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Summary
Wound and pressure ulcer prevention are key quality indicators of nursing care. This article describes a collaborative project between a community skin care service and a nursing home. The aim of the project was to establish whether the implementation of a wound and pressure ulcer management competency framework within a nursing home would improve patient outcomes and reduce the severity and number of wounds and pressure ulcers. Following the project's implementation, there was a reduction in the number of wounds and pressure ulcers, hospital admissions and district nursing visits. Nursing home staff also reported an increase in their knowledge and skills.
Keywords
Nursing homes, older people, pressure ulcers, wound care
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THE AUTHORS of this article are members of a skin care service within a local NHS community provider. The aims of the service are to improve health outcomes for the local patient population by promoting standardised, integrated, best practice in wound care. The service supports community nurses in the clinical assessment and management of complex wounds, such as large dehisced surgical wounds, non-healing wounds, acute and chronic dermatological conditions and severe pressure damage.
The authors identified a gap in service provision in the independent sector relating to wound care and the prevention and management of pressure ulcers. Individual members of the team had discussed the number and severity of referrals received in relation to nursing home patients. Since 2006 district nursing teams in Liverpool have been linked to specific nursing homes to support nursing home staff in managing all aspects of nursing care. Since then district nursing services have received a high volume of referrals requesting advice and support in wound care, and in pressure ulcer prevention and management. This has had an effect on the district nursing workload, increasing the stress of district nurses and the cost to the primary care trust. These costs are related to district nursing contacts (visits), inappropriate prescribing of wound care products...