Parker C, Edwards H, Finlayson K, Chang A, Gibb, M.Queensland University of Technology (QUT), Brisbane, Australia

1. Creating Champions for Skin Integrity:
Facilitating evidence based wound care in residential aged care
Parker C, Edwards H, Finlayson K, Chang A, Gibb, M.
Queensland University of Technology (QUT), Brisbane, Australia
Email: christina.parker@qut.edu.au

2. Background
 Wounds such as skin tears, pressure injuries and leg ulcers increase
in incidence with age and are a significant issue in residential aged
care facilities (RACFs)
 Pressure injury prevalence reported at ~20% in RACF samples1,2
 Skin tears account for up to 41% of wounds of residents 3
 Leg ulcers affect 1–3% of adults over 60 years, increasing to 5-10%
of those over 80 years4
1.Bours et al. Research in Nursing and Health 2002. 25: 99-110.
2.Young et al. J Wound, Ostomy & Continence Nurs 2002. 29: 234-241.
3.Everett et al. Primary Intention 1994. 2:11.
4.Briggs et al. EWMA Journal 2003. 3:14-20.

3. Background
Evidence-based practice gap
Despite the evidence available, a significant
evidence–practice gap exists in:
 appropriate assessment of wounds, and
 timely use of evidence based treatments 5-8
WHY?
 lack of information and skills5
 poor communication5,6
 limited access to evidence5
5. Coyer F et al. NICS Report: Phase I Evidence Uptake Network. 2005, QUT: Brisbane.
6. Graham ID et al. Adv Skin Wound Care 2003. 16:305-16
7. Kruger AJ et al. ANZ J Surg. 2003. Australia.
8. McMullin G. MJA. 2001. 175:375
9. White W. Primary Intention 2001. 9:138-49

4. Creating Champions for Skin Integrity
Aims
 To facilitate sustainable evidence-based wound care in residential
aged care facilities
 To preserve skin integrity through evidence-based management
and prevention of wounds
Objectives
 To develop, implement and evaluate the
of evidence-based wound care
 To assess staff, residents & carers’ attitudes, knowledge and
practices re wound care pre & post implementation
 To identify the prevalence of wounds pre & post implementation

5. Methods
Participants
 A consortium of 7 aged care facilities and School of Nursing, QUT
 Facilities ranged from 20–495 residents in size, including city,
regional, rural and remote locations
Data Collection
Clinical audit with random sample of 401 (200 pre, 201 post) residents
Surveys, interviews and focus groups with staff, residents and family
Procedure
 Champions for Skin Integrity model developed
 Six month implementation phase sequentially in each facility
 Model included education, skills development, multi-level Champion
teams, link clinicians, audit & feedback

6.  Interactive self-education DVD
 Dressing guide & tips
Evidence Based Guidelines Summaries – 7 topics
Brochures
2 sets on each topic – one set aimed at residents,
the other for health professionals
 Tip Sheets - A4, can be laminated
 Flow Charts - A3, laminated
Education Materials

7. Results – Staff surveys & chart audit
Pre-implementation survey, N = 126 (40% response rate)
Post-implementation survey, N = 143 (53% response rate)
Significant improvements were found in:
 Staff using emollient soap substitutes
 Increased use of preventive strategies
 Increased use of wound assessment tools and documentation
 Decreased barriers to implementing evidence based wound care

8. Results – Skin Integrity Survey
Random sample of residents - head-to-toe skin check & chart audit
* p < 0.05
**

9. Conclusions
 Pre-implementation data highlighted the significant need for evidence
based wound care in RACFs
 Improved skin integrity for residents and increased implementation of
evidence based wound care was achieved
 These facilities have acted as resources for other facilities
 The resource materials will now be disseminated around Australia
This Project is funded by the Australian Government Department of
Health and Ageing under the Encouraging Better Practice
in Aged Care Program.
Institute of Health and Biomedical Innovation
Queensland University of Technology
60 Musk Ave, Kelvin Grove Qld 4059 Australia
Phone +61 7 3138 6000 Fax +61 7 3138 6030
Email: ihbi@qut.edu.au www.ihbi.qut.com