Nursing Practice Innovation


FIG 2. COMMUNITY NPWT PATHWAY Referral from ward to ICT team via liaison/discharge team


Discharge team/liaison inform patient that the device will be changed in the community


Discharge team/liaison send referral to local ICT and copy to tissue viability team


ICT arrange date and time for changeover of hospital rental device at patient’s home within three days of discharge


ICT takes out device with appropriate dressings. Wound and risk assessment completed; any risk or potential risk documented and appropriate action taken. Patient/carer given written information and contact numbers


Hospital device cleaned and returned immediately after changeover


Each time a device is used details are entered on a NPWT spreadsheet on a shared drive to track and monitor the device


ICT contacts tissue viability for joint visit and to agree the care plan. Timescales for review documented in the care plan depending on patient needs. Decision to stop therapy agreed with tissue viability team, ICT or responsible medical practitioner where appropriate


Owned device and accessories cleaned and returned to ICT base. The ICT team is responsible for maintaining devices and ensuring accessories/leads are returned


important that any potential risks or hazards are identified for patients receiving therapy at home including clin- ical suitability for NPWT (European Wound Management Association, 2007). The risk of accidents and misuse can be reduced by ensuring the following points are considered: » Community staff delivering NPWT are trained by the tissue viability team in partnership with the appropriate manufacturer;


» Staff are familiar with local guidance and have been assessed by the tissue viability team as competent to carry out a wound assessment;


» Staff are aware of local infection prevention guidelines, wear protective gloves and aprons when changing the dressing or canister, and clean the equipment appropriately;


» Patients receive an information leaflet and contact details for reporting faults or clinical issues;


» Equipment is maintained and


serviced according to manufacturers’ guidance;


» The device can be plugged in to an electricity supply where necessary, without the use of extension leads to avoid causing a trip hazard;


» Patients are advised to be careful if they have animals or small children as unpredictable behaviour may lead to accidents.


Conclusion NPWT is a useful and effective wound treatment that can be applied in both the community and hospital setting. Col- laborative working between acute and pri- mary care can ensure a seamless care pathway for patients who will benefit from this therapy. However, there are risks asso- ciated with NPWT, not all of which have been fully explored in this article, that need to be considered before using it. The range of devices available today means NPWT can be accessible to patients in any setting. NT


20 Nursing Times 04.09.12 / Vol 108 No 36 / www.nursingtimes.net


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