Whole versus hole: enabling community nurses to implement holistic wound care

Area of Science:

• Wound Care Management
• Quality Improvement in Healthcare
• Patient-Reported Outcomes

Background:

• Hard-to-heal lower limb wounds significantly impact patient quality of life (QoL).
• Effective management requires multidisciplinary team involvement.
• Current care pathways may not adequately address holistic patient needs.

Purpose of the Study:

• To enhance wound-related QoL in patients with challenging lower limb wounds.
• To increase referrals to specialized multidisciplinary wound care teams.
• To evaluate the impact of a novel intervention package on patient outcomes and care practices.

Main Methods:

• A quality improvement project utilizing a pretest-posttest interventional design.
• Implementation of a multifaceted intervention including the WounDS app, wound care education, and client QoL self-assessment.
• Measurement of QoL via the Cardiff Wound Impact Schedule and tracking referrals through chart audits; nurses' experiences explored via interviews.

Main Results:

• Significant improvements observed in client QoL ratings: wellbeing (27%), physical symptoms/daily living (38%), and overall QoL (54%).
• Referrals to multidisciplinary teams increased by 78% post-intervention.
• Nurses reported interventions fostered a holistic approach to wound care.

Conclusions:

• The intervention package successfully improved QoL for patients with hard-to-heal wounds and promoted a holistic care culture.
• The WounDS app, education, and self-assessment are effective strategies for enhancing wound care.
• Sustainability strategies include champion groups and education tailored to nurses' needs; further research is recommended.