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Wound care practices across two acute care settings: A comparative study

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Listed:
  • Brigid M. Gillespie
  • Rachel Walker
  • Frances Lin
  • Shelley Roberts
  • Anne Eskes
  • Jodie Perry
  • Sean Birgan
  • Paul Nieuwenhoven
  • Elizabeth Garrahy
  • Rosalind Probert
  • Wendy Chaboyer

Abstract

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%; χ2: 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%; (χ2: 7.736, p = .021) and use of clean gloves using nontouch technique (Hospital A: 88/113, 78%; Hospital B: 90/144, 63%; χ2: 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

Suggested Citation

  • Brigid M. Gillespie & Rachel Walker & Frances Lin & Shelley Roberts & Anne Eskes & Jodie Perry & Sean Birgan & Paul Nieuwenhoven & Elizabeth Garrahy & Rosalind Probert & Wendy Chaboyer, 2020. "Wound care practices across two acute care settings: A comparative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(5-6), pages 831-839, March.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:5-6:p:831-839
    DOI: 10.1111/jocn.15135
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    References listed on IDEAS

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    1. Brigid M Gillespie & Claudia Bull & Rachel Walker & Frances Lin & Shelley Roberts & Wendy Chaboyer, 2018. "Quality appraisal of clinical guidelines for surgical site infection prevention: A systematic review," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-17, September.
    2. Baumann, Lisa Ann & Baker, Jannah & Elshaug, Adam G., 2018. "The impact of electronic health record systems on clinical documentation times: A systematic review," Health Policy, Elsevier, vol. 122(8), pages 827-836.
    3. Corallo, Ashley N. & Croxford, Ruth & Goodman, David C. & Bryan, Elisabeth L. & Srivastava, Divya & Stukel, Therese A., 2014. "A systematic review of medical practice variation in OECD countries," Health Policy, Elsevier, vol. 114(1), pages 5-14.
    4. Brigid M Gillespie & Wendy Chaboyer & Evelyn Kang & Jayne Hewitt & Paul Nieuwenhoven & Nicola Morley, 2014. "Postsurgery wound assessment and management practices: a chart audit," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(21-22), pages 3250-3261, November.
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