A Clinical Support App for routine wound management: reducing practice variation, improving clinician confidence and increasing formulary compliance.

Wounds continue to be of a global concern. Therefore, a more focussed, evidence-based approach to wound assessment and management is required. The WOUND COMPASS™ Clinical Support App (CSA) is designed to support the health care professional with wound assessment and management at the point of care. This real-world pilot study aimed to determine the utility of the CSA during routine wound management, in multiple care settings. A non-interventional, real-world pilot programme of the CSA was conducted at four sites. Patients received routine wound management. The CSA was programmed to replicate the site's formulary for evidence-based wound management. Anonymised pre- and post-pilot clinician opinion surveys on useability and impact of the CSA were collected and reported. Wound Specialists (n = 7 [100%]) and Non-Wound Specialists (NWS) (n = 58 [82%]) indicated that competence and confidence in wound assessment were enhanced with use of the CSA (100%; 82%). Furthermore, practice variation was reduced because of a greater compliance to their local formulary (n = 7 [100%]; 79% [54%]). This real-world pilot shows the positive impact of the CSA, and the improvements that can be potentially realised via reduction in practice variation, improvement in NWSs confidence when managing wounds and increased formulary compliance.

Epidermolysis bullosa: management complexities for paediatric patients.

The genetic skin condition, epidermolysis bullosa (EB) causes the skin to be fragile and blister. As a result, blisters need to be lanced and the skin needs to be dressed with specialist dressings for protection and to promote wound healing. METHOD: a prospective case series and product evaluation of the Allevyn™ Gentle Border Lite dressing range was conducted, with four paediatric patients diagnosed with the following types of EB: recessive dystrophic (generalised severe), dominant dystrophic, simplex (generalised severe) and junctional (localised). Specialist EB nurses at Birmingham Children's Hospital conducted the evaluation and compiled the case series. Management and outcomes: clinical, patient and health economic outcomes were captured. The outcomes reported suggest an increase in dressing time wear and a reduction in dressing changes when comparing Allevyn Gentle Border Lite dressings to the patient's regular foam dressing regime. Furthermore, a cost saving measure could be shown. CONCLUSION: this small case series suggests that the use of the Allevyn Gentle Border Lite dressing range can positively impact the clinical, patient and health economic outcomes of paediatric EB patients.

Implementation of a Pressure Injury Prevention Protocol for Intensive Care Unit Patients Undergoing Prone Positioning.

BACKGROUND: Pressure injuries remain the most common hospital-acquired condition, according to the Agency for Healthcare Research and Quality. Patients hospitalized with COVID-19 are at especially high risk for pressure injuries, including those related to medical devices, because of their lower tissue tolerance, prolonged intubation, and common treatment with prone positioning. LOCAL PROBLEM: The COVID-19 pandemic brought an increased incidence of hospital-acquired pressure injury. A 350-bed hospital in St. Joseph, Missouri, recognized that an intervention to lower the risk of pressure injury for these patients was needed. METHODS: A quality improvement project was initiated to reduce the incidence of pressure injuries in patients with COVID-19 in the intensive care unit. A protocol was implemented for patients with COVID-19 undergoing prone positioning that included the use of dressing packets. The incidence of hospital-acquired pressure injury during the 1-year periods before and after implementation of the protocol were determined. RESULTS: Before implementation of the new protocol, 18 of 155 intensive care unit patients with COVID-19 who were placed in a prone position (11.6%) experienced a hospital-acquired pressure or medical device-related injury, compared with 3 of 111 patients (2.7%) after protocol implementation, a reduction of 76.7% (P = .008). CONCLUSIONS: The risk of hospital-acquired pressure injuries can be reduced with additional education and the use of appropriate products and protocols. All patients who undergo prone positioning, regardless of diagnosis, may benefit from implementation of a pressure injury prevention protocol that includes the use of dressing packets.

Utilizing international consensus panel recommendations and a clinical decision tree to guide selection of negative pressure wound therapy.

INTRODUCTION: A variety of NPWT products have become commercially available in the last 30 years. Utilizing advanced wound therapies appropriately can improve patient outcomes and decrease health care expenditures. Due to the increasing number of available product options, Hurd and colleagues published 10 Consensus Statements and a clinical decision tree to provide guidance on how and when to use NPWT and when to transition between device types. OBJECTIVE: To demonstrate the applicability of the consensus panel's statements and the clinical decision tree, 2 clinicians in the United States and Canada explored the benefits of applying these recommendations into their routine wound management practice. MATERIALS AND METHODS: Case studies were collected and reviewed in accordance with the Consensus Statements and clinical decision tree. RESULTS: Case presentations illustrate the application of the consensus panel's guidance through the prescribing of the NPWT products utilized as standard of care within both facilities. CONCLUSION: Utilizing NPWT devices according to the consensus panel recommendations and the clinical decision tree may assist in optimizing care delivery to patients and address logistical and economic efficiencies.