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INFECTION PREVENTION & WOUNDCARE


Andrew Kingsley, clinical manager for infection control and tissue viability at North Devon Healthcare Trust, discusses best practice in wound infection prevention.


M


anaging the two departments of in- fection control and tissue viability,


Andrew Kingsley is in the perfect position to explain challenges in the fi eld and how these may be overcome. He facilitates the joining of the two departments, which work together to deliver best practice, with the obvious major crossover point of these two being the issue of infected wounds.


Kingsley said: “While I do management work, I can also put hands on fl esh and get involved in the nitty gritty of everyday, in terms of wounds and in infection control. So that gives me clinical oversight.


“We’re a combined integrated trust here in North Devon, so we have community hos- pitals, we have an acute hospital and dis- trict nurses, all under our wing. The labo- ratory itself also extends out to all the GP practices as well.


“The cross-over value works very well. The tissue viability nurses sometimes ask for information from the infection control nurses or for microbiologists and likewise it works the other way around as well.


“If the clinical microbiologists are going out and seeing a wound that they think might be infected or they want some further in- formation, then they will ask the tissue vi- ability nurses to perhaps accompany them on a ward round, go and view something, take a photo and come back and give an im- pression about whether the wound is clini- cally infected or not and that helps with the treatment.”


MRSA swab results are also sent to the lab- oratory to ensure that wound care is being carried out correctly and effectively, Kings- ley explained.


He said: “If MRSA crops up in a wound swab, the laboratory here deals with all the GP specimens so we get copy reports for that here in tissue viability, and then we can follow through on those individual cases. We can make sure that the wound care is going right, and if we need to inter- vene with a topical antiseptic of some kind, whether it’s a silver dressing, or honey, or iodine, or a PHMD dressing, which is more modern – a relatively new entrant to the marketplace. It tells us if we need an anti- septic dressing of some kind, or a strategy,


52 | national health executive Sep/Oct 11


in order to hopefully prevent, not only a local wound infection with MRSA, but to try to prevent the more serious wound related bacteraemia. In that way, tissue viability following through on the wound care should pay dividends in the control of bacteraemia.”


When discussing the biggest challenge in wound care, Kingsley believes that quickly assessing which wounds need further care is often a diffi cult task.


“The challenge is early assessment and early effective treatment,” he told us. “Getting it seen by the right person quickly, properly diagnosed, and getting a good wound care plan. Wound infection really starts and ends with closing that wound, fundamentally.


“At the moment in the UK I think, from my personal experience, and listening to the experience of others, tissue viability nurses from around the country, either people send referrals which don’t need to be sent,


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