Pinar Avsar

• Royal College of Surgeons in Ireland

Background Chronic wounds can pose a significant challenge for patients and healthcare professionals including the morbidity and associated costs. It is therefore essential to understand the specific challenges faced by patients to make wound care services more effective and convenient for the patient population. Aim Using the PEO model, this syste...

Background Pressure ulcers occur when people cannot reposition themselves to relieve pressure over bony prominences. They are difficult to heal, costly, and reduce quality of life. Dressings and topical agents (lotions, creams, and oils) for pressure ulcer prevention are widely used. However, their effectiveness is unclear. This is the third update...

Pressure ulcers (PU) are a globally recognised healthcare concern, with their largely preventable development prompting the implementation of targeted preventive strategies. Risk assessment is the first step to planning individualised preventive measures. However, despite the long use of risk assessment, and the >70 risk assessment tools currently...

To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub‐epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design t...

Transforming Wound Care Education: Enhancing Postgraduate Learning through a hybrid approach based on engagement and reflective learning

Aim To determine the impact of home‐based management on hospital re‐admission rates in patients with chronic obstructive pulmonary disease (COPD). Design Systematic review methodology was utilized, combining meta‐analysis, where appropriate, or a narrative analysis of the data from included studies. Data Sources Electronic databases CINAHL, MEDLI...

Aim To gain a greater understanding of how compression therapy affects quality of life, this systematic review appraised existing published studies measuring the impact of compression therapy on health quality of life (HRQoL), and pain, among people with venous leg ulcers (VLU). Method Five databases were searched, and two authors extracted data a...

Purpose This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults. Design/methodology/approach The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysi...

A 47-year-old woman who presented to the hospital with left sided weakness, left sided paraesthesia, ataxic gait, headache, nausea and vomiting was found to have multiple infarct strokes. Her past medical history was significant for iron deficiency anaemia secondary to menorrhagia. Her haemoglobin level on arrival at the hospital was 7.3 gm/dl. Her...

Aims To determine the impact of a multi‐component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community. Method A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science)...

Background Stoma formation is a commonly performed procedure both during and following colorectal surgery. When designed correctly, stomas can dramatically improve patients’ quality of life, but the reverse may occur when complications arise. Given the significant negative impact of complications following stoma formation, understanding risk factor...

Background Traumatic brain injuries (TBIs) are one of the leading causes of death or long‐term disability around the world. As a result of improvements in supportive care, patients are surviving more severe insults with more pronounced dependency on their families, hospitals, and long‐term care facilities. The introduction of brain tissue oxygenati...

Objective The aim of this systematic review was to critically appraise and synthesise the existing research literature pertaining to nurses' attitudes toward pressure ulcer (PU) prevention. Method The systematic review presented in our paper serves as an updated version of the definitive review conducted by Avsar et al. in 2019. Using systematic r...

Objective To investigate the impact of education for healthcare assistants (HCAs) on their knowledge and skills in pressure ulcer (PU) prevention and on the incidence of PUs. A secondary aim was to evaluate education methodologies used in PU prevention programmes. Method Using systematic review methodology, key databases were searched with no limi...

Purpose: The purpose of this study was to determine the point prevalence (PP) of general pressure injuries (PIs), hospital-acquired PIs, PI-related risk factors, and PI preventive interventions performed by nurses. Design: Descriptive, multicenter, prospective, analytical study. Subjects and setting: The sample comprised 5088 patients cared fo...

Aim: To determine the monetary costs identified in economic evaluations of treatment with compression bandages among adults with venous leg ulcers (VLU). Method: A scoping review of existing publications was conducted in February 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Results:...

Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of e...

Purpose: To explore the effect of silicone dressings on the prevention of pressure injuries in patients cared for in the acute care setting. Three main comparisons were explored: silicone dressing versus no dressing, all anatomical areas; silicone dressing versus no dressing on the sacrum; and silicone dressing versus no dressing on the heels. Me...

Background Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality. Parastomal hernias can occur after any surgery requiring stoma formation and is an area of concern as a complication as it can require a second surgery or emergency surgical intervention. Aim To assess the impac...

Objective Pressure ulcers (PUs) commonly occur over bony prominences and are notoriously difficult to treat. Proinflammatory cytokines are substances that initiate the inflammatory process preceding PU development. The aim of this review was to assess whether the increased presence of proinflammatory cytokines could potentially be used as an early...

