Role of antiseptics in the prevention and treatment of infections in nursing homes

Inadequate infection control, wound care, and oral hygiene protocols in nursing homes provide challenges to residents’ quality of life. Based on the outcomes from a focus group meeting and a literature search, this narrative review evaluates the current and potential roles of antiseptics within nursing home infection management procedures. We examine contemporary strategies and concerns within the management of meticillin-resistant Staphylococcus aureus (MRSA; including decolonization regimes), chronic wound care, and oral hygiene, and review the available data for the use of antiseptics, with a focus on povidone-iodine. Compared with chlorhexidine, polyhexanide, and silver, povidone-iodine has a broader spectrum of antimicrobial activity, with rapid and potent activity against MRSA and other microbes found in chronic wounds, including biofilms. As no reports of bacterial resistance or cross-resistance following exposure to povidone-iodine exist, it may be preferable for MRSA decolonization compared with mupirocin and chlorhexidine, which can cause resistant MRSA strains. Povidone-iodine oral products have greater efficacy against oral pathogens compared with other antiseptics such as chlorhexidine mouthwash, highlighting the clinical benefit of povidone-iodine in oral care. Additionally, povidone-iodine-based products, including mouthwash, have demonstrated rapid in vitro virucidal activity against SARS-CoV-2 and may help reduce its transmission if incorporated into nursing home coronavirus 2019 control protocols. Importantly, povidone-iodine activity is not adversely affected by organic material, such as that found in chronic wounds and the oral cavity. Povidone-iodine is a promising antiseptic agent for the management of infections in the nursing home setting, including MRSA decolonization procedures, chronic wound management, and oral care.N/

Wound curriculum for student nurses ::European Qualification Framework Level 4

In recent years, the care of people with chronic wounds has made enormous progress throughout Europe. However, aging populations, more complex wounds and advanced diagnostics are big challenges, especially because more people with chronic wounds are treated in their own homes. Bringing existing evidence-based and best practice knowledge to all nurses is a key objective of the European Wound Management Association (EWMA). The EWMA has previously published curricula for professional* nurse education intended for use in post-registration qualification in wound management on Levels 5–7 of the European Qualifications Framework (EQF). The aim of these curricula is to support a common approach to pre- and post-registration qualification in wound management for nurses across Europe. The curricula were developed by working groups representing different European countries and providers of education. However, as vocational qualifications throughout Europe are not uniform and pre-registration curricula may differ, there has been an unmet need to develop a curriculum covering pre-registration nurse education, to provide a starting point for increased and standardised education in wound care. This curriculum presents a framework and key content on skin integrity and wound care that is recommended for inclusion in student nurse curricula (general nurse education). In most European countries, this curriculum corresponds with the European Qualification Framework (EQF) Level 4. In combination, the full series of EWMA curricula can thus be adapted to meet the competencies expected at Level 4, progressing into Levels 5, 6 or 7