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Adapting national and international leg ulcer practice guidelines for local use: the Ontario Leg Ulcer Community Care Protocol.

https://arctichealth.org/en/permalink/ahliterature173361
Source
Adv Skin Wound Care. 2005 Jul-Aug;18(6):307-18
Publication Type
Article
Author
Ian D Graham
Margaret B Harrison
Karen Lorimer
Tadeusz Piercianowski
Elaine Friedberg
Maureen Buchanan
Connie Harris
Author Affiliation
School of Nursing, University of Ottawa, and Ottawa Health Research Institute, Ottawa, Ontario, Canada.
Source
Adv Skin Wound Care. 2005 Jul-Aug;18(6):307-18
Language
English
Publication Type
Article
Keywords
Community Health Services - standards
Evidence-Based Medicine
Humans
International Cooperation
Leg Ulcer - diagnosis - therapy
National Health Programs - standards
Ontario
Practice Guidelines as Topic
Severity of Illness Index
Total Quality Management
Abstract
Because of growing resources devoted to individuals requiring community care for leg ulcers, the authority responsible for home care in Ottawa, Ontario, Canada, established and evaluated a demonstration leg ulcer service. In an effort to provide current and evidence-based care, existing leg ulcer clinical practice guidelines were identified and appraised for quality and suitability to the new service.
The Practice Guideline Evaluation and Adaptation Cycle guided development of a local protocol for leg ulcer care, which included: (1) systematically searching for practice guidelines, (2) appraising the quality of identified guidelines using a validated guideline appraisal instrument, (3) conducting a content analysis of guideline recommendations, (4) selecting recommendations to include in the local protocol, and (5) obtaining practitioner and external expert feedback on the proposed protocol. Updating the protocol followed a similar process.
Of 19 identified leg ulcer practice guidelines, 14 were not evaluated because they did not meet the criteria (ie, treatment-focused guidelines, written in English and developed after 1998). Of the 5 remaining guidelines, 3 were fairly well developed and made similar recommendations. The level of evidence supporting specific recommendations ranged from randomized clinical trial evidence to expert opinion. By comparing the methodologic quality and content of the guidelines, the Task Force reached consensus regarding recommendations appropriate for local application. Two additional guidelines were subsequently identified and incorporated into the local protocol during a scheduled update.
Local adaptation of international and national guidelines is feasible following facilitation of the Practice Guidelines Evaluation and Adaptation Cycle.
PubMed ID
16096396 View in PubMed
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[A new system of specialized gastroenterological care to patients with inflammatory bowel diseases in St. Petersburg].

https://arctichealth.org/en/permalink/ahliterature114067
Source
Ter Arkh. 2013;85(2):17-20
Publication Type
Article
Date
2013
Author
A Iu Baranovskii
É A Kondrashina
A M Segal'
Source
Ter Arkh. 2013;85(2):17-20
Date
2013
Language
Russian
Publication Type
Article
Keywords
Colitis, Ulcerative - diagnosis - therapy
Crohn Disease - diagnosis - therapy
Early Diagnosis
Hospitals, Special - organization & administration - standards
Humans
Inflammatory Bowel Diseases - diagnosis - therapy
Russia
Severity of Illness Index
Time Factors
Urban Health - standards
Abstract
To substantiate the effectiveness of the set-up center in the early detection of patients with inflammatory bowel diseases (IBD) and in its organization and implementation of current therapeutic programs.
The therapeutic activity of the specialized medical care system set up in St. Petersburg for patients with IBD (ulcerative colitis (UC) and Crohn's disease (CD)), which is based on a multifunctional inflammatory bowel disease center at City Clinical Hospital Thirty-One, was analyzed.
The effective work of the center could reduce time for verification of the diagnosis of UC from 6.4 +/- 1.4 to 3.6 +/- 0.8 months and CD from 28.6 +/- 6.7 to 15.3 +/- 4.2 months, respectively; decline the annual number of patients with moderate and severe UC from 73.4 to 53.6 and CD from 66.7 to 47%, and also set up a centralized system for all required types of current therapeutic and diagnostic care for these patients.
The establishment of the St. Petersburg Center for the diagnosis and treatment of inflammatory bowel diseases could develop and realize in practice a new closed-loop urban system for the early detection and notification of IBD patients, the organization and rendering of individual effective therapeutic-and-prophylactic care.
PubMed ID
23653933 View in PubMed
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Comparing video consultation with inperson assessment for Swedish patients with hard-to-heal ulcers: registry-based studies of healing time and of waiting time.

