Community wound care Resources

Recruitment and retention challenges in community nursing have exacerbated disparities in wound care outcomes, particularly among housebound patients. In response, University Hospitals Coventry and Warwickshire NHS Trust Wound Healing Integrated and Community Care Services developed the Coventry community wound healing team (CWHT) in 2022 to improve healing outcomes and relieve pressure on district nursing services. This paper outlines the development, structure and outcomes of the Coventry CWHT, which delivers specialist wound care in patients’ homes through a skill-mixed team led by a wound healing clinical nurse specialist (CNS). Findings indicate significant benefits in terms of patient outcomes, workforce effciency and staff wellbeing. The model presents a scalable solution to current challenges in community wound care delivery.

This article outlines the development of a community tissue viability service over the same five-year-period in which a number of national issues with wound care were identified through research. These included a lack of evidence-based practice, a changing community workforce and an unwarranted variation in care attributed to a lack of education and training among generalist practitioners. The author describes how a proactive approach was taken to local service development to address these issues, and how partnership working with both colleagues and industry enabled improved wound care education delivery and uptake among a generalist community workforce. These measures resulted in a reduced spend on wound care dressings year on year, despite a predicted trend for increasing costs nationally.

Objective: In Slovenia, community nurses usually use tap water as a cleanser for chronic wounds, but is this the best practice? The purpose of this review is to establish if there is any difference in healing and infection rates when wounds are cleaned with tap water instead of sterile saline.

Method: An electronic literature search using the key words chronic wounds, wound cleansing, tap water and saline was undertaken.
Results: Results showed that there was no increase in infection or in wound healing rates between patients whose wounds were cleaned with tap water or sterile saline. Tap water may be as safe and effective as sterile saline but only when the water comes from the properly treated supply and used at body temperature.

Conclusion: Some evidence suggests that the use of tap water of drinkable quality appears to be a safe alternative to sterile saline, and that there are numerous benefits in its use.

Acknowledgements:
This contribution is part of Master’s Degree undertaken at College of Health Care, Izola. The author is grateful for the support and assistance of Professor Dame June Clark, Swansea University.

Andreja Ljubič RN, University of Primorska, Faculty of Health Sciences Izola, Slovenia and Health Center Postojna, Postojna, Slovenia.

Article accepted for publication: January 2012