Wound care practices across two acute care settings: A comparative study

Abstract

Aims and objectives Describe and compare current surgical wound care practices across two hospitals in two health services districts, Australia. Background Surgical site infections (SSI) are a complication of surgery and occur in up to 9.5% of surgical procedures, yet they are preventable. Despite the existence of clinical guidelines for SSI prevention, there remains high variation in wound care practice. Design Prospective comparative design using structured observations and chart audit. Methods A specifically developed audit tool was used to collect data on observed wound care practices, documentation of wound assessment and practice, and patients’ clinical characteristics from patients’ electronic medical records. Structured observations of a consecutive sample of surgical patients receiving wound care with a convenience sample of nurses were undertaken. The manuscript adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. Results In total, 154 nurses undertaking acute wound care and 257 surgical patients who received wound care were observed. Across hospitals, hand hygiene adherence after dressing change was lowest (Hospital A: 8/113, 7%; Hospital B: 16/144, 11%; χ2: 8.93, p = .347). Most wound dressing practices were similar across sites, except hand hygiene prior to dressing change (Hospital A: 107/113, 95%; Hospital B: 131/144, 91%; (χ2: 7.736, p = .021) and use of clean gloves using nontouch technique (Hospital A: 88/113, 78%; Hospital B: 90/144, 63%; χ2: 8.313, p = .016). The most commonly documented wound characteristic was wound type (Hospital A: 43/113, 38%; Hospital B: 70/144, 49%). What nurses documented differed significantly across sites (p < .05). Conclusions Clinical variations in wound care practice are likely influenced by clinical context. Relevance to clinical practice Using an evidence‐based approach to surgical wound management will help reduce patients’ risk of wound‐related complications.

Translating Hand Hygiene Practice Into Compliance During Aseptic Wound Dressing

“…In addition, we found that most HCWs have more than six years' experience in carrying out the wound dressing procedure since they are typically older than 30 years of age. Contrastingly, this finding does not support other studies which state that the greater the age of HCWs, the more likely they are to be involved in wound dressing (Gillespie et al, 2020). Thus, we posit that wound dressing responsibilities have no correlation with HCW's experience.…”

“…It is also assumed that wound healing has been under the aegis of basic nursing practice (Sen, 2019). In today standard, nurses will often spend an estimated 25-50% of their time dealing with various types of wounds, which typically range from acute wounds, such as simple lacerations, to more chronic wounds, such as bedsores or diabetic leg ulcers (Gillespie et al, 2020). Although nurses play a crucial role handling wound related procedure, it is not uncommon in today practice that other non-nurse Health Care Worker (HCW) getting involved in managing the wound care.…”

Conocimientos del personal del área de quirófano en el Hospital General Docente Ambato sobre sepsis quirúrgica.

“…Los profesionales y las organizaciones de salud pública deben aplicar estrategias de prevención de sepsis integral, para minimizar las complicaciones y mejorar el pronóstico de los pacientes (26)(27)(28)(29)(30).…”

Setting the surgical wound care agenda across two healthcare districts: A priority setting approach

“…Thus, there may be a potential bias due to the self-selecting nature of the sampling. Yet nurses provide the bulk of wound care (Gillespie et al, 2019). Third, we recognise that individuals were self-selecting, and inevitably may promote a personal or institutional perspective.…”