SummaryBackground
Compression bandaging is the most prevalent form of treatment for venous leg ulcers. Successful treatment requires knowledge of the appropriate materials and the ability to employ them following current guidelines. This study investigates German health-care providers for their knowledge of bandage materials and their practical ability in applying short-stretch compression bandages.

Participants and Methods
Within the framework of nationwide practical education on compression therapy, the participants’ knowledge was quantified by asking standardized questions. Furthermore, their practical ability was evaluated by having them apply compression bandages within a pressure range of 50–60 mmHg. Another criterion was the pressure drop after a four-time dorsiflexion.

Results
Overall, 891 providers (3.3 % physicians, 5.5 % medical assistants, 90.7 % nursing staff) participated. Within the practical test only few (just under 10%) applied the bandages with the intended pressure; 77.0 % applied them below and 13.7 % above the target pressure. After a four-time dorsiflexion there was an average pressure drop of 6.7 mmHg. Surveying the participant's skills revealed that only 11.9 % knew about padding beneath compression bandages, 15.0 % knew of multi-component systems, and 14.8 % were familiar with ulcer stocking systems.

Conclusions
Clearly, compression material and its application are unfamiliar to most practice employees. Without question there are deficits in the provision of compression therapy.

Compression therapy: scientific background and practical applications.

Wund-D.A.CH. is the umbrella organization of the various wound care societies in German-speaking countries. The present consensus paper on practical aspects pertinent to compression therapy in patients with venous leg ulcers was developed by experts from Germany, Austria, and Switzerland. In Europe, venous leg ulcers rank among the most common causes of chronic wounds. Apart from conservative and interventional wound and vein treatment, compression therapy represents the basis of all other therapeutic strategies. To that end, there are currently a wide variety of materials and systems available. While especially short-stretch bandages or multicomponent systems should be used in the initial decongestion phase, ulcer stocking systems are recommended for the subsequent maintenance phase. Another - to date, far less common - alternative are adaptive Velcro bandage systems. Medical compression stockings have proven particularly beneficial in the prevention of ulcer recurrence. The large number of treatment options currently available enables therapists to develop therapeutic concepts geared towards their patients' individual needs and abilities, thus resulting in good acceptance and adherence. Compression therapy plays a crucial role in the treatment of patients with venous leg ulcers. In recent years, a number of different treatment options have become available, their use and application differing among German-speaking countries. The present expert consensus is therefore meant to outline concrete recommendations for routine implementation of compression therapy in patients with venous leg ulcers.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/ddg.13091

Compression therapy in patients with venous leg ulcers.

Objective: The aim is to examine the prognostic validity of the Timed Up and Go Test with a cognitive and a manual dual task for predicting the risk of falls. Method: A follow-up study was performe...

https://journals.sagepub.com/doi/pdf/10.1177/2333721416637798

The Prognostic Validity of the Timed Up and Go Test With a Dual Task for Predicting the Risk of Falls in the Elderly

The aim of this study was to provide a systematic overview of available pressure ulcer prevention quality indicators and to evaluate the underlying empirical evidence. A systematic mapping review was conducted with combined searches in Embase and Medline, and websites of relevant institutions and organisations. The eligibility criteria were clear use of the term "quality indicator" regarding pressure ulcer prevention; English or German language; and all settings, populations, and types of resources, including articles, brochures, and online material. In total, n = 146 quality indicators were identified. Most indicators were published in the United States (n = 50). The majority of indicators was developed for the hospital setting (n = 102). Process indicators were the most common (n = 71), followed by outcome indicators (n = 49). Less than half of identified indicators appeared to be practically used. Evidence supporting the validity and reliability were reported for n = 25 and n = 30 indicators respectively. The high number of indicators demonstrate the importance of measuring pressure ulcer prevention quality. This is not an indicator of our ability to accurately measure and evaluate this construct. There is an urgent need to develop evidence-based and internationally comparable indicators to help improve patient care and safety worldwide.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1111/iwj.12854

Measuring the quality of pressure ulcer prevention: A systematic mapping review of quality indicators.

Das Kapitel beschaftigt sich mit dem Expertenstandard Sturzprophylaxe in der Pflege des Deutschen Netzwerks fur Qualitatsentwicklung in der Pflege DNQP, der im Jahr 2013 zum ersten Mal aktualisiert wurde. Die Vermeidung von Sturzen durch die Beeinflussung von entsprechenden Risikofaktoren und die Umsetzung der Inhalte des Expertenstandards in die Pflegepraxis sind Schwerpunkte dieses Kapitels. Handlungsleitend ist dabei nicht ausschlieslich die Vermeidung von Sturzen, sondern auch die Verminderung von Sturzfolgen. Die Inhalte des Expertenstandards konnen auch auf weniger untersuchte Gruppen, etwa Kinder oder Menschen mit Behinderungen, ubertragen werden. Dargestellt wird die Implementierung in den Pflegeprozess, z. B. durch eine Anpassung des Umfelds, durch den Einsatz von geeigneten Hilfsmitteln oder durch Gleichgewichtstraining, sowie die Implementierung in die hauseigenen Pflegestandards. Die erforderlichen Formulare, etwa geeignete Sturzrisikoskalen oder Sturzprotokolle werden vorgestellt, auserdem daraus resultierende organisatorische Besonderheiten, wie die Erhebung einer Sturzstatistik.

Anna Möller

Papers

Deutsches Netzwerk für Qualitätsentwicklung in der Pflege (DNQP): Aktueller Stand