Dissertations & Theses (Open Access)

Date of Award

Spring 5-2020

Degree Name

Doctor of Public Health (DrPH)

Advisor(s)

Linda D Highfield, Phd Academic Advisor/Committee Chair/Dissertation Supervisor

Second Advisor

Edward Buchanan Md

Third Advisor

Angelo Giardino Md,Phd

Abstract

Background: Wound care practices for neonatal and pediatric patients including the category of products, specific products within each category, and length of application of the products have created lack of standardized evidence-based guidelines for treatments in clinical practices. This dissertation addresses this concern by encompassing three crucial steps in developing evidence-based clinical guidelines for wound care specialists. Using a three-paper method, an expert consensus group was formed, a systematic review of reviews completed and a process for creating clinical decision trees created. Methods: Criteria for selection of the consensus group members included: 1) Research graduate active in Pediatric Wound Care research, 2) Board certified Physicians actively practicing in their aforementioned pediatric general surgery or pediatric plastic surgery subspecialty, and 3) Wound Ostomy Care Nurse actively practicing in Pediatric wound care. An adapted questionnaire was created to address eligibility criteria, information sources, systematic review database search strategy, study selection criteria including keywords, the clinical consensus group’s experience with clinical guideline development, and finally other clinically significant domains that the evidence should be evaluated for. Using domains identified, a systematic review of reviews was completed. PRISMA and AMSTAR were used to assess quality of reporting and quality of the evidence. Results and Conclusions: The consensus group members polled have been proficient in pediatric wound care for several years with the majority of the members practicing for more than 10 years within a hospital setting. Duration and lengths of discussion meetings whether in person or via electronic interface as well as how data collected was reviewed and analyzed, i.e. in person face to face or via conference call, was the driving force in establishing search domains. The articles found in the domain search identified themselves differently, with some identifying themselves as a systematic review, literature review, meta-analysis, or a combination of the two. It was determined that no true “gold standard” for assessing systematic reviews exists. Because this is the first systematic review of systematic reviews in wound care specifically, SRs of SRs in other healthcare related fields were relied upon.

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