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Suboptimal identification of patient-specific risk factors for poor wound healing can be improved by simple interventions

By:

Harris, L.S

Contributor(s):

Publication details: 2017Uniform titles:

International Wound Journal

Online resources:

Summary: Poor wound healing is an important surgical complication. At-risk wounds must be identified early and monitored appropriately. Wound surveillance is frequently inadequate, leading to increased rates of surgical site infections (SSIs). Although the literature demonstrates that risk factor identification reduces SSI rates, no studies have focused on wound management at a junior level. Our study assesses documentation rates of patient-specific risk factors for poor wound healing at a large district general hospital in the UK. It critically evaluates the efficacy of interventions designed to promote surveillance of high-risk wounds. We conducted a full-cycle clinical audit examining medical records of patients undergoing elective surgery over 5 days. Interventions included education of the multidisciplinary team and addition of a Wound Healing Risk Assessment (WHRA) checklist to surgical admissions booklets. This checklist provided a simple stratification tool for at-risk wounds and recommendations for escalation. Prior to interventions, the documentation of patient-specific risk factors ranged from 0·0% to 91·7% (mean 42·6%). Following interventions, this increased to 86·4-95·5% (mean 92·5%), a statistically significant increase of 117·1% (P < 0·01). This study demonstrates that documentation of patient-specific risk factors for poor wound healing is inadequate. We have shown the benefit of introducing interventions to increase risk factor awareness.

Holdings
Item type	Home library	Collection	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves	Staff publications for NMDX		Available

NMUH Staff Publications

Poor&nbsp;wound healing&nbsp;is an important surgical complication. At-risk wounds must be identified early and monitored appropriately.&nbsp;Wound&nbsp;surveillance is frequently inadequate, leading to increased rates of surgical site infections (SSIs). Although the literature demonstrates that risk factor identification reduces SSI rates, no studies have focused on&nbsp;wound&nbsp;management at a junior level. Our study assesses documentation rates of patient-specific risk factors for poor&nbsp;wound healing&nbsp;at a large district general hospital in the UK. It critically evaluates the efficacy of interventions designed to promote surveillance of high-risk wounds. We conducted a full-cycle clinical audit examining medical records of patients undergoing elective surgery over 5 days. Interventions included education of the multidisciplinary team and addition of a&nbsp;Wound Healing&nbsp;Risk Assessment (WHRA) checklist to surgical admissions booklets. This checklist provided a simple stratification tool for at-risk wounds and recommendations for escalation. Prior to interventions, the documentation of patient-specific risk factors ranged from 0·0% to 91·7% (mean 42·6%). Following interventions, this increased to 86·4-95·5% (mean 92·5%), a statistically significant increase of 117·1% (P &lt; 0·01). This study demonstrates that documentation of patient-specific risk factors for poor&nbsp;wound healing&nbsp;is inadequate. We have shown the benefit of introducing interventions to increase risk factor awareness.

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