The Effectiveness of Advanced Practice Nurses with Respect to Complex Chronic Wounds in the Management of Venous Ulcers

Jiménez-García, Juan Francisco; Aguilera-Manrique, Gabriel; Arboledas-Bellón, Josefina; Gutiérrez-García, María; González-Jiménez, Francisco; Lafuente-Robles, Nieves; Parra-Anguita, Laura; García-Fernández, Francisco Pedro

doi:10.3390/ijerph16245037

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Compression therapy is the primary method of VLU treatment. 5 Bandage system therapy has been considered the gold standard treatment for VLU. 6 O'Meara et al demonstrated that VLUs treated with adequate compression therapy heal significantly faster than those with no compression therapy; moreover, compression therapy also provides appropriate prevention of recurrence.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED: Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: A meta‐analysis

Xu,

2023

International Wound Journal

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This meta‐analysis assessed the effect of pneumatic compression therapy on the wound healing of venous ulcers, with the aim of providing a basis for the selection of clinical treatment. Randomised controlled trials (RCTs) on the application of pneumatic compression therapy to venous ulcers were collected by searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases, with a timeframe from database inception to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies, a meta‐analysis was performed using RevMan 5.4 software. Six RCTs with 367 patients were included, with 172 patients in the intervention group and 195 in the control group. The results showed that pneumatic and bandage compression therapies had a similar impact on wound healing rates of venous ulcers (54.65% vs. 53.84%, odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.49–2.12, p = 0.96), changes in wound area (standardised mean difference: −0.16, 95% CIs: −0.45 to 0.12, p = 0.26), adverse event rates (76.56% vs. 67.07%, OR: 1.62, 95% CI: 0.77–3.39, p = 0.20), and the differences were not statistically significant. Thus, current evidence suggests that the effects of pneumatic compression therapy on wound healing rates, changes in wound area, and the incidence of adverse events in patients with venous ulcers are similar to those of bandage pressure therapy. However, owing to the limitations in the number and quality of studies, more high‐quality RCTs are needed to clarify the feasibility and economics of pneumatic compression therapy in patients with venous ulcers.

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Section: Introductionmentioning

confidence: 99%

RETRACTED: Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: A meta‐analysis

Xu,

2023

International Wound Journal

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“… 32 , 33 This study model is capable of identifying significant differences between treatment regimens with relatively few subjects. 34 , 35 A recent review revealed that this model was greatly underused in studies that met the criteria. 36 …”

Section: Discussionmentioning

confidence: 99%

A Novel Randomized Trial Protocol for Evaluating Wound Healing Interventions

Bull

Clements

Collarte

et al. 2023

Advances in Wound Care

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Background: Randomized controlled trials using complete healing as an endpoint suffer from poor statistical power, owing to the heterogeneity of wounds and their healing trajectories. The Food and Drug Administration (FDA) has recently consulted with expert groups to consider percentage area reduction (PAR) of the wound over a 4-week period as a valid intermediate endpoint, creating the opportunity for more powerful study designs. Methods: A within-subject controlled study design comparing the PAR of venous leg ulcers (VLU) in patients over 4 weeks receiving different interventions. Twenty-nine patients received multilayer compression over 4 weeks, followed by neuromuscular electrostimulation (NMES) of the leg muscle pump in addition to compression for a further 4 weeks. Paired comparison was then made of PAR between the two phases. A second cohort of 22 patients received only multilayer compression throughout both 4-week phases. Results: Patients randomized to NMES saw a significant increase in healing rate compared with compression alone, whereas patients receiving compression only saw no significant change in healing rate throughout the course of the study. Conclusions: Intermittent NMES of the common peroneal nerve significantly accelerates the healing of VLU. It is well tolerated by patients and deserves serious consideration as an adjuvant to compression therapy. PAR is a useful metric for comparing the performance of wound healing interventions, and the self-controlled trial design allows sensitive discrimination with a relatively small number of subjects over a reasonably short trial period. The study is reported according to the CONSORT reporting guidelines. Clinical Trial Registration: NCT03396731 (ClinicalTrials.gov).

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“…The APN intervention included training and advice to clinical nurses on the proper management of injuries and the use of compression therapy. This intervention has been shown to improve the continuity of care and to optimize the resources used [40].…”

Section: Outcomes In Advanced Nursing Practicementioning

confidence: 99%

Advanced Nursing Practice in Austria under consideration of outcome measurement

Glarcher

Lex

2020

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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Background: Internationally, Advanced Practice Nurses (APN) are associated with improvements when measuring results in health care. Advanced Nursing Practice (ANP) refers to an extended nursing care with the aim of meeting the changing conditions in health care systems by providing evidence-based practice. APN outcomes are the endpoints of nursing interventions based on clinical experience, scientific knowledge, and practical skills. Due to the challenges in health care systems, Advanced Practice Nurses have become well established internationally in various fields. Problem: In Austria, the first nurses are currently trained in Advanced Nursing Practice on a master's level according to the International Council of Nurses core curriculum (ICN). However, national implementation and evaluation strategies are still missing. Objective: The aim of this short report is (i) to show the current situation of APNs in Austria, and (ii) to underline the importance of measuring APN outcomes in implementing this role for future developments in health care. Method: A literature search was conducted in CINAHL (Cumulative Index to Nursing and Allied Health), PubMed, and the Cochrane Library in the period 09/2019 to 01/2020. Results: With the help of APNs and coordinated, holistic, patient-centered care, a higher quality of care for different patient groups is clearly evident. The cost-effectiveness and the positive experience of both patients and nursing staff have been demonstrated in international studies. In particular, the guidance and educational skills of APNs have been shown to improve health outcomes in vulnerable population groups. Conclusion: With regard to the implementation of APNs in the health care system, more focus is needed on the measurement of outcomes in nursing research. Outcome research has been shown to help identify the unique effect of APNs in patient care and to highlight the health-related improvements through Advanced Nursing Practice for health policy and further developments in the health care system.

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The Effectiveness of Advanced Practice Nurses with Respect to Complex Chronic Wounds in the Management of Venous Ulcers

Cited by 8 publications

References 30 publications

RETRACTED: Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: A meta‐analysis

RETRACTED: Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: A meta‐analysis

A Novel Randomized Trial Protocol for Evaluating Wound Healing Interventions

Advanced Nursing Practice in Austria under consideration of outcome measurement

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