https://arctichealth.org/en/permalink/ahliterature294533
Source
BMJ Open. 2018 02 15; 8(2):e017623
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
02-15-2018
Author
Hanna L Wickström
Rut Frank Öien
Cecilia Fagerström
Peter Anderberg
Ulf Jakobsson
Patrik J Midlöv
Author Affiliation
Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Source
BMJ Open. 2018 02 15; 8(2):e017623
Date
02-15-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Office Visits
Physical Examination
Primary Health Care
Referral and Consultation
Registries
Severity of Illness Index
Sweden
Telemedicine - methods
Ulcer - diagnosis - therapy
Waiting Lists
Wound Healing
Abstract
To investigate differences in ulcer healing time and waiting time between video consultation and inperson assessment for patients with hard-to-heal ulcers.
Patients treated at Blekinge Wound Healing Centre, a primary care centre covering the whole of Blekinge county (150 000 inhabitants), were compared with patients registered and treated according to the Registry of Ulcer Treatment, a Swedish national web-based quality registry.
In the study for analysing ulcer healing time, the study group consisted of 100 patients diagnosed through video consultation between October 2014 and September 2016. The control group for analysing healing time consisted of 1888 patients diagnosed through inperson assessment during the same period. In the study for analysing waiting time, the same study group (n=100) was compared with 100 patients diagnosed through inperson assessment.
Differences in ulcer healing time were analysed using the log-rank test. Differences in waiting time were analysed using the Mann-Whitney U test.
Median healing time was 59 days (95%?CI 40 to 78) in the study group and 82 days (95%?CI 75 to 89) in the control group (P
Notes
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Cites: J Wound Care. 2006 Jun;15(6):259-62 PMID 16802562
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Cites: BMJ. 1992 Dec 5;305(6866):1389-92 PMID 1486301
Cites: J Wound Care. 2011 Apr;20(4):187-90 PMID 21537307
PubMed ID
29449288 View in PubMed
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Effect of a new silver dressing on chronic venous leg ulcers with signs of critical colonisation.

https://arctichealth.org/en/permalink/ahliterature170130
Source
J Wound Care. 2006 Mar;15(3):97-100
Publication Type
Article
Date
Mar-2006
Author
B. Jørgensen
N. Bech-Thomsen
B. Grenov
F. Gottrup
Author Affiliation
Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark.
Source
J Wound Care. 2006 Mar;15(3):97-100
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bandages
Chronic Disease
Denmark
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Risk assessment
Severity of Illness Index
Silver Compounds - therapeutic use
Single-Blind Method
Treatment Outcome
Varicose Ulcer - diagnosis - therapy
Wound Healing - drug effects - physiology
Abstract
To investigate the clinical performance and safety of a new silver-containing wound-contact layer, Physiotulle -Ag (Coloplast), in the treatment of chronic venous leg ulcers with delayed healing and signs of critical colonisation.
This was an open prospective non-comparative multicentre clinical study. Patients were treated for four weeks with Physiotulle -Ag, which was covered by Alione Hydrocapillary Dressing (Coloplast).
Thirty patients were recruited into the study. One ulcer healed after three weeks of treatment. The mean relative ulcer area reduced by 55% after four weeks. Over the study period the mean amount of healthy granulation tissue increased from 26% to 62%, and the mean amount of fibrin decreased from 63% to 32%. The ratio of malodorous wounds was 50% at inclusion, 20% after one week and 3% after four weeks. The dressing was considered easy or very easy to apply in 100% and easy to remove in 89% of dressing evaluations. The dressing combination showed good exudate-management properties. Incidence and severity of maceration, erythema and eczema decreased during the study and no device-related adverse events were recorded.
Physiotulle -Ag is safe and easy to use in chronic venous leg ulcers in which healing is delayed and with signs of critical colonisation.
PubMed ID
16550661 View in PubMed
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Evaluation of the quality of venous leg ulcer care given in a multidisciplinary specialist centre.

