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Wound care practices across two acute care settings: A comparative study
Author(s) -
Gillespie Brigid M.,
Walker Rachel,
Lin Frances,
Roberts Shelley,
Eskes Anne,
Perry Jodie,
Birgan Sean,
Nieuwenhoven Paul,
Garrahy Elizabeth,
Probert Rosalind,
Chaboyer Wendy
Publication year - 2020
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.15135
Subject(s) - medicine , wound care , surgical wound , audit , acute care , observational study , hygiene , health care , medical record , medline , emergency medicine , medical emergency , intensive care medicine , surgery , management , pathology , political science , law , economics , economic growth
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%; χ 2 : 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%; (χ 2 : 7.736, p = .021) and use of clean gloves using nontouch technique (Hospital A: 88/113, 78%; Hospital B: 90/144, 63%; χ 2 : 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.