Development of a generic wound care assessment minimum data set

Say Goodbye to Wet-to-Dry Wound Care Dressings

To describe the assessment and management of chronic wounds and detail current recommendations for optimal wound care practices. Selected scientific literature, clinical practice guidelines, and the authors' clinical experience. Multiple factors play a role in the problems associated with chronic wounds. Wound care is costly in regards to medical care, as well as costly in terms of the hardship placed on the patient, family and staff. Too often, wound care practices are based on rituals than research. The assessment and management of chronic wounds needs to be individualized according to a thorough assessment of the wound, the patients' lifestyle, and the caregiver's knowledge and skill for managing th wound. It is also important to know what wound care products are available and the types of wounds appropriate for their use.

BackgroundSuicidal behavior is a major cause of mortality and disability worldwide. Accurate and consistent collection of data on suicide, suicide ideation, and suicide attempts presents many challenges for public health practitioners, policymakers, and researchers. This study aimed to establish a minimum data set (MDS) for integrating data across suicide registries and other data sources.MethodsThe MDS proposed in this study was developed in two-stepwise stages. First, an extensive literature review was performed in order to identify the potential data items. Then, we conducted a two-round Delphi stage to reach a consensus among experts regarding essential data items and a supplementary one-round Delphi stage for validating the content of the final MDS by calculating the individual item content validity index (CVI) and content validity ratio (CVR) and using other statistical tests.ResultsAfter the literature review, 189 data items were extracted and sent to a panel of experts in the form of a questionnaire. In the Delphi stage and CVI calculation, 55 and 10 experts participated in kappa and CVR calculation, respectively. Finally, the MDS of the suicide registry was finalized with 84 data elements that were classified into four categories, including patient profile, socio-economic status, clinical and psychopathological status, and suicide circumstances.ConclusionsThe suicide MDS can become a standardized and consistent infrastructure for meaningful evaluations, reporting, and benchmarking of suicidal behaviors across regions and countries. We hope this MDS will facilitate epidemiological surveys and support policymakers by providing higher quality data capture to guide clinical practice and improve patient-centered outcomes.

The purpose of this descriptive study was to evaluate use of a previously validated, online, interactive wound assessment and wound care clinical pathway in a group of RNs. Specific aims were to (a) evaluate the proportions of correct, partially correct, and incorrect algorithmic decisions and dressing selections, (b) compare response rates between nurses who are and who are not wound care certified, and (c) evaluate its ease of use, educational value, and applicability in clinical practice. Descriptive study. Participants were recruited using convenience and snowball sampling methods. Four hundred eighteen nurses completed all 15 assessments; nearly half held a bachelors' degree in nursing (189, 45%), more than two-thirds worked in an inpatient acute care settings (277, 68%), and 293 (70%) were not certified in wound care. After providing written informed consent and completing the participant demographics form, participants assessed 15 photographs of wounds with accompanying moisture descriptions and completed an algorithm and dressing selection for each. All responses were anonymously collected by the program. Existing, retrospective, program data were also downloaded and data from nurses who completed all assessments were extracted and analyzed. Descriptive statistics were used to analyze all variables. Selection outcomes and survey responses between nurses who were and who were not wound care certified were compared using a 2-sample Student t test assuming unequal variances. Individual responses for the first 6 wounds were compared to the last 6 wounds using a paired t test. The mean (M) proportions of fully or partially correct (operationally defined as safe but not fully correct) algorithm and dressing choice were 81% (SE: 0.88, 95% confidence level: 1.73) and 78.1% (SE: 0.70, 95% confidence level: 1.39), respectively. Wound care-certified nurses had higher mean algorithm scores than those who were not certified (M: 89.2%, SE: 1.27 vs M: 77.8%, SE: 1.10, P < .001). Most incorrect/partially correct choices were attributable to incorrect necrotic tissue assessment (n = 845, 58%). The difference between fully correct first 6 and last 6 algorithm choices was statistically significant (M: 310, SE: 0.02 vs M: 337, SE: 9.32, P = .04). On a Likert scale of 1 (not at all) to 5 (very), average scores for ease of program and algorithm use, educational value, and usefulness for clinicians ranged from M: 4.14, SE: 0.08 to M: 4.22, SE: 0.08. Results suggest that the algorithm is valid and has potential educational value. Initial evaluation also suggests that program refinements are needed. Evaluation of participant responses indicated potential problems with the definitions used for necrotic tissue or assessment knowledge deficits. Results also substantiate the importance of instructional design and testing online education programs. More research is needed to uncover potential gaps in nurses' wound care knowledge that may hamper evidence-based practices adoption and the need to develop effective, evidence-based education-delivery techniques.

