This document discusses building international collaborations for nursing research in skin and wound care. It begins by outlining Professor Carol Dealey's work developing tissue viability nursing in the UK, which led to increased research and guidelines. Over time, relationships were strengthened across European societies like EWMA and through projects like developing international pressure ulcer guidelines with NPUAP and EPUAP. Currently, Dealey's research program involves an NIHR Programme Grant with an international steering group and expert panel, representing progress on collaborations. She encourages pursuing collaborations through conferences, publications, and international society memberships to continue building bridges for nursing research globally.

1. Building International Bridges for
Nursing Research in Skin Care &
Wound Care
Professor Carol Dealey

2. Building bridges
• Is complex
• There needs to be a
good foundation on
each side
• Many different groups
may need to be
considered
• It takes time

3. Why should we bother?
• We are doing fine on
our own
• I do not know anyone
elsewhere
• It is a lot of effort
• I might not be
successful
• I don’t have time

4. All of those comments are true, but...
• The world is getting
smaller
• Communication is
getting easier
• Others are working
together to improve
health
• So should nurses

5. Back to building bridges

6. This is a big topic
• So I am going to set the scene by starting with
the development of Tissue Viability Nursing in the
UK and how this led to research initiatives
• I will move on to improving relationships across
Europe
• I will conclude with discussing my current
research programme

7. • Much of the work has been achieved through
working within societies such as SOBENDE and
they will be very much part of my description
• Some of this describes my own personal
journey

8. • Is the main wound care organisation in the UK
• One of the founding principles of TVS was the
importance of different professional
disciplines working together
• I think it is reasonable to state that TVS
influenced the development of TV services in
the UK.

9. 1980s 1990s 2000s 2010s
I joined TVS in 1986
Tissue
Viability Tissue Viability was not
mainstream clinical practice – but
I was very impressed that it was
multidisciplinary
There was a small amount of
Clinical research going on, but it was
Practice mostly small scale unfunded or
company funded
Small
research
projects

10. What did we learn from these events?
• Tissue Viability needed to be mainstream to
make progress
• Being a multidisciplinary society was a
strength
• We needed research evidence to support our
practice – but there was not a lot about

11. 1980s 1990s 2000s 2010s
By 1990, TV was seen
as relevant to clinical Government-funded
practice – appointment research
of TVNs (prevalence
surveys)
Systematic
Reviews
TVNs More
appointed TVNs
Clinical
Practice
1st TVNs
All Party RCN
Guidelines
TVS was starting Parliamentary
Group on Skin Policy developments
get political
TV Projects
DoH

12. All Party Parliamentary Group on Skin
• It was started by the British Eczema Society
• Other groups joined in
• Chaired by an MP, with other MPs
participating and held in Houses of Parliament
• Produced a document on the importance of
skin and wound care
• Disintegrated after a general election and MP
lost his seat

13. But there were good outcomes
• We learnt the importance of lobbying –
including talking to the relevant people who
selected topics for funded research
• We caught the attention of the Dept of Health
as questions were raised in Parliament about
the cost of treating pressure ulcers
• The Dept of Health funded several projects
which lead to more research and guideline
development

14. What did we learn in the ’90s?
• The value of the TVN role (I would say that
wouldn’t I?)
• Not to put to put too much hope in politicians
– they can lose their seats in elections
• Having the ear of people in the Dept of Health
can make things happen
• Raising awareness with research funding
bodies is important

15. What was happening in Europe at this time?

16. International Societies
• ETRS
• EWMA
• EPUAP

17. ETRS – Partnerships through Wound Repair &
Regeneration
• The official journal of
The Wound Healing
Society (USA), The
European Tissue Repair
Society, The Japanese
Society for Wound
Healing, and The
Australian Wound
Management
Association

18. EWMA – acts as an umbrella organisation for
national societies
• Co-operating
organisations – 46
societies across 35
countries in Europe
• Examples: TVS, Wound
Management
Association of Ireland,
Serbian Wound Healing
Society

