Implementing Wound Care Guidelines: Observations and Recommendations from the Bedside

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Jan Lloyd-Vossen, RN, BScN, MN

Abstract:The successful implementation of wound care guidelines requires an appreciation for the frustrations experienced by nurses trying to incorporate these tools into clinical practice. These frustrations or barriers to best wound care practice implementation are examined from the perspective of: 1) the practice environment, which must be understood; 2) the potential adopters, predominantly nurses seeking the best fit between evidence and their clinical practice setting; and 3) the evidence-based innovation created to change wound care practice at the point of care. Barriers identified include lack of available resources, time constraints, prescriptive guidelines that incorrectly assume details of the practice environment, and wound care product confusion. Recommendations to facilitate implementation from the bedside are discussed and include expanding guidelines to incorporate detailed educational content and dissemination strategies that serve to increase relevancy to everyday practice. Additional suggestions include decreasing wound care product confusion by developing standardized, function-based product nomenclature and improving the quality of wound care research to increase nurses’ confidence in the evidence and resultant recommendations. Resources currently used to develop guidelines also should be utilized to create accompanying educational material to support the transfer and uptake of knowledge.

Key Words: wound care, guidelines, implementation, barriers, nursing

Ms. Lloyd-Vossen is a member of the faculty, Nursing Education Program of Saskatchewan. Please address correspondence to: Jan Lloyd-Vossen, NEPS SIAST Kelsey Campus, PO Box 1130, Saskatoon, Saskatchewan S7K 3R5 Canada; email: jan.lloydvossen@siast.sk.ca.




     Tracey is a 30-year-old registered nurse who graduated from a baccalaureate program 5 years ago. She recently accepted the only clinical nurse educator position in her 100-bed hospital. Tracey’s manager asked her to create an effective in-service to remedy “all the confusion the nurses have about those new dressings.” Tracey investigated the value-added educational programs offered by the wound care manufacturers.

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