Background Intracranial pressure (ICP) monitoring and cerebral perfusion pressure (CPP) monitoring are long established adjuncts in the management of traumatic brain injuries (TBIs). However, brain tissue oxygenation (PbtO 2 ) monitoring, used in conjunction with ICP or CPP monitoring, is an additional element that could be used in directing the ma...

This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149...

Objectives To ascertain the impact of home non-invasive ventilation (NIV) on the health-related quality of life (HRQL) of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Design Systematic review. Methods A preliminary search of computerised databases (CINAHL, Medline, Clinical Key, Cochrane) was conducted in June 20...

Aim: This study aimed to adapt the Pressure Ulcer Quality of Life instrument to Turkish and to determine the validity and reliability by using the Rasch model. Materials and methods: This methodological study used forward translation, expert opinion, back translation, pilot testing, and finalization for the language adaptation of the instrument....

Objective The aim of this clinically orientated paper is to offer an overview of diabetic foot ulcer (DFU) dressings generally, and more specifically, their use in the treatment of DFUs. Method The TIME clinical decision support tool (CDST) has been used as a clinical tool that can help clinicians bring together the different aspects of dressings...

This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion cri...

Objective The aim was to assess evidence related to the measuring of subepidermal moisture (SEM) to detect early, nonvisible development of pressure ulcers (PUs). Method Using systematic review methodology, all quantitative animal and human research studies written in English were considered. In January 2021, PubMed, CINAHL, SCOPUS, Cochrane and E...

The present study sought to explore the impact of movement monitoring devices on risk prediction and prevention of pressure ulcers (PU) among adults. Using systematic review methodology, we included original research studies using a prospective design, written in English, assessing adult patients' movement in bed, using a movement monitoring device...

This meta-review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR-2 tool was used for quality appraisa...

Objective: This systematic review assesses the effects of care bundles on the incidence of surgical site infections (SSIs). Data sources: The search was conducted between February and May 2021, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. Study selection: Studies were included if they used systematic review methodology, were i...

Early transition to full enteral intake reduces the risk of nosocomial infection and metabolic complications related to prolonged use of parenteral nutrition. Evidence on what feed advancement rates will reduce these complications and minimize extrauterine growth restriction is necessary. This is a systematic review to determine the efficacy and sa...

Background: EM has been hypothesized to help prevent the development of ICU acquired weakness and may therefore result in positive outcomes for ICU patients. Aim: To establish the impact of Early mobilization (EM) on adult Intensive Care Unit (ICU) patients in terms of ICU length of stay (LOS), as well as hospital LOS, duration of mechanical ven...

Aim The aim of this systematic review was to determine the impact that specialist community palliative care teams (SCPCT) have on acute hospital admission rates in adult palliative care (PC) patients who require End of Life Care (EOLC). Method Using systematic review methodology, eight studies were obtained from thorough searching of CINAHL, Medli...

Aim: To examine the impact that patient violence, experienced in the Emergency Department has on emergency nurses' intention to leave their job. Background: Emergency Departments have become known for their overcrowding, chaos, unpredictability, and violence. Emergency nurses are at high risk of experiencing workplace violence which is cited in...

PATTON, D., WILSON, H., AVSAR, P. & MOORE, Z. 2022.Pressure Ulcer Risk and Surgery: Practice Considerations. Wound Masterclass, 1 (1): 70-72. (Editorial) Link to the full-text article: https://issuu.com/woundmasterclass/docs/pressure_ulcer_risk_and_surgery_-_practice_conside?fr=sNDYxMzU1NzEyOTk

Objective The primary objective of this systematic review was to determine the effect of vasopressor agents on the development of pressure ulcers (PUs) among critically ill patients in intensive care units (ICUs). The secondary outcome of interest was length of stay in the ICU. Method A systematic review was undertaken using the databases searched...

The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries among frontline health care workers wearing personal protective equipment (PPE) during the COVID‐19 pandemic. This was a mixed methods study. First, a pre‐posttest observational design was employed to evaluate the imp...

Aim: This review explores the impact of skincare bundles on the development of skin tears in older adults (≥65 years). Method: A systematic search of publications using MEDLINE, CINAHL and Cochrane databases was conducted in July 2020. The evidence-based librarianship (EBL) checklist assessed the methodological quality of the included studies. D...

Objectives The aim of this systematic review (SR) is to establish if video is a beneficial teaching method when teaching psychomotor skills in nursing. Design Systematic review. Data sources A database search of CINAHL, MEDLINE, EMBASE and Cochrane was performed with search terms ‘video’, ‘nurse’ ‘RCT’ and ‘practical skills’ resulting in seventy-...

To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embas...

IntroductionIn orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes.Aim...

