Background Holistic patient- centred care is an essential part of palliative care, and wound and pressure ulcer management is no exception. Previously, patients were kept waiting for a competent nurse to assess and treat their wound/pressure ulcer. This practice resulted in delayed healing and exacerbation of disease symptoms. Relatives’ visits were interrupted, which reduced the valuable time spent with loved ones. Nurses lacked knowledge and confidence to assess and treat complex wounds/pressure ulcers, and felt that their practice was not evidence based and current.
Aim To improve the patient and relative experience, by introducing a training programme which would ensure that all staff were competent and confident to implement evidence based and current best practice.
Methods We reviewed the old system of provision of wound/pressure ulcer prevention and management, and discussed how it could be improved. We designed a new strategy of wound/pressure ulcer provision, which included an education and ward- based training programme for all staff, which we felt would resolve those issues which staff felt did not facilitate the best patient and relative experience. The programme consisted of a full day mandatory training educational day for all registered nurses and healthcare assistants, mandatory ward based competencies, and annual updates. The results of this strategy have been evaluated through a research study which has formed the dissertation of one of the authors MSc in wound healing and tissue repair.
Staff of all grades are now able to provide a gold standard wound/pressure ulcer service
Patient experience has improved
Relatives’ experience has improved
Documentation has improved
Efficiency on the ward has improved.
Conclusions We believe that the implementation of this new strategy has improved the patient and relative experience, and improved service provision. We also believe that this strategy could be tested and duplicated in other settings.
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