https://arctichealth.org/en/permalink/ahliterature175218
Source
J Wound Care. 2005 Apr;14(4):145-50
Publication Type
Article
Date
Apr-2005
Author
M L Kjaer
L T Sorensen
T. Karlsmark
J. Mainz
F. Gottrup
Author Affiliation
Copenhagen Wound Healing Center, H:S Bispebjerg Hospital, University of Copenhagen, Denmark. m.kjaer@dadlnet.dk
Source
J Wound Care. 2005 Apr;14(4):145-50
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care Facilities - standards
Denmark
Humans
Medical Audit
Patient Care Team - standards
Practice Guidelines as Topic
Quality of Health Care
Retrospective Studies
Varicose Ulcer - diagnosis - therapy
Wound Healing
Abstract
To determine the quality of venous leg ulcer care given in a multidisciplinary, specialist wound-healing centre and to identify problem areas that might affect it.
The case records of 90 consecutive patients with venous leg ulcers, diagnosed and treated at the Copenhagen Wound Healing Centre, Denmark, were retrospectively audited by a Scandinavian cross-sectional and multidisciplinary expert panel. Quality of care was audited in each case using implicit criteria. The experts then formulated key recommendations for good clinical practice for patients with venous leg ulcers.
Quality of care was satisfactory in 74 patients (82%). The one-year healing rate was 77% (69/90), with a three-month recurrence rate of 12% (11/90). Identified problem areas included the lack of systematic assessment of patients' suitability for surgery; lack of systematic, duplex-verified diagnoses of venous aetiology; and the lack of systematic examination of distal arterial pressure. The recommendations include the need for venous diagnosis, differential diagnosis, compression therapy, surgery, systemic treatment, access to venous leg ulcer care and better communication.
The quality of venous leg ulcer care given in this multidisciplinary centre was satisfactory.
PubMed ID
15835223 View in PubMed
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[New Swedish guidelines for the management of dyspepsia, H pylori, and duodenal and gastric ulcers].

https://arctichealth.org/en/permalink/ahliterature282920
Source
Lakartidningen. 2017 Feb 28;114
Publication Type
Article
Date
Feb-28-2017
Author
Lars Agreus
Magnus Simrén
Source
Lakartidningen. 2017 Feb 28;114
Date
Feb-28-2017
Language
Swedish
Geographic Location
Sweden
Publication Type
Article
Keywords
Critical Pathways
Duodenal Ulcer - diagnosis - therapy
Dyspepsia - diagnosis - therapy
Helicobacter Infections - diagnosis - therapy
Helicobacter pylori - isolation & purification
Humans
Middle Aged
Practice Guidelines as Topic
Stomach Ulcer - diagnosis - therapy
Sweden
Abstract
New Swedish guidelines for the management of dyspepsia, H pylori, and duodenal and gastric ulcers The management of dyspepsia in Sweden differs between national county councils, and is often not in line with international recommendations. The Swedish Society of Gastroenterology has together with the Swedish College of General Practice (SFAM) developed new national guidelines for the management of uninvestigated dyspepsia, functional dyspepsia, Helicobacter pylori, and uncomplicated duodenal and gastric ulcers. The new Swedish guidelines emphasize that patients under 50 years of age with new onset of uninvestigated dyspepsia without any alarm symptoms or signs can be managed with the »Test and treat« strategy. Moreover, patients with a known H pylori infection and bothersome symptoms of functional dyspepsia shall be offered eradication therapy. The recommendations for triple therapy for H pylori eradication take into account the estimated average national antibiotic resistance patterns, environmental factors and potential effects on gut microbiota.
PubMed ID
28267193 View in PubMed
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[Prospective examination of newly diagnosed cases of ulcerative colitis and regional enterocolitis (Crohn's disease) in Norway. Results from 1972].

https://arctichealth.org/en/permalink/ahliterature252972
Source
Tidsskr Nor Laegeforen. 1974 Nov 10;94(31):2143-6
Publication Type
Article
Date
Nov-10-1974

A qualitative study of the key factors in implementing telemedical monitoring of diabetic foot ulcer patients.

