Exudate management is one of the key challenges for clinicians who have to deal with wounds. The World Union of Wound Healing Societies (WUWHS, 2007) highlighted the importance of appropriate dressing selection for exudate control and removal of excess exudate. Correct dressing selection ensures that the wound bed remains moist without becoming saturated, which in turn prevents damage and pain to the surrounding skin and reduces the risk of infection from strikethrough. This article examines the role of exudate in wound healing, and the inherent challenges in its management, both for patients and carers. The role of superabsorbent dressings is discussed and the findings of an evaluation of clinicians’ requirements and expectations of superabsorbent dressings are presented.
June Jones, JJ TVE, Tissue Viability Education, Southport, Merseyside
Jo Barraud, Tamaris Communications, Hitchin, Hertfordshire
The recent and ongoing changes to the NHS were instigated to absorb the increasing costs of an ageing population: the NHS needs to save £15–20 billion by the end of 2013/14 for reinvestment into frontline services (Department of Health [DH], 2010a; 2010b).
David Gray, Professor of Tissue Viability, Tissue Viability Practice Development Unit, Birmingham City University, and Clinical Nurse Specialist Tissue Viability, NHS Grampian, Aberdeen
With more and more advanced wound dressings becoming available, clinicians need to be selective when choosing the most appropriate treatment for patients with wounds in the community. Dressings are no longer tasked simply with protecting wounds and offering some level of absorbency, but need to be able to address both the physical and psychological aspects of having a wound to ensure patient-centred care. The sorbion range of dressings are developed to offer clinical solutions and provide cost-effective care.
Lisa Sutherland, Tissue Viability Lead, West Suffolk Hospital, Bury St Edmunds, Suffolk
Pressure ulcers are a significant problem in both the acute sector and the community, where nurses can spend a great deal of their time dealing with what is a painful and debilitating condition. As government policy encourages more care to be delivered in patients’ homes, finding solutions to pressure damage that aid healing and improve patients’ quality of life, as well as being cost-effective, is paramount. This article examines the background to pressure damage, as well as looking at its effect on community nurses’ workload. In particular, it focuses on the heel as a common site of pressure damage.
Lorraine Grothier, Clinical Nurse Specialist (Tissue Viability), Tissue Viability Service, Provide, delivering NHS and local authority services
The NHS spends the majority of its budget on labour costs and it could be argued that frontline staff such as community nurses are the organisation’s most valuable resource. However, optimal wound care is dependent upon effective patient engagement, the application of clinical expertise and access to wound management products. The tension between increasing demands for services and the number of nurses is already causing problems in care provision as staff cuts and excessive workload inevitably endanger patient care. Enhancing efficiency through the use of innovative products will become essential in the future if nurses are to continue to provide expert care against a backdrop of cost-savings. This article details the appraisal process undertaken within Worcestershire Health and Care NHS Trust to investigate the in-practice clinical performance of a silicone foam dressing (Allevyn™ Life Smith & Nephew, Hull).
Declaration of interest: Richard Searle and Alistair Bielby are employees of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew.
Jackie Stephen-Haynes, Professor and Nurse Consultant, Practice Development Unit, Birmingham City University and Worcestershire, Health and Care Trust
Alistair Bielby, Clinical Team Manager, Smith & Nephew Healthcare Ltd
Richard Searle, Health Economics Manager, Smith & Nephew Medical Ltd
This article outlines a survey that was undertaken in the community to find out how often patients with venous disease who are wearing compression hosiery have their ankle brachial pressure index (ABPI) monitored. It also asked clinical nurse specialists (CNSs) their opinion on the desired frequency of ABPI follow-up, and which patient groups they considered to be most at-risk. The survey findings highlight the lack of consensus and consistency in follow-up care. The majority of CNSs identified potential high-risk patient groups, the majority of which have their ABPI monitored every three months. However, there were inconsistencies in time interval for follow-up in patients with similar risk factors.
Winnie Furlong, Lead Clinical Nurse Specialist, Princess Alexandra Hospital and West Essex Leg Ulcer Service
The health of the population is determined by a range of complex and interconnected influences, many of which, such as poverty, inequality, housing, education, employment, mobility, transport and pollution, fall outside a medical remit. In order for nurses and other healthcare professionals to tackle public health, they not only need to engage with individuals, families and communities, but should also have the ability to influence the design and development of services and understand the new relationships with local authorities and other agencies.
Jane DeVille-Almond, Independent Nurse Consultant/Chair of the British Obesity Society; Senior Lecturer at the University of
Wolverhampton.
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. In this issue, after recent reports of poor care, we take a look at services for older people and ask the question...
Since The Queen’s Nursing Institute (QNI) was established in 1887, we have been a charity focused on improving the experience of the patient cared for in the home and community.
One of the many ways in which we can demonstrate that we make a tangible difference to patients, families and carers is through the support we give every year to the successful delivery of our QNI frontline innovation projects.
Crystal Oldman, Chief Executive of The Queen’s Nursing Institute (QNI).
