Providers encouraged to make a ‘skin-vestment’

Chronic skin wounds such as leg ulcers and pressure injuries can be difficult to prevent and challenging to heal. Among older people, who often have chronic health conditions and reduced mobility, chronic wounds may be highly prevalent and negatively impact quality of life.

For care providers, and particularly nurses, these wounds present significant challenges in terms of the complexity of the assessment and care required to prevent and treat them. Chronic wounds are also costly to service providers and society.

Our understanding of chronic wounds is evolving and so too must our approaches to prevention and management. The aged care sector must do more to address the issue of wounds. As such, I was delighted to be appointed national manager wound prevention and management at Regis Aged Care last year.

Our residents, clients, employees and the organisation more broadly will benefit from the clinical excellence, innovative education and training, translational research and organisational oversight. And through our advances, we are also contributing positively to the broader aged care sector in Australia.

My role is to provide leadership and advocacy for wound prevention and management at our 68 aged care homes across Australia. At the heart of our strategy is building the capacity of our nursing and care employees to excel in wound prevention and management.

I believe this is a pertinent goal for all aged care providers, as we are not alone with respect to the challenge of wounds. For example, the prevalence of pressure injuries – also known as bed sores – is unacceptably high across the sector in Australia. But it can be reduced given the majority of these wounds are preventable.

Greater attention is now being paid to incontinence associated dermatitis meaning that more than ever, aged care nurses and personal care workers must be on their game with respect to skin care.

At Regis Aged Care we are on the cusp of implementing a wound prevention and management education and training program targeting the advanced beginner through to expert. In addition to my clinical expertise, I bring my experience teaching evidence-based practice and clinical leadership to our program.

The program provides important opportunities for our nurses to learn new skills via hands-on workshops and scaffolding methods – which move students progressively toward stronger understanding and independence in the education process – to achieve relevant learning outcomes.

By embedding my research in my teaching, and the evidence base more broadly for wound prevention and management, the learning and resulting practices of our nurses will be contemporary and evidence based.

Supporting nurses to increase their expertise and realise their clinical passion is an important way to keep them engaged in the aged care sector. It is also a meaningful way to raise the profile of aged care as a place to work that is full of exciting challenges and opportunity.

Providing a career pathway for advanced practice wound prevention and management nurses is also on our radar for 2024. This step is essential given that such expertise is hard to come by in residential aged care – the issues of access to external wound consultants were among those identified during the Royal Commission into Aged Care Quality and Safety – and the size of our organisation.

My work to progress this initiative started several years ago when Regis Aged Care partnered with me through the University of Melbourne’s nursing department to undertake the Remote Repair Project. Funded by the Victorian Medical Research Acceleration Fund, the project involved evaluating the implementability of a remote expert wound nurse consultation model for pressure injury prevention and management at Regis.

Our intervention provided remote consultation from wound nurse experts employed by Regis Aged Care – which proved timely given the pandemic and associated service delivery constraints. The intervention standardised the approach to consultations, prioritised engagement with nurses, residents and family members and was tailored to individual resident need.

We prioritise raising awareness

Implementation research is essential for such initiatives and our focus on ascertaining the feasibility, acceptability and fidelity of the intervention has provided valuable evidence about what worked well and what could have worked better. These outcomes are important as interventions are seldom easily replicable. Instead they often fail once projects finish resulting in wasted time and cost. 

Our research team has published the remote expert wound nurse intervention so that other aged care providers may consider implementation of such an approach for the benefit of their residents, families and organisations. Our innovative intervention was also recognised with an industry award in 2023 – a testament to its relevance to Australia’s aged care sector.

Through this and other initiatives we are contributing beyond our organisation – which is dedicated to preventing and managing chronic wounds, often overlooked in the wider community. We prioritise raising awareness among residents, clients and their families about conditions such as pressure injuries and our efforts to address them.

Our recent success on Stop Pressure Injury Day – which took place on 16 November in 2023 – highlighted the collaborative efforts of our care, culinary and technology teams.

Our chefs and catering teams nourish our residents every day and our information technology teams support innovation in digital-wound imaging and measurement. This company-wide approach ensures effective wound prevention and management.

Wound care offers excellent leadership opportunities in nursing and it is a great privilege to help aged care residents to wear skin well. Wound prevention and management are fundamental aspects of caregiving for older people, making ‘skin-vestment’ a no-brainer for aged care providers.

Dr Suzanne Kapp is the national manager of wound prevention and management at Regis Aged Care, and a clinical associate professor in the Department of Nursing at University of Melbourne

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