Background: Success of infection treatment depends on the availability of accurate, reliable, and comprehensive data, information, and knowledge at the point of therapeutic decision-making. The identification of a national minimum data set will support the development and implementation of an effective surveillance system. The goal of this study was to develop a national antimicrobial resistance surveillance minimum data set.Methods:In this cross-sectional and descriptive study, data were collected from selected pioneering countries and organizations which have national or international antimicrobial resistance surveillance systems. A minimum data set checklist was extracted and validated. The ultimate data elements of the minimum data set were determined by applying the Delphi technique.Results: Through the Delphi technique, we obtained 80 data elements in 8 axes. The resistance data categories comprised basic, clinical, electronic reporting, infection control, microbiology, pharmacy, World Health Organization-derived, and expert-recommended data. Relevance coding was extracted based on the Iranian electronic health record coding system.Conclusion:This study provides a set of data elements and a schematic framework for the implementation of an antimicrobial resistance surveillance system. A uniform minimum data set was created based on key informants’ opinions to cover essential needs in the early implementation of a global antimicrobial resistance surveillance system in Iran.

In the developing countries with high mortality rates, poisoning is considered to be one of the most common causes of admission to emergency wards. Given the importance of registering data on poisoned patients, it is very important to have a complete poisoning Minimum Data Set (MDS). Therefore, the purpose of this study was to determine an MDS for poisoning registry in Iran. This applied and cross-sectional study was conducted through of Delphi technique in the poisoning ward of Imam Reza Hospital (northeastern Iran) in 2019. Literature reviews were initially carried out on such databases as PubMed, Web of Sciences, Scopus, and Embase. Then, Google search was done to retrieve poisoning forms and poisoning registry websites. Also, we considered International Classification of Diseases, 10th Revision coding guidelines of poisoning. Then, a questionnaire containing data elements of poisoning was developed. In total, 558 data elements were developed during two rounds of Delphi technique. The MDS was divided into 10 categories including patient and communication data, encounter data, diagnostic data and medical history, exposure data, clinical data, treatment data, complications, paraclinical tests, biobank, and discharge data. Establishing an MDS as the first and most important step towards implementing poisoning registry can be the standard basis for collecting poisoned patient data. The data registered in the poisoning registry can be used for planning, policy-making, prevention, and control purposes.

Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations. In this cross-sectional prospective study, we observed a convenience sample of 60 nurses from four surgical units using a specifically developed observational audit tool. Inter-rater reliability for this tool was assessed during the observation period. Of 60 observed episodes of wound care, post-procedure hand hygiene (n=49, 81.7%) was less evident compared with pre-procedure hand hygiene practice (n=57, 95%). Over one-third of nurses observed did not correctly use clean gloves (n=16, 38.1%) and one in five did not properly use sterile gloves (n=4, 22%). More than half of surgical nurses (n=37, 61.7%) did not educate patients on post-discharge wound management. Fewer than a quarter (n=14, 23.3%) of wound care events were recorded on both wound assessment charts and patients' progress notes. Inter-rater reliability testing indicated good agreement (intra-class correlation coefficient 0.859; 95% CI: 0.771-0.923; p<0.0005). Despite surgical wound care guideline recommendations on aseptic technique compliance, patient education, wound assessment and documentation practices, there is a clear gap between recommended and observed wound care practice. This study highlights an area where clinical practice is not reflective of evidence-based recommendations, suggesting that to minimise SSI as an adverse event, practice should be evaluated and strategies incorporating evidence into practice are explored.