https://arctichealth.org/en/permalink/ahliterature272983
Source
Int J Med Inform. 2015 Oct;84(10):799-807
Publication Type
Article
Date
Oct-2015
Author
B S B Rasmussen
L K Jensen
J. Froekjaer
K. Kidholm
F. Kensing
K B Yderstraede
Source
Int J Med Inform. 2015 Oct;84(10):799-807
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Ambulatory Care - organization & administration
Computer Literacy
Denmark
Foot Ulcer - diagnosis - therapy
Humans
Models, organizational
Monitoring, Ambulatory - methods
Nurses, Community Health - organization & administration
Remote Consultation - organization & administration
Abstract
The implementation of telemedicine often introduces major organizational changes in the affected healthcare sector. The objective of this study was to examine the organizational changes through the perception of the healthcare professionals regarding the implementation of a telemedical intervention. We posed the following research question: What are the key organizational factors in the implementation of telemedicine in wound care?
In connection with a randomized controlled trial of telemedical intervention for patients with diabetic foot ulcers in the region of Southern Denmark, we conducted an organizational analysis. The trial was designed as a multidisciplinary assessment of outcomes using the Model of ASsessment of Telemedicine (MAST). We conducted eight semi-structured interviews including individual interviews with leaders, and an IT specialist as well as focus group interviews with the clinical staff. A qualitative data analysis of the interviews was performed in order to analyze the healthcare professionals and leaders perception of the organizational changes caused by the implementation of the intervention.
The telemedical setup enhanced confidence among collaborators and improved the wound care skills of the visiting nurses from the municipality. The effect was related to the direct communication between visiting nurses and specialist doctors. Focus on the training of the visiting nurses was highlighted as a key factor in the success to securing implementation. Concerns regarding lack of multidisciplinary wound care teams, patient responsibility and lack of patient interaction with the physician were raised. Furthermore, the need for clinical guidelines in future implementation was underlined.
Several influential factors were demonstrated in the analysis including visiting nurses wound care training, focus on management, economy, periods with absence from work and clinical care. However, the technology used here could provide an additional option to offer patients after an individual assessment of their health condition.
PubMed ID
26093794 View in PubMed
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Shared Electronic Health Record Systems: Key Legal and Security Challenges.

https://arctichealth.org/en/permalink/ahliterature292507
Source
J Diabetes Sci Technol. 2017 Nov; 11(6):1234-1239
Publication Type
Journal Article
Date
Nov-2017
Author
Ellen K Christiansen
Eva Skipenes
Marie F Hausken
Svein Skeie
Truls Østbye
Marjolein M Iversen
Author Affiliation
1 Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway (UNN), Tromsø, Norway.
Source
J Diabetes Sci Technol. 2017 Nov; 11(6):1234-1239
Date
Nov-2017
Language
English
Publication Type
Journal Article
Keywords
Access to Information - legislation & jurisprudence
Computer Security - legislation & jurisprudence
Confidentiality - legislation & jurisprudence
Electronic Health Records - legislation & jurisprudence
Health Policy
Humans
Information Dissemination - legislation & jurisprudence
Norway
Patient care team
Policy Making
Telemedicine - legislation & jurisprudence
Ulcer - diagnosis - therapy
Abstract
Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.
Notes
Cites: J Diabetes Sci Technol. 2011 May 01;5(3):768-77 PMID 21722592
Cites: Stud Health Technol Inform. 2011;169:417-21 PMID 21893784
Cites: JMIR Res Protoc. 2016 Jul 18;5(3):e148 PMID 27430301
PubMed ID
28560899 View in PubMed
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[The characteristics of treating gastric and duodenal peptic ulcer in workers in an oil-refining enterprise].

https://arctichealth.org/en/permalink/ahliterature216550
Source
Med Tr Prom Ekol. 1995;(4):27-8
Publication Type
Article
Date
1995
Author
M M Murzanov
M N Iskakov
Source
Med Tr Prom Ekol. 1995;(4):27-8
Date
1995
Language
Russian
Publication Type
Article
Keywords
Absenteeism
Adult
Aged
Bashkiria
Chemical Industry
Chronic Disease
Duodenal Ulcer - diagnosis - therapy
Female
Humans
Male
Middle Aged
Occupational Diseases - diagnosis - therapy
Petroleum
Stomach Ulcer - diagnosis - therapy
Abstract
The article covers a topical problem--study of transitory disablement in oil-processing workers suffering from peptic ulcer. The authors demonstrate data on increased occurrence of peptic ulcer among those workers engaged mostly into the main industrial process and stress the great economic detriment caused by the disease. Application of endoscopy treatment and therapy within the local prophylactic department appeared to dramatically decrease the transitory disablement. The article could be interesting for gastroenterologists, industrial medicine officers.
PubMed ID
7613780 View in PubMed
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10 records – page 1 of 1.