Wound champions wanted

Residential aged care providers are invited to participate in the implementation of a new government supported, evidence based training program which promises to be the last word on best practice wound care.

Pictured: The CSI project team, from left:  Ms Michelle Gibb, Dr Kathleen Finlayson, Professor Helen Edwards, Mr Bob Jensen, Ms Christina Parker.

By Keryn Curtis

Residential aged care facilities across Australia are invited to nominate their own wound care champions to adopt and help disseminate the evidence based Champions for Skin Integrity (CSI) Program

Following the successful piloting of the CSI program, the Department of Health and Ageing is supporting the dissemination of the model and its project resources to residential care services nationwide.

The CSI program has been developed by researchers in the School of Nursing at Queensland University of Technology (QUT) in Brisbane to preserve the skin integrity of residents in residential aged care facilities where the incidence of skin tears, pressure ulcers and chronic leg or foot ulcers are a serious issue.

The first stage of the CSI Program was developed and implemented by a consortium of seven RACFs across Qld and NSW with QUT researchers, as part of the Department of Health and Ageing’s Encouraging Better Practice in Residential Aged Care (EBPRAC) Program.  The second stage of the program aims to make it available to all aged care facilities across Australia.

Led by Professor Helen Edwards, the Champions for Skin Integrity program has involved a range of elements designed to increase the use of evidence based, best practice approaches to wound management.  The broad elements involve developing a supportive environment with local ‘champions’ of best practice within each facility; creating easy access to education and information; and providing hands-on skill development and clinical decision making support. 

Consistent best practice advice

Professor Edwards said the impetus for the project came from the wealth of evidence highlighting the significant pain and functional disability caused by chronic wounds, and the burden on carers and health system resources.  This is aggravated, she says, by ‘evidence to practice’ gaps in appropriate assessment and timely use of best practice treatments.  

“While there is a large number of evidence based guidelines addressing differing aspects of wound management and/or different types of wounds, very few guidelines cover all aspects of wound management,” said Professor Edwards.

“This contributes to the difficulties faced by clinicians trying to quickly locate appropriate evidence based information on wound care; and it is exacerbated by the large number of guidelines.  It all serves to increase confusion for clinicians and carers in deciding which guidelines to follow.”

A key part of the original study involved the development of a suite of ‘guidelines summaries’. These provided a simple summary, drawn from multiple documents and sources, of all the different evidence-based guidelines, grouped under the three main headings: assessment, management and prevention.  All the resources and education for the project were based on these summary documents.

Positive results

Professor Edwards said the results of the first stage of the program were very positive, leading to significant reductions in the number and severity of wounds, pressure ulcers, skin tears and leg ulcers in the participating RACFs.

“The figures indicated that the CSI model did enable the implementation of evidence based prevention and management strategies, with positive outcomes,” said Professor Edwards.  

The significance of this, she said, was far reaching with the potential to improve the quality of life of people with, or at risk of developing chronic wounds, while also reducing the burden on their carers.  

“Also, in the current climate of the strain being experienced by the Australian aged care sector, improved prevention and management can lead to a potential reduction of the burden on health system resources.” 

She said there had also been overwhelming demand from a range of organisations for access to the project resources. 

“We received many requests from organisations across all states – residential aged care facilities, community nursing associations, hospital in the nursing home programs, GP practice nurses, and from the acute care hospital sector,” said Professor Edwards.  

Getting involved

With the support of the Department of Health and Ageing, the CSI program and its resources are being rolled out to interested RACFs throughout 2013 and 2014.  

The pivotal requirement for participating facilities is to have identified a clinical leader within the facility who has a strong commitment to evidence based practice in skin integrity and wound care, who can become a ‘champion’ and CSI trainer.  

“This champion would attend a ‘train the trainer’ workshop given by the project team on the CSI model and use of the resource kit, with the expectation that those skills and the knowledge acquired at the workshops would be used to train a team of champions within their RACF,” said Prof Edwards. 

The clinical leader champion would also be asked to lead a small project on evidence based wound care, providing feedback to the CSI project team in the few months following the workshop.  

“The idea is that the clinical leader champion, together with their new team of CSIs, would become a resource for wound management advice and the first point of contact for education and change management strategies for promoting evidence based wound care,” Professor Edwards said. 

For further information about the project, go to:  http://www.qut.edu.au/research/research-projects/wound-care-in-residential-aged-care-facilities 

Anyone interested in becoming involved in the CSI program should contact: 
Dr. Kathleen Finlayson – Research Fellow, Institute of Health and Biomedical Innovation, Queensland University of Technology

Tel:     07 3138 6105
Fax:    07 3138 6030
Email:  k.finlayson@qut.edu.au 

This project is funded by the Department of Health and Ageing under the Encouraging Better Practice in Residential Aged Care (EBPRAC) program.

Tags: csi-program, professor-helen-edwards, qut, wound-care,

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