Identifying Failure to Thrive in the Long Term Care Setting

Advances in biomaterials for wound care management: Insights from recent developments.

Objective:Many people suffer from kidney disease, and self-management is essential in these patients. Personal health record (PHR) can be used as a tool to improve self-management in these patients. This study aimed to identify a minimum data set (MDS) of PHR in dialysis patients.Methods:This descriptive and cross-sectional study was conducted in 2019, and national and international scientific literature entitled “Personal Health Record,” “Electronic Personal Health Record,” “Dialysis Patient Portal,” “Dialysis Health Record,” and “Dialysis Information Needs” by content analysis method was reviewed. A questionnaire with 14 items was designed to examine patients’ problems and data needs based on the review of scientific literature and web-based PHRs. Based on the patients’ survey and the review of scientific literature, a questionnaire with 114 questions was designed. Finally, with experts’ opinions, data elements were determined.Results:An MDS for developing web-based PHR for patients under chronic dialysis was created with 17 data classes including demographic information, insurance information, contact information in case of emergency, information on dialysis sessions, physicians information, dialysis center information, information on individual measured values (blood pressure, blood sugar, and weight), disease history information, information on surgical procedures and operations, history of visits, allergies, vaccinations, family history, drugs, laboratory tests, diet, and education materials for the patient.Conclusion:In this study, an MDS was developed for a web-based PHR for dialysis patients. The use of standard data can help collect the data that is essential to improve the patient’s health and track his medical condition.

With the passage of the Affordable Care Act and the development of a National Workforce Commission, multiple entities have increased their interest in collecting standardized health care workforce data at the state and national levels. In a tight budget environment, developing data sets which collect the minimum needed information that is necessary for workforce planning and supply/demand projections has become critically needed. This article represents the second of a two part series describing the work that the Forum of State Nursing Workforce Centers has undertaken during the last 3 years toward standardizing nursing workforce data. Part I described the initial steps that informed the development of national nursing workforce minimum data sets. Part II describes the consensus model used to develop the minimum data sets as well as an update on the implementation of the minimum data sets in individual states including challenges and barriers encountered.

BackgroundCurrent wound assessment practices are lacking on several measures. For example, the most common method for measuring wound size is using a ruler, which has been demonstrated to be crude and inaccurate. An increase in periwound temperature is a classic sign of infection but skin temperature is not always measured during wound assessments. To address this, we have developed a smartphone application that enables non-contact wound surface area and temperature measurements. Here we evaluate the inter-rater reliability and accuracy of this novel point-of-care wound assessment tool.Methods and findingsThe wounds of 87 patients were measured using the Swift Wound app and a ruler. The skin surface temperature of 37 patients was also measured using an infrared FLIR™ camera integrated with the Swift Wound app and using the clinically accepted reference thermometer Exergen DermaTemp 1001. Accuracy measurements were determined by assessing differences in surface area measurements of 15 plastic wounds between a digital planimeter of known accuracy and the Swift Wound app. To evaluate the impact of training on the reproducibility of the Swift Wound app measurements, three novice raters with no wound care training, measured the length, width and area of 12 plastic model wounds using the app. High inter-rater reliabilities (ICC = 0.97–1.00) and high accuracies were obtained using the Swift Wound app across raters of different levels of training in wound care. The ruler method also yielded reliable wound measurements (ICC = 0.92–0.97), albeit lower than that of the Swift Wound app. Furthermore, there was no statistical difference between the temperature differences measured using the infrared camera and the clinically tested reference thermometer.ConclusionsThe Swift Wound app provides highly reliable and accurate wound measurements. The FLIR™ infrared camera integrated into the Swift Wound app provides skin temperature readings equivalent to the clinically tested reference thermometer. Thus, the Swift Wound app has the advantage of being a non-contact, easy-to-use wound measurement tool that allows clinicians to image, measure, and track wound size and temperature from one visit to the next. In addition, this tool may also be used by patients and their caregivers for home monitoring.

