Spotlight: Enhancing Vascular Care

Tell us about your work within the vascular service.

Our vascular service covers nine outpatient clinic sessions a week, in addition to working on the acute vascular ward, clerking emergency and elective patients and overseeing their ongoing complex wound care needs. The majority of patients admitted on the vascular ward have a wound of some description– acute limb ischaemia with tissue necrosis, ulceration (arterial/venous/mixed), diabetic foot, surgical wound or pressure ulceration. Often, multiple wounds with different underlying aetiology can be challenging to manage. It’s important to not only have a good knowledge of the wound healing process but also to address the underlying aetiology and intrinsic and extrinsic factors that have the potential to delay wound healing.

What motivates you to do your job, and how do you stay motivated?

I am privileged to work within a small team of caring, compassionate practitioners who have a shared goal of delivering the best evidence-based, quality care to our patients. We motivate each other to strive for positive patient experiences and outcomes. We are fortunate to have variety within the role with no two days the same.

Are there any particular moments or patient experiences that have reinforced your passion for this work?

I am fortunate to see the majority of our patients on their entire pathway from initial presentation in the outpatient department, to hospital admission/treatment and following discharge. This allows us to build a good, longstanding relationship with our niche, complex patient group for many years. The patients feel reassured to see a familiar, friendly face with trust and mutual respect, with the recognition of the importance of the patient-clinician partnership that makes a real difference to the patients’ journey.

How do you overcome challenges or setbacks while maintaining motivation?

Resource constraints are challenging with an ever-decreasing number of qualified, motivated, skilled practitioners working within clinical practice. It is essential to overcome these challenges by working within the multidisciplinary teams to collaborate, share best practices, and support one another including less experienced staff, to build confidence and ensure the delivery of timely high-quality care. Vascular patients can sometimes be challenging, not engaging with treatment and modifiable lifestyle changes. Effective communication, including listening to the patient and establishing their individual priorities and concerns is key to gain the patients trust and actively involve them in their care. Consumables are limited with budgetary constraints; therefore, we use dressings that not only address the wound healing environment but can multitask and aid wound bed preparation, debridement and exudate management in one, hence cost effective and ease of application in clinical practice.

You have been instrumental in the development of the wound balance framework. Why do you think this is important?

Wound balance is a much-needed concept to shift the clinician’s mindset away from ritualistic practice towards evidence-based care. A tool to guide clinical practice using a standardised, simplistic approach (with no jargon), addressing multiple parameters focusing on wound healing rather than wound management. It improves patient care and clinical decision making as it signposts generalist nurses to the right care at the right time, aids early intervention to prevent wound chronicity by adopting a holistic approach, placing the patient at the centre of all decision making.

Has your involvement in the wound balance framework changed or influenced your daily practice?

I have applied the framework in conjunction with the National Wound Care Strategy for lower limb wounds. This has helped with early assessment and active involvement with the patient from the beginning. As a result, we then adopted RespoSorb® Silicone Border and application of class 1 hosiery as first-line treatment in the absence of any red flags at initial assessment, whilst adopting a shared care strategy to prevent the wound becoming chronic.

How has it affected your approach to wound assessment and treatment planning?

I now consider the patients QOL and what is the most important priority for them with a greater focus on clinician and patient shared care planning, ownership and accountability rather than dictatorial from myself as the care provider; this in turn leads to better patient engagement and outcomes.

Can you tell us about how RespoSorb® Silicone Border has had a positive impact on your patients’ outcomes?

RespoSorb® Silicone Border helps with ease of application and atraumatic removal, with less pain and discomfort for the patient. This means it’s liked by both the clinician and patient. There is no need for an additional primary or secondary dressing, with a high absorption capacity that conforms well and fits nicely under compression therapy. It also helps address the wound bed environment – SAP protease modulation to reduce bioburden. The transparent silicone border allows observation and protection of the peri wound area, negating the need to remove the dressing unnecessarily. Exceptional fluid handling capacity prevents maceration, has a good range of sizes, whilst remaining cost-effective.