'The SARS-Cov-2 (COVID-19) pandemic saw the introduction of safety measures such as social distancing, isolation and shielding. This has facilitated health care services transformation, particularly in tissue viability services, where a decrease in community nursing visits, limited outpatient appointments and few face-to-face GP appointments have increased the need for patients to be actively involved in their own care. Such a shift has contributed towards patients and health professionals (HCP) sharing treatment and care responsibilities to maintain the patients' health. This shift brings about its own challenges, with patients requiring a degree of knowledge and skills of wound care to be able to confidently manage their wounds. The terms self-care, shared care and supported self-management are often used to refer to patient involvement in their treatment and care but a lack of consensus around the extent of patient involvement and an absence of strategic guidelines for shared or self-management of lower limb wounds contributes towards difficulties in understanding the extent of patient involvement. This paper provides a narrative review of current literature focused on shared, self or supported self-management practices and perceptions in the management of lower limb wounds.
Like many sectors, tissue viability services have been affected by and had to learn lessons from the COVID-19 pandemic. The pandemic has had an impact on service delivery and patient communication, and there has been some debate over whether this will permanently change the ways in which care is delivered. A group of specialist nurses and academics working in wound care met online via Zoom on 15th June 2021 to discuss how care has evolved since the start of the pandemic, and what this might look like as we move forward. This builds on a previous discussion that took place one year earlier (18th June 2020), in which a similar group discussed the challenges of delivering care at the height of the pandemic, which was published in Wounds UK in September 2020 (Fletcher et al, 2020).
The COVID-19 pandemic has affected many different services over the last year, including tissue viability. In some cases these changes may have helped us see both the good and also what needs changing within the service. As things begin to return to normal you may want to justify and add to your service using the new information acquired. In this article, Karen Ousey explains how to make a business case for your service and what it requires.
Protecting the skin of frontline NHS staff suddenly became a priority during the COVID-19 pandemic. This article includes two reflective accounts, one from a critical care sister and another from a tissue viability nurse consultant, both working in acute hospital settings. It details the challenges encountered as staff developed skin damage from wearing personal protective equipment (PPE) and the range of interventions employed to reduce this risk. The importance of learning from this experience and sharing data on a national level is highlighted.
Wound care consumes a considerable proportion of NHS resources, particularly for services that deliver healthcare outside hospitals.1 It is estimated that around 50% of community nursing time is spent delivering wound care.2 The burden is considerable for people living with wounds who too often cannot access the right care early enough in their wound care journey. As we move through the Covid pandemic towards recovery, the need to improve wound care is more pressing than ever.
Background: This study aimed to determine whether the TREZZO HS Advanced foam mattress system could reduce the use of dynamic mattress systems (Alternating and Constant Low Pressure) in patients on vascular and stroke wards. Methods: TREZZO HS mattresses were evaluated in a vascular and stroke wards over a 6-week period with respect to the outcome of reduction in need for dynamic mattress use and any affect on skin integrity. Data was compared with corresponding retrospective data from the previous year in which high specification pressure reducing foam mattresses were available. Mean length of patient stay on both types of mattresses, and the dynamic mattress, was evaluated. Cox semiparametric time-to-event methods were used to assess the hazard of patient transfer to a dynamic mattress in patients positioned on TREZZO HS, rather than the previously used foam mattress. Results: Use of the TREZZO system reduced mean length of stay on a dynamic mattress by 70% over both wards; from 41.0 days to 12.6 days. The proportion of patient-days spent on dynamic mattress systems decreased from 47.8% to 7.1%. Mattress type was significantly associated with the event (p=0.036); hazard ratio 0.328 (95% confidence interval 0.116 to 0.929). Ward type was not significantly associated with the event (p=0.333). Conclusion: The TREZZO HS system has been shown to substantially reduce the use of dynamic mattress usage and may be a cost-effective way of reducing the likelihood of pressure ulceration in vascular and stroke patients.
