PURPOSE The aims of this study were to develop the unit specialist-led pressure ulcer nursing algorithm for hospital nurses, and to examine its clinical adequacy. METHODS The study used a methodological design. The algorithm was developed through the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model using the combination of systematic review, clinical staff interview, and expert panel interview. Thirty nurses in two hospital units applied the algorithm to 30 patients from September 7, 2017 to September 20, 2017. RESULTS The contents of the nursing algorithm included roles of the unit specialist, application of the algorithm, assessment, nursing interventions, and documentation. The algorithm had acceptable validity of Scale-level Content Validity Index (S-CVI) from .93 to .95. The Braden scale scores were significantly improved from 12.37±3.30 to 13.67±3.59 (t=20.55, p<.001) in the patients who used the algorithm. The hospital unit nurses rated the algorithm's clinical adequacy as acceptable, with a mean score ranging from 3.30±0.65 to 3.67±0.48. The most highly rated item was that “pressure ulcer has been detected and managed promptlyâ€. CONCLUSION The unit specialist-led pressure ulcer nursing algorithm in general hospital units facilitated the prompt and accurate decision-making for hospital unit nurses. Using this algorithm, the hospital unit nurses will be able to provide relevant and prompt care for pressure ulcer prevention and management.
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PURPOSE Although post-stroke sensory disorder is different from post-stroke pain, it is often considered as central pain or overlooked in the clinical field. The purposes of this study were to develop the nursing algorithm for stroke patients with sensory disorder and examine its effect. METHODS The study used a methodological design to develop the nursing algorithm and a pretest-posttest design to examine its effect in stroke patients. The algorithm was developed through the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) using systematic review, expert panel interview, and patient interview. The algorithm was applied to 51 ischemic stroke patients experiencing sensory disorder at subacute stage by 10 nurses in a university hospital in Seoul city, Korea. RESULTS The contents of the algorithm included inclusion and exclusion criteria for relevant patients, assessment tool developed in this study, and the intervention (non-pharmacological and pharmacological) process based on the assessment results. The assessment tool and the intervention process had acceptable inter-rater reliability with Cohen's Kappa .82 and .94, respectively. The scores of sensory disorder decreased from 2.71 to 0.51 with the algorithm application in 51 patients. CONCLUSION The nursing algorithm for sensory disorder in stroke patients improved the symptoms and can be used conveniently by clinical nurses. Using this algorithm, nurses can provide relevant care for stroke patients with stiff, cool, obtuse, or vibrating sensors that cause insomnia, anorexia, and physical functional decline.
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Development of the Unit Specialist-led Pressure Ulcer Nursing Algorithm Yuna Noh, Jia Lee Korean Journal of Adult Nursing.2019; 31(4): 365. CrossRef
PURPOSE The purpose of this study was to develop an algorithm for preventing and managing of pressure ulcer and to verify the its appropriateness. METHODS: The first step was development of a pre-algorithm through a literature review and expert opinion. The second step was to establish content validity by submitting the algorithm questionnaires about the content to 12 experts. The third step was the revision of the algorithm. The fourth and last step was to establish the clinical validity of the algorithm with 25 experienced nurses. RESULTS: For the ease of the practitioner the algorithm for prevention and the management of pressure ulcers was confined to one page depicting the main algorithm pathway and seven stepwise guidelines. The guidelines included skin care of pressure ulcer prevention, mechanical loading care, support surface care , reposition care of pressure ulcer, and Stages II, III and IV explanations along with debridement/wound irrigation and infection control. Most of all algorithm courses chosen more than 80% of agreement by expert index of content validity. The usefulness, appropriateness, and convenience of the algorithm were demonstrated through clinical validity with intensive care unit and ward nurses. CONCLUSION: The algorithm will improve the quality of pressure ulcer nursing care as it provides a model for decision making for clinical nurses as well as providing consistent and integrated nursing care for patients with pressure ulcer throughout an institution.