Wound care
focusing on these other factors as endpoints on their own, or at least alongside the ultimate goal of wound closure, could lead to treatments that enhance quality of life for patients like these. Other aspects of wound care research that Probst is pushing to change are the number of participants, or the “N”, in studies, as well as the methodological bias and lack of standardisation he sees. “We really need rigorous studies that measure with the same instruments and a larger N, so that we can generalise the results to different settings,” he says.
Interest and knowledge
In order to move the discipline of wound care closer towards science, both in research and by standardising care in the clinic, there’s a need to cultivate interest in the topic among the medical profession. Although wound care has become more collaborative over the years, with teams made up of different specialities, “it’s still very nurse led,” says Probst. “Without a proper diagnosis, we cannot manage or treat these wounds and only a physician can make a diagnosis,” he adds. The problem, according to Probst, is that wound care doesn’t tend to attract the same interest as other specialties. “There are not that many physicians that are into wound care,” he says. He adds that this is even true for the rural parts of Switzerland, the country in which Probst has worked alongside colleagues in the field to elevate the importance of wound care in the clinic. Before patients even reach the clinic, the first line of investigation is the general practitioner and Probst says here too there’s a lack of interest in wound care. “There’s a lot of tissue viability nurses, but we also need GPs that are interested in wound care,” he says. One way that Probst has addressed this
issue during his presidency is by condensing the information in EWMA’s larger documents on diagnosing and managing different wound types, as well as antimicrobial stewardship, into “one pagers” that physicians across the spectrum can understand quickly and make decisions with the knowledge at hand. “For example, for the antimicrobial document we have some bullet points and then a flowchart,” adds Probst. For those that undergo formal education in wound care, EWMA provides education on the topic so that medical staff are aware of what to look for when assessing patients, and Probst says this effort is as much about educating physicians as it is nurses. “We started with a curriculum for nurses,” he says. But in an effort to advance the standardisation of wound care among doctors too, EWMA designed a curriculum for the European Union of Medical Specialists (UEMS) in 2015. Now,
Above: G D Winter proved the benefits of a moist healing environment by
experimenting on pigs in the early 1960s.
Below: Florence Nightingale influenced the politicians of her time to make hygiene measures mandatory in hospitals.
Practical Patient Care /
www.practical-patient-care.com
53
r.classen; Perfect Lazybones/
Shutterstock.com
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