Closing The Loop: How Digital Systems Can Support Safer Wound Management
Liz Lear
Clinical Specialist
Liz is a registered nurse and Clinical Specialist at VCare. She is passionate about supporting care teams and educating nurses. In this article, she explores how digital systems can support safe, consistent wound care.
| 5 Min Read |
Wound Management – More than Dressings
Wound management in aged residential care is about much more than applying the right dressing.
It requires ongoing assessment, evaluation of healing, accurate documentation, timely escalation and, importantly, making sure the wound is reviewed again when it needs to be.
Recent Health and Disability Commissioner decisions continue to highlight what can happen when one of these steps is missed. Concerns identified in wound-related cases have included delays in wound assessment and reassessment, incomplete documentation, inconsistent monitoring, delayed referral or escalation, and insufficient clinical oversight.
These findings provide an important reminder that having a wound care policy or assessment form is not enough. The processes around the resident also need to support staff to put that policy into practice.
The Challenge of the ‘Next Review’
In a busy aged care environment, an RN may assess a wound, document its appearance, select the appropriate treatment and complete the dressing correctly.
But what happens next?
- When should the wound be reassessed?
- Who knows that it is due?
- How does the next RN know a review has been planned?
- And how can the Clinical Manager easily see which wounds are current and which assessments are coming due?
This is an area where a well-designed electronic clinical system can provide valuable support.
Making the next wound assessment part of the process
VCare provides nurses with a clear way to manage wound assessment.
Wound assessments in VCare can be configured so that the RN is required to document whether the wound has healed.
If the wound has not healed, a Next Assessment Date can be made mandatory.
This means that completing today’s wound assessment also requires the RN to consider and plan the next assessment.
If the wound is documented as healed, the requirement for another assessment date is removed.
It is a relatively simple workflow, but an important one: the next review becomes part of completing the current assessment rather than something that has to be remembered later.
From Documentation to Visibility
Recording the next assessment date is only useful if that information becomes visible to the people responsible for the resident’s care.
VCare brings wound information together through the Wound Register on the Clinical Dashboard, providing clinical staff with visibility of residents with current wounds and their wound management information.
The planned wound assessment also appears on the Task page, helping staff identify assessments that are due.
Instead of the review date sitting within an individual resident’s wound assessment waiting for someone to find it, it becomes part of the clinical workflow.
This provides another layer of support for the RN and greater visibility for clinical oversight.
Supporting Clinical Governance
This is also where digital systems can contribute to clinical governance.
Clinical Managers need to be able to answer questions such as:
- Which residents currently have wounds?
- When was each wound last assessed?
- When is the next assessment due?
- Are assessments being completed within the planned timeframe?
- Is a wound failing to improve or deteriorating?
- Does the resident require further clinical review or escalation?
The Health and Disability Commissioner has repeatedly highlighted the importance of accurate wound documentation, ongoing assessment, timely intervention and escalation.
Technology cannot replace an RN’s clinical assessment, critical thinking or responsibility to escalate concerns. What it can do is make important information more visible and create prompts within the everyday workflow that support those responsibilities.
Closing The Loop
Good wound management is a continuous cycle.
The important part is making sure that cycle does not stop after the dressing has been applied or the assessment has been saved.
By requiring the next wound assessment to be planned, displaying wound information through the Clinical Dashboard and bringing planned assessments onto the Task page, VCare can help services create a clearer line of sight from today’s wound assessment to tomorrow’s clinical responsibility.
Because sometimes the most important question at the end of a wound assessment is a very simple one:
When are we looking at this wound again?