Management and prevention of wound infections during Covid-19 - Part Three
In September 2020, we interviewed Louisa Way, Interim Head of Clinical Practice – Falls Prevention, Moving & Handling and Tissue Viability at University Hospitals Dorset, about her experiences of working as a wound care / tissue viability specialist during the Covid-19 pandemic. Here is the final part of the series of videos.
If you have chosen to use an antimicrobial dressing, when would you take that decision to step down treatment and what would you consider treatment wise afterwards?
It's really important once you've stepped up to actually review the patient regularly and see if there's any improvement.
If the wound is improving, we would want to review the use of topical antimicrobials within two weeks. We don't advocate the use of them for longer than two weeks, particularly without a specialist review or referral.
In the acute, that review may be doing blood tests or wound swabs and then stepping down treatment accordingly to some of the products that are available and simple to use, such as wound irrigation solutions or wound cleansing solutions, that can help to continue to establish that reduced bacterial burden that that wound may be experiencing.
What would be your key ‘take home message’ for other wound care nurses at this time?
I think the main message is to say that you're not alone. It can feel very isolating as a clinician that people look to, to have the answers.
It's okay not to have the answers, but I think what you really need to do is to know what resources are around you. Whether that's in the form of clinical support, educational resources or whether it's knowing who you can escalate to if required.
What would your advice be to other nurses working in wound care during the COVID-19 pandemic?
If you as a clinician are unsure, have the confidence to escalate and to ask for support because that's how we learn.
The educational resources are there to look at generalisms or generic circumstances, but it's your experience as a clinician faced with the patient in front of you, either virtually or physically, and it's your skill that you need to put into that scenario knowing that one wound care product will not take you from the beginning to the end.
The real value of a clinician in wound care is that you constantly review what works, what doesn't work, what hasn't worked as you expected, or what is actually something that you really want to continue and that's really important.
It's also vital to foster those really clear, good lines of communication with the patient so that you can manage expectations. You may explain that actually, our treatment aim at the moment is to prevent infection rather than to push you on to healing in these COVID times, if the patient understands this it can only improve the situation.
In summary, understand what resources are available, what valuable assets you've got around you, know your products and know your patients!
I'd just like to take this opportunity to say a massive thank you to everyone who has contributed to the enormous NHS effort over the last few months and ongoing.
So stay strong, stay safe and stay together. Thank you.