Karen Ousey

Nursing and aggression in the workplace: a systematic review

Personal experiences of aggression or violence in the workplace lead to serious consequences for nurses, their patients, patient care and the organisation as a whole. While there is a plethora of research on this topic, no review is available that identifies types of aggression encountered, individuals perceived to be most at risk and coping strategies for victims. The aim of this systematic review was to examine occupational anxiety related to actual aggression in the workplace for nurses. Databases (MEDLINE, CINAHL and PsycINFO) were searched, resulting in 1543 titles and abstracts. After removal of duplicates and non-relevant titles, 137 papers were read in full. Physical aggression was found to be most frequent in mental health, nursing homes and emergency departments while verbal aggression was more commonly experienced by general nurses. Nurses exposed to verbal or physical abuse often experienced a negative psychological impact post incident.

Lower Extremity Wounds

Foreword (David Gray). Introduction (Karen Ousey and Caroline McIntosh). 1 The Need for a Multiprofessional Approach in Wound Care (Caroline McIntosh and Karen Ousey). 2 Physiology of Wound Healing (Karen Ousey and Caroline McIntosh). 3 Skin Changes in the At-Risk Limb (Caroline McIntosh and Kimberley Martin). 4 Infected Wounds (Nicoletta Frescos and Tabatha Rando). 5 Leg Ulcers (Adrienne Taylor). 6 Surgical Wounds (Jacqui Fletcher). 7 Pressure Ulcers (Karen Ousey and Caroline McIntosh). 8 Diabetic Foot Ulcers (Caroline McIntosh and Veronica Newton). 9 Foot Ulceration in Rheumatoid Arthritis (Deborah Turner, Jill Firth and Heidi Davys). 10 Nail Surgery Wounds (Caroline McIntosh and Steve Hancox). Editor and Author Biographies. Index.

Evidence update on prevention of surgical site infection

Purpose of review Surgical site infection (SSI) is a common healthcare-associated infection and complicates up to 10–20% of operations with considerable strain on healthcare resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and perioperative glycaemic control to reduce SSIs, this review has considered new research and systematic reviews, and whether their findings should be included in guidelines. Recent findings The efficacy of preoperative bathing/showering, antibiotic prophylaxis for clean surgery and perioperative oxygen supplementation to reduce the risk of SSI is still in doubt. By contrast, the use of 2% chlorhexidine in alcohol skin preparation, postoperative negative pressure wound therapy and antiseptic surgical dressings do show promise. Antimicrobial sutures in independent meta-analyses were found to reduce the risk of SSI after all classes of surgery (except dirty) whereas the use of wound guards, or diathermy skin incision (compared with scalpel incision), did not. Summary The incidence of SSI after surgery is not falling. Based on this review of published trials and evidence-based systematic reviews some advances might be included into these care bundles. More research is needed together with improved compliance with care bundles.

The clinical credibility of nurse educators: Time the debate was put to rest

The proverbial discussion surrounding the clinical credibility of nurse lecturers has almost become a preoccupation within the nursing literature and professional circles. It is not coincidental that it this has occurred alongside the cessation of hospital-based training and the associated reassignment of the responsibility for nurse education to institutes of higher education. This paper aims to put the debate to rest and proposes that the focus of the nurse lecturer should not be on establishing clinical credibility but on developing strong partnerships between academic and service areas. Such partnerships or communities of practice are more likely to facilitate high quality preparation of nursing students for future roles within a diverse and dynamic profession.

Solution Focused Nursing. Rethinking Practice

This book discusses an innovative approach to nursing practice. Solution-focused nursing is a practical philosophy which emphasizes change at three levels: the client, nursing and society. It teaches three important principles: to be cautious of dominant paradigms, to focus not only on problems but solutions too, and to work with and for clients rather than on them. Solution-Focused Nursing challenges common assumptions about care and provides a framework for nursing that is not just technical, but psychosocial too. [Book Synopsis]

Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review

BACKGROUND CONTEXT The management of postoperative spinal wound complication remains a challenge, with surgical site infection (SSI) incidence rates ranging from 0.4% to 20% after spinal surgery. Negative pressure wound therapy (NPWT) has been highlighted as an intervention that may stimulate healing and prevent SSI. However, the wound healing mechanism by NPWT and its effectiveness in spinal wounds still remain unclear. PURPOSE To systematically search, critically appraise, and summarize randomized controlled trials (RCTs) and non-RCTs assessing the effectiveness of NPWT in patients with a spinal wound. STUDY DESIGN Systematic review. METHODS A systematic review based on search strategies recommended by the Cochrane Back and Wounds Review Groups was undertaken using Cochrane Library, MEDLINE, EMBASE, and CINAHL databases. Any publications between 1950 and 2011 were included. Funding to undertake the review was received from the University of Huddersfield Collaborative Venture Fund (

A systematic review and meta-analysis of factors that relate to aggression perpetrated against nurses by patients/relatives or staff

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A pilot study exploring quality of life experienced by patients undergoing negative-pressure wound therapy as part of their wound care treatment compared to patients receiving standard wound care

4,820). RESULTS Ten retrospective studies and four case studies of patients with spinal wound complication were included in this systematic review. No RCTs were found. Only one study described more than 50 patients. Generally, a pressure of -125 mm Hg was used in adults. Duration of NPWT in situ ranged from 3 to 186 days. Wound healing was assessed every 2 to 3 days and generally completed between 7 days and 16 months. Negative pressure wound therapy is contraindicated in the presence of active cerebrospinal fluid leak, metastatic or neoplastic disease in the wound or in patients with an allergy to the NPWT dressing and in those with a bleeding diathesis. CONCLUSIONS Published reports are limited to small retrospective and case studies, with no reports of NPWT being used as a prophylactic treatment. Larger prospective RCTs of NPWT are needed to support the current evidence that it is effective in treating spinal wound complications. In addition, future studies should investigate its use as a prophylactic treatment to prevent infection and report data relating to safety and health economics.

Problems with competence assessment as it applies to student nurses.

AIMS AND OBJECTIVES The aim of this meta-analysis was to identify the factors that related to aggression (verbal abuse or physical abuse/assault) perpetrated against the nurse or other health professionals by patients/relatives or staff. In the light of the paucity of systematic reviews on this common issue in nursing, the objective was to present a comprehensive systematic review and meta-analysis of these papers. BACKGROUND Aggression towards nurses is common around the world and can be the impetus for nurses leaving the profession or developing anxiety when working in particular settings. DESIGN Systematic review with meta-analysis. METHODS Meta-analyses were conducted to assess the effect of the factors of gender and context (dichotomised as mental health/psychiatric or nonmental health/psychiatric). The databases of Medline (1966-2015), CINAHL (1982-2015) and PsychInfo (1920-2015). RESULTS A total of 1571 papers were screened by two reviewers. At the final decision 14 were selected for analysis. A higher proportion of female nurses than male nurses were reported to be the victims of verbal abuse, with the difference in proportions being statistically significant. A statistically significant higher proportion of male nurses than female nurses were reported to be the victims of physical abuse. There was a significantly higher proportion of mental health nurses reported experiencing physical abuse as compared to nonmental health nurses. CONCLUSIONS The analysis reveal female nurses have greater odds of verbal abuse than male nurses and male nurses have greater odds of physical abuse than female nurses. Overall mental health nurses had three times higher odds of physical assault than other nurses. RELEVANCE TO CLINICAL PRACTICE In the light of the findings it is recommended organisational support improve in high aggression potential clinical areas and for nursing curriculums to incorporate education about the management of challenging behaviours in undergraduate programmes.

Achieving International Consensus for the Prevention of Orthopaedic Wound Blistering; Results of a Delphi Survey

The use of negative pressure wound therapy (NPWT) has been widely documented as a technique to help heal complex wounds. This article presents the findings of a preliminary study which aimed to explore quality of life (QoL) experienced by patients undergoing NPWT as part of their wound care treatment in comparison to that of patients with a wound using traditional (standard) wound care therapies. A quasi‐experimental study was undertaken, with patients treated in wound care/vascular clinics with chronic/acute wounds. QoL impact was measured using the Cardiff Wound Impact Schedule and administered post‐consent at timed intervals. Our results identified that there were no real differences in QoL scores recorded by patients over the 12‐week period. Although there was no overall interaction between the therapies used for wound healing, NPWT did have an effect on social life: during the first 2 weeks of the application of therapy, patients in the NPWT group reported an increase in the social life domain. The authors conclude that true QoL can only be elicited if an accurate baseline is established or if data is collected over a long enough period to allow comparison of scores over time.