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Nurses' Education, Confidence, and Competence in Appropriate Dressing Choice
Joanna Blackburn1, Karen Ousey, John Stephenson
1At the Institute of Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, in Huddersfield, England, United Kingdom, Joanna Blackburn, PhD, is a research fellow; Karen Ousey, PhD, is a professor; and John Stephenson, PhD, is a senior lecturer. Acknowledgments: This project was funded through an unrestricted research grant from Mölnlycke Health Care. The company had no input into the design, data collection, or analysis. The authors have disclosed no other financial relationships related to this article. Submitted October 11, 2018; accepted in revised form November 30, 2018; published online ahead of print August 9, 2019.
Tissue viability nurses (TVNs) often change dressings more frequently than evidence suggests, impacting wound healing. Addressing staff attitudes and beliefs is crucial for optimizing dressing wear time and improving patient care.
Area of Science:
- Nursing Care
- Wound Management
- Healthcare Quality Improvement
Background:
- Dressing complications can impede wound healing and cause patient distress.
- Healthcare professionals frequently change dressings, contradicting evidence for infrequent changes.
- This practice increases complication risks and wound care costs.
Purpose of the Study:
- To explore tissue viability nurses' (TVNs) experiences and current practices in wound care.
- To investigate dressing wear time in acute and community settings.
- To understand nurse rationale for dressing renewal.
Main Methods:
- Mixed-methods quality improvement project.
- Retrospective audit of foam dressing renewal rationale.
- Semistructured qualitative interviews with 12 registered TVNs.
Main Results:
- Key themes identified: Training and Education, Knowledge and Information, Lack of Confidence, and Dressing Choice.
- Subthemes included TVN Experience, TVN Training, Reasons for Dressing Change, and Ritualistic Practice.
- Analysis revealed factors influencing dressing change frequency.
Conclusions:
- Optimizing dressing performance requires fundamental shifts in staff attitudes towards dressing wear time.
- Flexible community services tailored to needs are vital for increasing dressing wear time.
- Improving patient quality of care is linked to evidence-based dressing practices.