Community Wound Healing Services

Within the community, the first Community Clinical Nurse Specialist in Wound Healing was appointed in 2000 and in addition to their current caseload of housebound and Nursing Home patients with wounds have developed five Community based Nurse-led Wound Healing Clinics to enhance and improve existing treatment programmes offered by community practitioners.

As a community team they provide:

• Advice to health care professionals on wound care issues.
• Holistic assessments and individual care plans to patients within the 5 nurse leg community wound healing clinics.
• On-going care within their healed leg ulcer clinics run by their Health Care Support Worker.
• Domiciliary visits for housebound and nursing home patients.

Wound Team Clinics Clinics

Healed Clinics

The types of wounds referred include:

• All category 3 and 4 pressure ulcers (Mandatory)
• Fungating or malignant wounds where symptoms are not being adequately managed
• Patients with non-healing or deteriorating surgical wounds
• Patients with wounds that are deteriorating or become static and have not responded to appropriate treatment
• Haematomas
• Patients discharged home with Topical Negative Pressure that are not being reviewed in outpatients
• Patients with symptoms i.e. pain or exudate where management is difficult or not responding to current treatment plans
• Leg ulcers that have not responded to appropriate treatment after four weeks or where aetiology has not been established

To improve continuity of care and ensure effective treatment is offered to the patient by the appropriate professional, a robust system of referral criteria have been developed between primary, secondary and tertiary care. Based on wound aetiology and severity which are linked to National and International Guidelines, this endeavours to offer a seamless referral system which is accessible for patients and ensures timely levels of intervention.

This has proved to be particularly effective for patients with vascular and other complicated problems requiring specialist intervention being referred into the Department. The specialist input from the WHRU enables effective use of resources and cuts down on unnecessary referrals to the overburdened vascular services.

This referral system has also been successful for patients with non-complicated venous ulceration who, prior to the Community Nurse-Led Wound Clinics, would have received care in the WHRU outpatient clinic and are referred back to the community under the care of the Clinical Nurse Specialists.