Browsing Health and Social Care by Publisher "Mark Allen Publishers"
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The abused perineumThis article discusses whether too many second degree tears are being left to heal themselves, when in fact they should be sutured. There is a need for more research based evidence by randomised controlled trial to help with decisions as to the best treatment
Childbearing women, violence and abuse in the workplacePregnancy may trigger or exacerbate domestic violence, but current involvement of health professionals in dealing with this is poor. A training initiative undertaken in Leeds has developed a programme to help the midwife to recognise and support women who experience violence.
Cold therapy and perineal wounds: Too cool or not too cool?Perineal trauma following childbirth often has numerous negative consequences for many women and the associated pain can dominate the experience of early motherhood. Applications of cold compresses have been in use for centuries as a form of localized treatment and these have become a generally accepted method to treat acute injuries. However, concerns have been expressed as to whether cold therapy can delay wound healing. The purpose of this article is to review the recent evidence concerning the beneficial use of cold therapy, when applied locally to perineal wounds and non-perineal wounds and to consider if such treatment may have an adverse effect on the rate of wound healing. In addition, the mechanism of the action of cold therapy is discussed. We conclude that there is no clear evidence to support the suggestion that when controlled therapy is applied to the traumatized perineum or other injured parts of the body that this will result in a delay in wound healing. Such treatment should continue until clear evidence is produced to the contrary.
Evidence-informed practice: simplifying and applying the concept for nursing students and academicsAbstract Background: Nurses’ ability to effectively apply evidence into practice is a critical factor in the delivery of quality patient care. Evidence-Based Practice (EBP) is recognized as the gold standard for the delivery of safe and effective person-centred care. Yet, after several decades of its inception, nurses continue to encounter difficulties in implementing the concept. Existing models for implementing EBP offer stepwise approaches, nevertheless, certain factors, such as the context of care and its mechanistic nature act as barriers to the effective and consistent implementation of EBP. It is, therefore, imperative that a solution to solving the way in which evidence is applied into practice is found. Evidence-Informed Practice (EIP) is an evolving concept. In recent times, there has been a focus on EIP as an alternative to EBP. This has generated an international debate as to which of the two concepts better facilitate the application of evidence into practice. While several EBP models and educational interventions exist, there is limited research directed towards understanding the concept of EIP and how it facilitates the application of evidence into clinical nursing practice. Aim: This article aims at clarifying the concept of EIP and provides an integrated systems-based model of EIP in facilitating the application of evidence into clinical nursing practice. This is achieved through the application of two nursing case scenarios. Case scenario 1 is about caring for a high-dependent patient and case scenario 2 involves a patient with a low white blood cell count. Method: this article takes the reader through the various factors, elements, and associated systems and processes of the EIP model. Results: The case scenarios detail the various factors and elements of the EIP model and defines how it facilitates the application of evidence into clinical nursing practice. Conclusion: The EIP model provides a framework for nurses (indeed all healthcare practitioners) to deliver clinically effective care, and to be able to defend the processes used and the service provided by referring to reliable evidence. Revised