The client and family experience of attending a nurse-led clinic for chronic wounds.

BACKGROUND: The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds. METHODS: Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken. RESULTS: Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic. CONCLUSIONS: The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.

The outcomes and experience of people receiving community-based nurse-led wound care: A systematic review.

AIMS AND OBJECTIVES: To review the literature related to the outcomes and experience of people receiving nurse-led care for chronic wounds in the community. BACKGROUND: Chronic wounds lead to a poor quality of life and are an economic burden to the Australian healthcare system. A lack of awareness into the significance of chronic wounds leads to limited resources being available to facilitate the provision of evidence-based care. The majority of chronic wounds are managed by nurses in the community, and a better understanding into current models of care is required to inform future practice. DESIGN: A systematic quantitative literature review. METHODS: A systematic search was conducted in four electronic databases, and the inclusion criteria were as follows: English language, peer-reviewed, published from 2009-2019 and primary research. The data were compiled into an Excel database for reporting as per the Pickering and Byrne (Higher Education Research & Development, 33, 534.) method of systematic quantitative literature review. This review used the PRISMA checklist. The Mixed Methods Appraisal Tool was used for quality appraisal. RESULTS: Twelve studies were included in the review. Home nursing care, social community care and nursing within a wound clinic were identified as three types of nurse-led care in the literature. The findings demonstrate that nurse-led care was cost-effective, reported high levels of client satisfaction and contributed to improved wound healing and reduced levels of pain. CONCLUSIONS: Nurse-led care is a positive experience for people with chronic wounds and leads to better outcomes. The findings suggested a need for further client education and specialised training for healthcare practitioners managing chronic wounds. RELEVANCE TO CLINICAL PRACTICE: This review demonstrates that nurse-led care for people with chronic wounds in the community is cost-effective and improves client outcomes. Raising awareness into the significance of chronic wounds aims to promote the resources required to facilitate evidence-based care.