Objective Numerous systematic reviews have examined the impact of prone positioning on outcomes, including pressure injury (PI). The objective of this meta-review was to synthesise the evidence on the effect of prone positioning on the incidence and location of PIs in adult intensive care unit patients. Review method This is a meta-review of publi...

Objective To test the feasibility of using a standardised data collection tool to estimate the cost of stage 2–4 pressure ulcer (PU) care within an acute care setting. Method Data on resource use and cost were obtained through a retrospective survey of nursing and medical notes collecting cost data for individual patients who received care for sta...

Background: A pressure ulcer (PU) is a localized injury to the skin or underlying tissue usually over a bony prominence. The prevention PU per patient per day is costly; therefore, the detection of a PU at its earliest stage is imperative to afford timely interventions. Currently, there are very few clinically useful tools to assist with early PU...

Objective The aim of this systematic review was to determine the impact of topical oxygen therapy (TOT) on diabetic foot ulcer (DFU) healing. Method Using systematic review methodology, we considered randomised controlled trials (RCTs), controlled trials, pilot studies and observational studies. The search was conducted in January 2019, using PubM...

Aim This study was conducted to determine the impact of tailored training provided to nurses for preventing pressure injuries (PIs) on nurses’ knowledge levels and the PI point prevalence (PP). Materials and Methods This interventional study was carried out in a university hospital with a bed capacity of 1114 in an urban center in xxxxx. Ethics co...

Aim To examine the impact of team triage on waiting times in adult emergency departments. Design A systematic review using narrative analysis. Method Systematic review methodology, which included quantitative research papers consisting of randomized control trials, cohort or quasi-experimental studies. The PICO framework was used to formulate the...

Purpose The aim of this systematic review was to determine the impact of specialist palliative care consultations in outpatient settings on pain control in adults suffering from cancer. Methods Systematic Review. Databases CINAHL, Medline, PsychInfo, and Embase were searched in February 2021. Relevant studies were also hand-searched and grey liter...

Pressure ulcers (PUs) have a profound impact on individuals, with studies demonstrating that compared with similarly aged persons, those living with a PU have a significantly lower quality of life. The aim of this study was to explore the impact of the Shanley Pressure Ulcer Prevention Programme (SPUPP) on older persons' knowledge of, and attitudes...

Background: Pressure ulcer (PU) development begins with an inflammatory response, arising due to pressure and shear forces causing changes to the cytoskeletal structure of cells. Thus, pain, synonymous with inflammation, may be an indicator of PU development. Aim: To explore the role of pain as an indicator of PU development and to determine how...

Aim: To examine the effectiveness of discharge planning on length of stay and readmission rates among older adults in acute hospitals. Background: Discharge planning takes place in all acute hospital settings in many forms. However, it is unclear how it contributes to reducing patient length of stay in hospital and readmission rates. Evaluation...

Aim To determine the impact of larval therapy on the debridement of venous leg ulcers, in comparison to other debridement methods or no debridement. Method Using systematic review methodology, published quantitative studies focusing on the effect of larval therapy on the debridement of venous leg ulcers were included. The search was conducted in J...

Background: Surgical site infection (SSI) is a common postoperative concern. Purpose: To provide an in-depth understanding of the lived experience and quality of life (QoL) of individuals with SSI. Methods: A systematic search for published studies that explored the impact of SSI on QoL among adult patients (older than 18 years) who had underg...

Background: Leg ulcers are open skin wounds that occur below the knee but above the foot. The majority of leg ulcers are venous in origin, occurring as a result of venous insufficiency, where the flow of blood through the veins is impaired; they commonly arise due to blood clots and varicose veins. Compression therapy, using bandages or stockings,...

Objective Lymphoedema is a debilitating condition that results in the swelling of one or more limbs, leading to a significant impairment of mobility. From a psychosocial perspective, body image and quality of life (QoL) are also adversely affected. To date, non-cancer lymphoedema has been under-researched. The primary objectives of this study were...

Objectives The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries (PI) among frontline healthcare workers wearing personal protective equipment (PPE) during the COVID-19 pandemic. The primary outcome of interest was the incidence of facial PIs. The secondary outcomes of i...

Medical devices provide effective therapeutic care for patients. However, medical device-related pressure injuries (MDRPI) are caused by prolonged pressure or shear from a medical device on any location on the body, including mucosal cavities. The primary outcome of this quantitative systematic review was to identify the incidence of MDRPIs in adul...