19. All of which leads me on……

20. EPUAP – collaboration on a
project
• Development of
International
Pressure Ulcer
Guidelines with
NPUAP

21. Why did we start it?
• EPUAP guidelines were out of date
• NPUAP guidelines were out of date
• It seemed silly for both societies to
review the same evidence separately and
draw up roughly similar guidelines

22. What were our aims?
• Initially – high quality guidelines that would be
accepted by other colleagues in tissue viability
circles
• Then we just wanted them to be finished!
• Ultimately – we hoped that they would impact
on practice and change policy

23. The guidelines were finally launched in
October 2009

24. 1980s 1990s 2000s 2010s
The systematic reviews Large HTA NIHR
led to large funded funded studies Programme
Grants
research studies
International
Guidelines
Clinical
Practice
Policy recognises the
CQUINS
importance of pressure NICE & SIGN Patient
ulcers as a quality Guidelines Safety
indicator

25. Research Funding
• Money is needed to
fund large research
projects
• This means funding
agencies at national or
international level
• There is unlikely to be
commercial funding on
this scale

26. National Institute for Health Research (NIHR)

27. Research Programmes
Opportunities!

28. In Europe
• Must be international
research
• Can include countries
outside Europe
• Very topic specific – skin
and wound care not a
topic so far
• EWMA has been
lobbying for it to be
included

29. Research and Clinical Practice
• Although NIHR funding is hard to get – TV
research is recognised as being of value and
we are building up evidence
• There is yet to be a breakthrough into EU
funding – international research

30. Where does this leave us today?

31. Possibly with a half built bridge!

32. But it is important to persevere

33. Looking at the positives
• In the UK we have built up good relationships
with others in Europe and beyond
• This not only includes other nurses, but
doctors and scientists
• There was and is money for research in the UK
and chronic wounds were being accepted as a
relevant topic for research

34. Next step – identify source of serious
money for pressure ulcer research

35. Programme Grants for Applied
Research
• Run for 5 years
• Are worth up to £2million (approx 6.5 million
reals)
• Should comprise a programme of several
interrelated research studies
• Could be on any topic

36. NIHR PURPOSE Programme

37. How is this a bridge to
International Nursing Research?

38. Well, I would describe it as more of
a small foot bridge!

39. PURPOSE Research
Programme
Has a steering group with
international members
Study 3 included an
international expert panel
to review literature and
determine a minimum
data set for pressure ulcer
reporting and the items for
a risk assessment tool.
There will also be a wide
international peer review
of the process

40. How has this been achieved?
• Some of us met through the Tissue Viability
Society
• We maintained and developed the
relationship through membership of European
societies and widened it to include others
• We also met the Americans though working
on the international guidelines

41. Other things that matter
• All the senior members of the research team
– Had previously undertaken research
– They had published their work and spoken at
international conferences
– So we have a track record which means others
also have respect for us and are interested in
joining us

42. But....
• We are not there yet
• International research
funding is dominated by
scientific and medical
topics – which is not
wrong, but we need an
interest in wound care

43. So maybe I only have the right to
talk about starting to build a bridge

44. Where did I start?
• I started locally and got drawn into things at
national level
• I joined societies and stood for committees as
it meant I could go to conferences for free!
• I worked hard and became passionate about
wounds and research
• I wrote papers and books and presented my
research

45. Carol’s 10 Point Plan
1. Well you have already
started through
societies like SOBENDE
2. Collaborations
between universities
and hospitals for
simple research
studies (simple does
not mean poor quality,
but not costly)

46. There’s more
3. Publish papers
4. Use the findings to
lobby politicians
5. Find out about available
research monies from
government or
elsewhere – and apply
for it!
6. Collaborations are good

47. Venture outside Brazil
7. I know some of you
have attended
international
conferences – now
think of a poster or
presentation, maybe at
a Portuguese or
Spanish-speaking
conference to start with

48. 8. How about publishing in
an English-speaking
journal?
9. Is there an international
society you could join?
10. Once a member,
consider joining a
committee

49. One thing is for certain...
• You will find many
others in other
countries with a passion
for wound care
• Maybe if we all work
together we can build a
nice shiny bridge!