Changing Wound Care Practice Improves Outcomes at Benetas' Colton Close

Colton Close Nursing Home is one of Benetas' 12 residential care facilities located in the western suburbs of Melbourne, Victoria. It has 92 high care beds and is collocated with a 58 low care facility. Over the past few months there has been a substantial improvement in the rate of wound infections in both high care and low care and this is attributed to a substantial change in policy and practice relating to wound care.

After reviewing the data on wound infections Benetas decided to appoint Jan Rice, a wound management specialist to provide guidance and assistance on the management of wounds. Jan visits the facility every two to three months, or as required, and has done so since November 2009. If the facility has a resident with special wound care needs, Jan will either provide advice over the phone or arrange for a special visit.

As a result of Jan Rice's involvement, Benetas and Colton Close Nursing Home have developed more focused policies and guidelines for the treatment of wounds. Key improvements have been:

• Arranging for all complex wound dressings to be done by Division 1 Nurses only. This helps to ensure the correct processes are followed and that the infection risk posed by numerous people attending to the wounds is minimised.
• Implementing a new assessment and wound care plan devised by Jan Rice.
• Standardising the type of wound care products being used. In particular, the introduction of `Mepitel', a silicone impregnated gauze that allows for cleaning of the wound and the change of ointment without removal of the gauze. The use of this product has:
• substantially reduced manual handling and thereby reduced the risk of infection
• reduced the risk of resident discomfort or pain during treatment
• reduced workload for staff, and
• reduced the cost of care.

Another reason for the improvement has been the Benetas initiative of introducing Portfolio Managers in various key clinical areas. Ancica Kosaros is the Portfolio Manager for Wound Care at Colton Close and explains that the Portfolio Manager concept has facilitated the development of expertise in a range of areas. For Ancica, the opportunity to participate in a four day wound management course run by Jan Rice was critical to a better understanding of best practice in wound care. As a Portfolio Manager, Ancica is now able to share this expertise with other staff and other facilities.

The results are impressive. As the graph below shows Colton Close had been experiencing relatively high rates of wound infections for the months of July to December 2009. Jan Rice commenced her work in November 2009 and after she changed the way wound care was managed the number of wound infections dropped to zero for January to March. As Ancica explains, "the new systems are better, they have reduced our workload, improved clinical outcomes and our residents are benefiting from the changes we have put in place - we intent to keep it that way".

Colton Close Nursing Home Wound Infection Rates showing infection rates dropping from double the industry average to zero over a period of 4 months.