Pressure ulcers (PUs) negatively affect quality of life (QoL) and cause problems for patients, such as pain, distress and often specific difficulties with treatments used to manage the wound. Thus, it is important to implement appropriate prevention strategies in order to achieve high-quality care, thereby reducing the burden of PUs on patients, th...

Background The incidence and prevalence of pressure ulcers in critically ill patients in intensive care units (ICUs) remain high, despite the wealth of knowledge on appropriate prevention strategies currently available. Methods The primary objective of this systematic review was to examine the economic impact of pressure ulcers (PU) among adult in...

Objective The aim of this systematic review was to assess the effects of different repositioning regimens on pressure ulcer (PU) incidence in at-risk adult individuals without existing PUs. Method Using systematic review methodology, randomised controlled trials (RCTs), including cluster-RCTs, prospective non-RCTs, pre–post-studies and interrupted...

This paper aims to discuss the literature pertaining to early pressure‐shear induced tissue damage detection, with emphasis on sub‐epidermal moisture measurement (SEM). The current method for pressure detection is visual skin assessment (VSA); however, this method is fraught with challenges. Advances in early detection of pressure ulcers are report...

Objective Pressure ulcers (PUs) involve the destruction of skin and underlying tissue due to prolonged pressure and shear forces. These ulcers are painful and significantly reduce a person's quality of life. PUs are also expensive to manage and impact negatively on the achievement of cost-effective, efficient care delivery. Method Prone positionin...

Aim To identify how activity and mobility lead to pressure ulcer development, using two objective assessments, one for mobility and one for early pressure ulcer detection. Methods 150 older persons from long‐term settings were followed‐up for 20 days, using an observational, quantitative, prospective study design. The study was conducted in accord...

Objective The aim of this systematic review was to examine the associations and relationship between commonly cited risk factors and the pathology of pressure ulcer (PU) development. Method Using systematic review methodology, original research studies, prospective design and human studies written in English were included. The search was conducted...

Objective To investigate the impact of patient education interventions on preventing the recurrence of venous leg ulcers (VLU). Method A systematic review was undertaken using the following databases: Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library); Ovid; Ovid (In-process and...

Objective: To critically appraise and synthesise existing research literature pertaining to nurses' attitudes towards pressure ulcer (PU) prevention. Method: Using systematic review methodology, published quantitative studies focusing on nurses' attitudes towards PU prevention measured by psychometric tests were included. The search was conducte...

The Patient Knowledge of, and Attitude and Behaviour towards Pressure Ulcer Prevention Instrument (KPUP) was developed and validated using a two‐stage prospective psychometric instrument validation study design. In Stage 1, the instrument was designed, and it is psychometrically evaluated in Stage 2. To establish content validity, two expert panels...

Objective The main aim of this systematic review was to establish the prevalence of pressure ulcers (PU) within published studies from Europe. Method Using systematic review methodology, quantitative design studies which explored prevalence data and/or the epidemiology of PUs in Europe were considered. The primary outcome was PU prevalence. The se...

Purpose: The purpose of this study was to determine the knowledge of incontinence-associated dermatitis (IAD) among nurses working in intensive care units. Design: Descriptive study. Subjects and setting: The study was conducted in 6 intensive care units of a 550-bed academic research hospital in Turkey. Licensed practical and registered nurse...

Purpose: The purpose of this study was to determine nurses' knowledge and practices regarding pressure injury and identify relationships between these factors and professional nurse characteristics. Design: Cross-sectional, descriptive study. Setting and subjects: The sample comprised 347 nurses attending the 2013 and 2015 Wound Management Con...

Üriner ve fekal inkontinas, hastanın fiziksel, sosyal, psikolojik olarak yaşantısını etkileyen ve ekonomik yük getiren önemli bir sağlık sorunudur. İnkontinansın yol açtığı en yaygın deri sorunu inkontinansa bağlı dermatittir. Hemşirelik bakımı ile yakından ilişkili olan inkontinansa bağlı dermatit; deride idrar ve/veya dışkı temasına bağlı olarak...

Background: A reduction in tissue tolerance promotes the development of pressure ulcers (PUs) and incontinence-associated dermatitis (IAD). Aims: To determine the cost-effectiveness and efficacy of evidence-based (EB) nursing interventions on increasing tissue tolerance by maintaining tissue integrity. Methods: The study involved 154 patients...

Risk evaluation scales are used as part of prevention strategies for pressure ulcers (PUs). Two of the more used scales, the Braden and Waterlow Pressure Ulcer Risk Assessment Scales (B-PURAS and W-PURAS, respectively) are used in Turkey and worldwide, and their validity in terms of sensitivity, specificity, and predictive validity have been examin...