Nursing Interventions in Prevention and Healing of Leg Ulcers: Systematic Review of the Literature

Aim: The purpose of this study was to define nursing interventions for patients with venous, arterial or mixed leg ulcers. Methodology: A survey was conducted in EBSCO (CINAHL Plus with Full Text, MEDLINE with Full Text), MedicLatina, Academic Search Complete, with full text articles, published between 2008/01/01 and 2015/01/31, with the following keywords: [(MM "leg ulcer") OR (wound care) OR (wound healing)] AND [(nursing) OR (nursing assessment) OR (nursing intervention)]. Results: The different leg ulcer etiologies require different therapeutic approach to prevention and treatment. Predictive factors were identified associated with healing: patient-centred care, interpersonal relationship, pain control, control of the exudate, education for health self-management, self-care, therapeutic compliance, implementation of guidelines, auditing and feedback on the practices. Conclusion: Evidence-based practice helps to improve efficiency, safety and quality of nursing care directed to people with leg ulcers or at risk of developing this type of wounds.

Assessment of the elderly’s functional ability to manage theirmedication: a systematic literature review

Background The evaluation of the elderly’s ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly’s functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P—Population(elderly), I—Instruments (tools for assessing medication management ability), C—Context (community) and O—Outcomes (functional ability to manage medication). Thefinal search query was run in MEDLINE/PubMed,CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults’ ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.

Functional defict and sensitive outcomes to nursing care for elderly: Systematic literature review.

ABSTRACT Objective of this study was to determine sensitive outcomes to nursing care in relation to the functional deficit of people aged 65 and older. It is a Systematic Literature Review with qualitative synthesis and meta-analysis. From the qualitative synthesis, it was found that sensitive outcomes to nursing care, observed from structured intervention, were described as improvement of: functional status, self-care, symptom control, safety/adverse events, customer satisfaction, psychological support, decreased healthcare costs, therapeutic system management and quality of life. In meta-analysis we found that there is an improvement of effect on the level of sensitive outcomes to the nursing care between the experimental and control groups. It is noticed that it is necessary to rouse more guided study in clinical practice, to understand the importance of interventions sensitive to nursing care and health outcomes.