502 Sweet or Sour? Real-World Experience with Honey in the Burn Center
Notice bibliographique
Résumé
Honey is a non-toxic product of nature that is antimicrobial, antifungal and promotes wound healing. Several honey dressings (HD) are available in the U.S.; however, there are limited data on experience with HD in U.S. burn centers. Our burn center recently began using HD and encountered several challenges: HD application, dressing maintenance, patient discomfort and staff acceptance. The purpose of this project was to implement HD utilizing an evidence-based, systematic approach and to evaluate our experience. The FOCUS-PDCA model was utilized. A team, led by a Clinical Nurse Specialist, identified process variations and formulated an improvement plan. 115 of 142 burn centers (81%) were surveyed regarding their HD use via telephone; the Burn Care Resource Directories for US and Canadian burn centers were utilized. Guidelines and a standard order set were developed; education was provided. Product evaluations were completed by staff who applied dressings. Descriptive statistics were utilized. HD use for burn wounds was reported by 13/115 U.S. and Canadian burn centers (11%). Recommendations were to perform daily dressing changes by impregnating sheets of petrolatum gauze with pre-warmed honey gel or paste and to cover with roller gauze or a foam dressing. Thirty-three evaluations have been completed thus far for 23 individual patients who have received HD at our burn center. Overall, 52% of staff recommend to continue using HD (17/33) while 18% do not (6/33); 10 staff are undecided. Staff commented that honey “appears to work well”, was “easy to apply” with petrolatum gauze, and “seems to help in circumstances where other treatments have not”. However, staff feel that HD preparation was “tedious and time consuming”, would be more effective if “manufactured in a roll” or larger sizes, and that HD “cause pain”. Staff found that a tongue depressor is helpful in spreading the honey, frequent glove changes must be anticipated and to have supplies and dressings ready before application. As a result of this project, we are currently in the process of obtaining HD in pre-impregnated sheets and rolls that will improve the application process. HD are currently being used in a limited number of U.S. and Canadian burn centers. Despite feedback that HD are challenging to use, staff reported improved eschar removal and benefits when other treatments had failed. Pain is important to consider and alternative dressings should be placed if the patient does not tolerate HD. Honey has been shown to be a safe and effective treatment for a variety of wounds, to decrease bio-burden and to effectively sterilize wounds. Larger, better-designed trials are warranted to establish benefits of honey on wound healing.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».