Award Winners! Integrating a Wound Cleansing Pathway into standard care.
The Doncaster Skin Integrity Team recently received a Bronze JWC award in the Infection and Biofilm category for their work on their local Wound Cleansing Pathway.
Kelly Phillips (was Moore) (RGN, BSc, MSc)
Lead Nurse – Skin Integrity Team Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
As part of the drive to improve practice in the Skin Integrity complex wound clinic at DBTH the role of an ‘active cleanser’ was reviewed. Wound bed preparation and implementation of an active cleanser for hard-to-heal wounds was prioritised. This was implemented though the Trust developing its Wound Cleansing Pathway, with Prontosan chosen and introduced for wound cleansing for all patients’ wounds which met the criteria of being at risk.
The process was written up and published in the BJN, you can read the article here.
Six months following the introduction of the Wound Cleansing Pathway, the Skin Integrity Team undertook an audit to determine the policy’s effectiveness and followed up at the same time each year.
A 4-week period was identified in October and November for the completion of the audit for patients attending the Trust’s complex wound clinics.
In 2017 7.3% of wounds (19/261) had a confirmed wound bed anaerobic/aerobic bacterial infection.
In 2018 3.4% of wounds (8/236) had a confirmed wound bed anaerobic/aerobic bacterial infection.
In 2019 1.25% (3/240) had a confirmed wound bed anaerobic/aerobic bacterial infection.
In 2020 1.28% (1/78) had a confirmed wound bed anaerobic/aerobic bacterial infection (this was a non-concordant patient).
The year-on-year review showed an 84.3% reduction in wound infection, which was in line with the results reported by Collier and Hofer (2017).
In 2021 4.3 (2/46) had a confirmed wound bed anaerobic/aerobic bacterial infection. It is important to note that this was during covid and there was an increase of self-supported care where wound cleansing and debridement may not have been consistent at each dressing change.
The pathway has been updated over the years in line with updated practice and research, and re developed and launched collaboratively across the Doncaster wound care alliance to be in place throughout all wound care environments in Doncaster. Therefore, there is a consistent approach in place across secondary care, District Nurse, practice Nurses Community tissue Viability and podiatry services.