Louise Toner

Product evaluation of an absorbent, antimicrobial, haemostatic dressing

This article reports on a product evaluation of KytoCel, an absorbent wound dressing used in the treatment of 30 wounds treated in community care and 10 split-thickness skin-graft donor sites treated in acute care. Within the community-treated cohort, unspecified leg wounds were the most common wound type (n=6) with the mean wound area of the 30 wounds being 17.6 cm2 (standard deviation (SD) 31.7) and mean volume being 8.4 cm3 (SD 21.4). Most community treated wounds (27/30; 90%) were reported to have moderate to high levels of wound exudate with the majority (n=19) either healed or improved during treatment. All ten split-thickness skin graft donor sites healed during the evaluation. A semi-structured focus group consisting of 17 nurses provided their opinions on KytoCel, with positive comments offered on the dressing during the focus group and of the 17 participants, 10 commented that the KytoCel dressing was available on their local wound care formulary.

Listen, lead and learn

We are now well into the new NHS financial year, and despite the Coalition Government’s ongoing listening exercise, many of the expected changes are well underway. This is resulting in the development of social enterprises, community services being incorporated into acute services and in respect of tissue viability, for many areas, there are now more services being provided for mental health trusts, fundamental given the increasing number of older adults in receipt of mental health services. The listening exercise is due to report in June 2011 so we will know shortly what elements will be retained and what will be subject to change. However, what is clear is that the main thrust of the reforms won’t change given that many have already been implemented. It will be interesting to see the recommendations in respect of the public health agenda given the lack of clarity in the proposals to date and the strength of concerns being expressed by public health practitioners. To consider a more specific and exciting development, you will be pleased to note the establishment of a Tissue Viability Practice Development Unit in the Faculty of Health at Birmingham City University. Three visiting professors of tissue viability have been appointed to lead this initiative: Michael Clark, David Gray and Jackie Stephen-Haynes – all well known and respected in the field. Further information about the unit will be featured in the next edition of Wound Care. As promised in my last editorial, the Wound Care Alliance are pleased to confirm that a study day on High Impact Actions – Your skin matters will be held on 20th October 2011 in conjunction with the Tissue Viability Practice Development Unit at Birmingham City University. For more information and to book a place please visit www.wcauk.org or contact natasha.king@bcu.ac.uk. The conference will cost £5 for WCA members and £15 for non members, which will include one year’s membership of the WCA; so don’t delay, book your place today. Have a good summer. BJCN

Targeting pressure ulcers

S3 Ask health professionals about the development of pressure ulcers and you will likely find a consistent view that they are preventable; however, historically there has been an attitude of fault finding and denial among health professionals about the issue. Indeed, Judy Waterlow once joked to me that pressure ulcers must all develop in the ambulance! The thinking about pressure ulcers being preventable is now fully supported by the Government, with the implementation of high impact actions (NHS Institute for Innovation and Improvement, 2009) and the Quality, Innovation, Productivity and Prevention (QIPP) programme (Department of Health (DH), 2010). Equally importantly, the culture of fault and denial surrounding pressure ulcers is now being challenged by the QIPP Safe Care Workstream, ‘Safety Express’. In January 2011, 1000 frontline staff (100 from each Strategic Health Authority) united with the shared aim of reducing harm from pressure ulcers, falls, catheter-acquired urinary tract infections and venous thrombo-embolism. The objective of Safety Express is to increase the proportion of patients who complete their episodes of care ‘harm-free’; the target is an 80% reduction in category III and IV pressure ulcers developed in a care setting, and a 30% reduction in category III and IV pressure ulcers developed outside a care setting. Interestingly, Safety Express will challenge traditional organizational and geographical boundaries and promote sharing and learning together. Harm will no longer be someone’s ‘fault’, but will be regarded as the responsibility of the whole system. The patient experience is now paramount, and Safety Express is a call to action for NHS staff who want to see a safer, more reliable NHS with improved outcomes at significantly lower cost. The focus will be on how to implement change, with an acceptance that the evidence already indicates the nature of the required changes. Tissue viability staff are already involved in the process, but the key to success will be the further 3000 frontline staff who will be engaged by September 2011. The challenge will be to raise awareness among frontline staff about risk assessments, management plans and outcomes. Pressure ulcer prevention has long been on the agenda of tissue viability staff. Now it is on the agenda nationally, strategically and locally, and with executive support and direct accountability for improvement in harm-free care, it can become reality. If you have the opportunity to be involved, seize it. BJCN

Research and tissue viability

The recent research assessment exercise has proved a huge success for nursing, rated 44th from the 67 subject areas, whose research was identified as being internationally recognized or world leading. This was a far cry from the relatively poor results in the 2001 Research Assessment Exercise where nursing was recognized as one of seven emerging research disciplines. As a result, funding was made available to increase nursing research capability and this, together with other factors, has played a significant part in placing nursing on a par with other academic disciplines. This is an important step forward for the profession in the context of advanced practice, multi-professional and cross boundary working with the emphasis on the provision and delivery of evidence-based patient care.

Exciting times for tissue viability

Welcome to this edition of Wound Care, the first since the emergence of the Wound Care Alliance UK. I hope you like our new corporate image and the changes the British Journal of Community Nursing team has made to reflect our new logo and colour scheme. I feel sure you will continue to find this supplement an invaluable resource to support you in your clinical practice, academic study and research.

Wound Care Alliance: a new charity

It is with great excitement that we announce the birth of a new charity. The Wound Care Alliance UK has risen, phoenix-like, from the ashes of the Wound Care Society (WCS) and Tissue Viability Nurses’ Association (TVNA). Many people belong to both societies, and members have voted overwhelmingly in favour of dissolving the WCS and TVNA to form a single new organization to provide help and support both educationally (which the WCS has always been proud to do) and professionally; (a key aspect of the TVNA).