Wound Care Certificate for Remote Settings - Lesson 2A: Clinical Best Practices in Wound Care

Please watch the following recorded lecture and respond to the discussion question below.

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What best practice guidelines are used in your organization and how are they implemented? What are some benefits and limitations to their use?

Instructions: You must post your responses in the comments section below before the next live lesson. The instructor will review your comments and have a debrief discussion at the start of the next live session. The comments section will not be moderated otherwise.

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10 comments on “Wound Care Certificate for Remote Settings - Lesson 2A: Clinical Best Practices in Wound Care

  1. I typically try to reference the manufacturer's website for choosing case specific dressings. I also use my co-workers at the health centre, as they have a wealth of knowledge, as well as best practice guidelines (RNAO, Wound Canada, CLWK, Up-to-Date...etc.). As a new nurse, courses like this one are vital to helping inform and shape my practice.

  2. We usually refer to BC or Alberta guidelines or best practice here in the Yukon. We also use best practice guidelines recommended by Wounds Canada or NSWOC. Most of our policies are on a shared file that we can access using our computers at work however those policies usually do not reflect the best practice so we still usually have to find credible resources such as those I mentioned earlier. The advantages of referring to these best practice guidelines are nurses can use the most evidence based informed recommendation for our practice. It is good that our employer support us in taking courses such as this to keep us up to date.

  3. As my co workers have said we don’t have a lot of standardized wound care directives at kwanlin dun. In my practice I try and use the websites of the products and past training to inform the dressing selection with a balance of what the clients life style and medical history would dictate for best wound care. This obvious downfall is like Hilary said it is on the onus of the nurse to ensure best practice which as I learned in Tuesday’s class isn’t always happening. I learned already that we are doing dressings too frequently.

  4. Up-To-Date is probably my go to for current evidence-based practice, but it is not very applicable to wound care. I will occasionally use the CLWK site, but I do find that most of my knowledge about best practice comes from attending workshops such as these are sharing information with colleagues. Of course, this runs the risk of practice not staying current.

    I remember in my nursing program in Ontario, we lived and died by the RNAO BPG's. However in Yukon, our practice is a bit more wild-west. I would like to have a balance of being able to consult resources that contain best-practice, while still having the freedom to work creatively beyond what a BPG may suggest.

  5. I implement the use of several guidelines to help inform my practice for wound care. Previously working in Ontario I had the ability to be the wound champion for the ER I worked in which allowed me to complete some additional training through RNAO. This not only provided insight into various wounds but also consideration for things such as surfaces that client's are on. Although we have less control over this in the home setting it is something I always consider in the back of my mind. One of the main sources for information promoted in my current place of work is the BC skin and wound community of practice. The CLWK provides best practice information on both documentation as well as education on dressing selection. I think the benefits of these tools is of course increased knowledge and education and increased autonomy to make changes. One of the limitations we really struggle with is still access. We have (at least from my previous experiences) a wide range of products stocked at home care, however many products we do not have available or there is pressure on us to have client's order these supplies. Of course ordering supplies takes time and often clients do not have money. The other downfall is if we do order supplies often 2-3 weeks later if the dressing is not showing to benefit healing and we want to try something else than we must go through this all over again.

  6. Being a new nurse I depend on finding best practice guidelines through product monographs/product online resources , up to date and the CLWK site for resources. Although I really enjoy the autonomy of wound care, it is so important to have the knowledge of best practise guidelines to draw from and help in decision making for best outcomes. I guess one of the draw backs to blindly following best practice guidelines would be, not taking into account the individual and their specific/unique needs in care.

  7. At Kwanlin Dun Health Centre we have the wound assessment and treatment flow sheet, but more for tracking what we are using as a current dressing change and how the wound is healing, and not as a best practice guideline for what dressing is best for the wound. I am excited to learn more about CPGs that we might be able to implement at KDHC to better care for clients.

  8. Honestly, I am often searching for current up-to-date information on wound care specific guidelines and have used RNAO, Wounds Canada, and Up-To-Date to find the information I need to guide my practice. I use these guidelines when I have a chronic wound I need help deciding how to best treat. Unfortunately, the workplace culture and resources we have does limit the time we have to implement preventative best practice guidelines, so we're already in the thick of it when we go searching for information. I would love to take away some preventive treatment measures we could implement in our diabetic population from this course.

  9. I was going to say the same thing Terri:)
    Just kidding, but I do agree.
    We use WATFS and I really don't find they give much objective info, I would actually rather write out a detailed progress note as well as read a detailed progress note than see how another nurse completed a WATFS.

  10. Best practice guidelines used in my practice at Home Care: 1) WATFS (Wound Assessment and Treatment Flow Sheet) 2) Bates-Jensen if not using WATFS; 3) Braden Scale for Pressure Ulcer Risks 3) upper and lower leg assessments (adapted by VIHA). Implementation process includes discussion with nursing to determine what tools are being used and discussion re: benefits/limitations of each tool. Often there is a trial process for an determinate amount of times to assess which tools are best then the implementation process followed by policy to support use of tools. Benefits for best practice guidelines: 1) valid and replicable; 2)standardized by using nursing language and terminology; 3) evident based 4) less charting by using standardized tools in a check mark format; 5) Easier to follow patterns/trends than by progress note charting alone. 6) economizes nursing time by using a tool. Limitations: 1) subjective (eg. moderate to large amounts of drainage). 2) Difficult to capture all details of charting with a tool.

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