Implementing a pilot skin and wound care programme in two residential aged care facilities

Abstract

Background Skin and wound care programmes in residential aged care (RAC) facilities are essential to prevent and manage wounds in this complex population. Method A 6-month pilot research study was conducted in two hospital-level RAC facilities using a mixed method and a continuous quality improvement methodology. The first part of this study aimed to determine professional knowledge about, and reporting of, skin tear and pressure ulcers/injuries (PIs) within this setting – both by nurses and by healthcare assistants (HCA) – in order to determine educational need in this area of practice. Focus groups were held for both nurses and HCAs, and responses to questions asked in the sessions were analysed. In addition, both of these groups completed knowledge questionnaires in order to determine further educational requirements. This was followed up by a programme of education, including educational resources. Nurse and HCA ‘champions’ were also recruited to aid programme implementation. Finally, in order to evaluate the effectiveness of the programme, a post-programme reassessment of knowledge using the same focus group questions and knowledge questionnaires was implemented. The number of facility-reported skin tears and PIs were also recorded periodically over 16 months, from 6 months before the start of the programme to 4 months afterwards. Results Retrospective and post-programme PI numbers in both facilities were low. During pre-programme knowledge testing, PI numbers increased in one facility, which may be attributed to an increase in reporting. In both facilities, skin tear numbers declined, and this was maintained 3 months post-programme; this was attributed to the implementation of a skin care regime. The champion role, developed throughout the programme, was also seen as aiding both staff leadership and programme ownership. Conclusion The establishment of an evidence-based skin and wound programme determined from staff-identified practice issues and associated learning needs can improve professionals’ knowledge and practice, and can improve resident care. The two programmes were comparable in both facilities and therefore may be transferable to other RAC facilities.