-based think-aloud study

AIMS

To undertake a comprehensive investigation into both the process of information acquisition and the clinical decision-making process utilized by primary care nurses in the course of treating chronic wounds.

DESIGN

Scenario-based think-aloud method, enriched by the integration of information processing theory. The study was conducted within the framework of home care nursing organizations situated in [placeholder]. A cohort of primary care nurses (n = 10), each possessing a minimum of one year of nursing experience, was recruited through the collaboration of three home care nursing organizations.

METHODS

Two real-life clinical practice scenarios were employed for the interviews, with the researcher adopting the roles of either the patient or another clinician to enhance the realism of the think-aloud process. Each think-aloud session was promptly succeeded by a subsequent follow-up interview. The Consolidated criteria for Reporting Qualitative research checklist was followed to guarantee a consistent and complete report of the study.

RESULTS

Amidst noticeable variations, a discernible pattern surfaced, delineating three sequential concepts: 1. gathering overarching information, 2. collecting and documenting wound-specific data, and 3. interpreting information to formulate wound treatment strategies. These concepts encompassed collaborative discussions with stakeholders, while the refinement of wound treatment strategies was interwoven within both concepts 2 and 3.

CONCLUSIONS

Evident variations were identified in chronic wound care clinical decision-making, regardless of educational background or experience. These insights hold the potential to inform the development of clinical decision support systems for chronic wound management and provide guidance to clinicians in their decision-making endeavours.

Development and evaluation of a digital education tool for medical students in wound care

The aim of this study was to develop and evaluate an interactive, video‐enhanced, and case‐based online course for medical students. We chose a case about wound care since this topic is still underrepresented in the medical curriculum. First, instructional videos were created to teach practical skills in wound care. These were implemented into a case‐based online course, using the online learning platform ILIAS. In a comparative initial and final survey, numbers of users were assessed, content and structure of the course, as well as the thematic interest of the students and self‐assessed gain of competence, were evaluated. Since the summer of 2019, 310 students have successfully completed the course. The survey data showed a high participation rate and a positive response regarding the content as well as the structural concept. Most of the students rated the content within the course as useful for their future medical work (86.1%) and the gain of knowledge superior to a traditional lecture (69.4%). Self‐assessments of video‐mediated skills showed a significant increase in subjectively perceived competence. The online course is an efficient way to reach many students by the small use of resources. It resembles an option to arouse growing interest in wound care in medical students.

Prevalence and risk factors of chronic wounds in nursing homes in Germany: A Cross-Sectional Study

The burdens caused by chronic wounds on the affected persons themselves and also on the health care system are well recognised. The aim of this study was to investigate the prevalence and risk factors of chronic wounds in German nursing homes. An annual cross-sectional study was conducted in nursing home residents from 2012 to 2018. The proportion of men affected by chronic wounds was to some extent higher than that of women, 9.0% males vs 7.5% females. In total, 7.8% of all residents were affected by chronic wounds. Of all residents with a chronic wound, 50.5% were affected by pressure ulcer. Male residents were twice as often affected by diabetic foot ulcer than female residents (18.0% vs 8.9%; P = 0.002). Bivariate analysis showed that chronic wounds were highly associated with poor nutrition, urinary incontinence, stool incontinence, diabetes mellitus, and limited mobility (P = 0.000). According to multivariate analysis, the strongest predictors for chronic wounds were limited mobility and diabetes mellitus. The highest prevalence of chronic wounds was in residents who were not restricted in their mobility, had diabetes, were male, and lived in a metropolitan region (23.7%). This study identified the prevalence and risk factors of chronic wounds in nursing home residents. Further research is needed to identify causal factors of the gender difference in the prevalence of chronic wounds. This may have an impact on the choice of prophylactic and therapeutic measures.