This paper provides an overview of literature on wound management, including wound assessment and wound care and their relationship to the healing process. No attempt is made to describe individual tools or dressing materials as this literature can be found elsewhere. Patient and economic benefits of accurate wound assessment and choice of dressing material are highlighted. The case for an improved and updated nursing knowledge base regarding all aspects of wound care is made.

BackgroundChronic wounds (CWs) represent a significant and growing challenge in healthcare due to their prolonged healing times, complex management, and associated costs. Inadequate wound assessment by healthcare professionals (HCPs), often due to limited training and high clinical workload, contributes to suboptimal treatment and increased risk of complications. This study aimed to develop an artificial intelligence (AI)-powered wound assessment tool, integrated into a mobile application, to support HCPs in diagnosis, monitoring, and clinical decision-making.MethodsA multicenter observational study was conducted across three healthcare institutions in Western Switzerland. Researchers compiled a hybrid dataset of approximately 4,000 wound images through both retrospective extraction from clinical records and prospective collection using a standardized mobile application. The prospective data included high-resolution images, short videos, and 3D scans, along with structured clinical metadata. Retrospective data were anonymized and manually annotated by wound care experts. All images were labeled for wound segmentation and tissue classification to train and validate deep learning models.ResultsThe resulting dataset represented a broad spectrum of wound types (acute and chronic), anatomical locations, skin tones, and healing stages. The AI-based wound segmentation model, developed using the Deeplabv3 + architecture with a ResNet50 backbone, achieved a DICE score of 92% and an Intersection-over-Union (IOU) score of 85%. Tissue classification yielded a preliminary mean DICE score of 78%, although accuracy varied across tissue types, especially fibrin and necrosis. The models were optimized for mobile implementation through quantization, achieving real-time inference with an average processing time of 0.3 seconds and only a 0.3% performance reduction. The dual approach to data collection, prospective and retrospective—ensured both image standardization and real-world variability, enhancing the model’s generalizability.ConclusionsThis study laid the foundation for an AI-driven digital tool to assist clinical wound assessment and education. The integration of robust datasets and AI models demonstrated the potential to improve diagnostic precision, support personalized care, and reduce wound-related healthcare costs. Although challenges remained, particularly in tissue classification, this work highlighted the promise of AI in transforming wound care and advancing clinical training.Trial registrationNot applicable.

Introduction. Wound healing of the anal canal and perineum after surgery is a complex process, often accompanied by prolonged recovery and the risk of non-healing wounds. There are 2 stages of postoperative rehabilitation. It is the second stage of rehabilitation that is the most difficult for the patient and the doctor.Aim. To study the effectiveness of lanolin Superlimf® cream-balm in the treatment of anal canal wounds and its practical application in the postoperative period in patients with benign diseases of the anal canal, rectum and perianal region.Materials and methods. A total of 15 patients (mean age 39 ± 7 years) who underwent hemorrhoidectomy were enrolled in the pilot interventional non-comparative study. The patients applied the cream-balm to the wounds 2 times a day starting from day 15 after surgery. The follow-up observation included monitoring of wound healing status, assessment of pain syndrome, discomfort, the nature of discharge and treatment satisfaction. The wound assessment and documentation of findings were conducted every 5 days.Results. Complete epithelialization of subcutaneous wounds within 45 days was recorded in 87% (13/15) of cases. At the same time, the effect of local therapy was completely satisfactory to patients, due to the low level of pain and discomfort in the anus, and the nature of the discharge. Cream-balm has shown a good safety profile, which is confirmed by the absence of adverse events. Discussion. When assessing effectiveness regarding skin wound healing, accelerated epithelialization and angiogenesis were observed with the use of MSC-CM (mesenchymal stem cell conditioned medium) compared to placebo. Cytokine proteins isolated from pig blood are suitable for humans due to their highly conserved structure and comparability of properties observed in different mammalian species, which makes it possible to model experimental data and approaches from one mammal to another.Conclusion. Cream-balm has demonstrated efficacy and safety in the treatment of wounds of the anal canal and perianal area.