DEVELOPMENT
L
ord Darzi’s High Quality Care impact can be high. substantial burden on NHS funds and
for all: NHS Next Stage Review that this will only increase.
(Department of Health [DoH],
2008) heralds a new era for the By selecting treatment The key determinants of wound
NHS where, according to the that is appropriate to the care costs need to be assessed and
National Nursing Research Unit cause and the condition understood by wound care specialists.
(NNRU, 2008), the focus on quality of the wound, healthcare These variables include hospitalisation
promises to be relentless. The report professionals will improve rates, number of procedures, mean
includes a commitment to hold trusts length of stay, time to heal, frequency
their performance in line
accountable for and to reward quality of dressing change, and the cost of
of care, and pressure ulcers are with the recommendation all dressing materials per change. It is
featured as one of the most frequently to have ‘quality at the heart therefore advisable that trusts employ
cited quality indicators. of everything we do’ (DoH, wound management specialists who
2008)... . are able to collate data against these
While the chances of a patient determinants when undertaking the
developing pressure ulcers may relate appropriate management of wounds
to the quality of nursing care, early The emphasis on quality needs to and wound care audits (Hamilton,
detection and proper documentation be seen in the context of finite NHS 2008).
resources and wound care costs must
also be an ongoing consideration. By selecting treatment that is
The cost of wound care to the NHS appropriate to the cause and the
has been estimated to be £2.3bn and condition of the wound, healthcare
Karen Ousey is Principal Lecturer, Department of Nursing £3.1bn per year (based on 2005–2006 professionals will improve their
and Health Studies, Centre for Health and Social Care costs) (Posnett and Franks, 2007). The performance in line with the
Research, University of Huddersfield; Richard H Shorney DoH (2008) estimated that the budget recommendation to have ‘quality at
is Professional Development Manager, Smith and Nephew for the NHS in England in 1996/7 was the heart of everything we do’ (DoH,
Healthcare Ltd £33bn and that in the year 2008/9 it 2008), and in keeping with the report’s
clinical skills, including business acumen, offer a quality assured wound care Watret L (2005) Teaching wound
are essential to support a service that service is evolving, so too does the management: a collaborative model
for future education. Available online
is both good quality and cost-effective. education provided to support the at: www.worldwidewounds.com/2005/
healthcare professionals working in november/Watret/Teaching-Wound-Mgt-
In clinical practice and more this healthcare arena. To enable wound Collaborative-Model.html#ref14 (last
specifically in wound care, there care to embrace the challenges set accessed 14 March, 2009)
are tremendous variations in the by the Darzi report (DoH, 2008), a Welsh Assembly Government (2003)
knowledge and skills of individual stronger working relationship will need Fundamentals of Care: Guidance for Health
healthcare professionals involved. to be made between the NHS, higher and Social Care Staff. Welsh Assembly
Despite an acknowledged theory- education institutions and industry. WUK Government, Cardiff. Available online at:
http://new.wales.gov.uk/docrepos/40382/
practice gap, education is often viewed dhss/510356/booklete (last accessed 14
as an effective method of facilitating March, 2009
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