The non-profit organization Wondzorg proposed a project to the Belgian Burns Foundation to improve burn aftercare. The project aims to: 1) Educate home care nurses specifically in burn care; 2) Create a network of burn care nurses accessible to hospitals, burn centers, and primary care; 3) Provide first aid and wound care information to emergency services and physicians. The project will run for two years with financial support from the Belgian Burns Foundation and involvement from burn centers, colleges, and wound care organizations. Initial results include training over 100 nurses in burn care and developing an online resource for first responders.

1. Creating an organization for burn injuries after care
Aim:
The non profit association wondzorg , an association of Wound care specialists,
proposed a project to improve burn after care to the Belgian Burns foundation( BBF).
A study (1) done by the Belgian Healthcare knowledge center KCE showed the existing
problems for burned patients in Belgium. The organization Wondzorg will effect some
of the recommendations proposed in the study of the KCE.
The main objectives to be carried out:
1.Education of home care nurses specifically for the care of burn patients after
discharge from the hospital or after being burned in home care.
2.The creation of a network of burn care nurses that can be easily accessed by the
primary care, hospitals and burn centers.
3.Providing useful information to the emergency services and physicians about first
aid and wound care for burns.
4.The follow up of patients with burns and collect their data for better prevention and
care.
Methods:
First the study of the KCE was analyzed and the items that’s belongs to the home care
and nurses were selected. These recommendations were translated into concrete
objectives. We kept only the targets that were viable for our organization and were
easily implementable in home care. After approval of the Belgian burns foundation,
we set a schedule and we laid the first contacts with the various actors.
The project will run over two years and enjoys financial support from the BBF.
There is no support from the government, they have their own time schedule and
focus first on the establishment of a college of physicians. Other actors such as some
burn centers, PXL college and wound care association WCS lent their support to the
project.
1 Christiaens W, Van De Walle E, Devresse S, Van Halewyck D, Dubois C, Benahmed N, Desomer A, Van de
Sande S, Van Loey N, Paulus D, Van den Heede K. Organisation of aftercare for patients with severe burn
injuries. Health Services Research (HSR) Brussels: Belgian Health Care Knowledge Centre (KCE). 2013. KCE Reports 209.
D/2013/10.273/72.
1

2. Creating an organization for burn injuries after care
Results
The project started in January 2014 and has already reached the following results:
1. The first training on burns is furnished and knew at once full occupancy. The
training is designed to describe a burn patient, from the moment of burning to
complete healing and scar treatment. ,the entire process
The lessons are given by health care providers specialized in burns, which are usually
also working in a burn center. Participants come from all parts of the country, and
usually already have had a training course on wound management. The most of them
work in home care and have already a few years of experience. The course consists of
48 hours of training and allow that all disciplines are covered, such as nurses,
physiotherapists, psychologists, social workers and doctors from the burn centers.
There is also attention to bandagers, patients and patients associations.
2. In the preparation of the project it quickly became clear that there was a need for
continuity of care. The burn centers could make no claim to quality specialized care
for burn patients. The recommendations of the study of the KCE proposed to establish
a network of paramedics in primary care. This network can be established only if
there is enough paramedics who are trained to do this. There is already a network of
physiotherapists, which are specifically formed in scar therapy. Our goal is to train at
least 100 nurses in the next 2 years .From 2015, the program will also be arranged in
French. With our organization we will also seek in the future for recognition for this
training by the government and to strive for a better reimbursement of burn care by
these nurses.
3. The emergency services and general practitioners are the first to see the burned
patients. They usually have a limited knowledge of wound care and contacts in doubt
usually the burn centers. As there is little patients who are severed burned by region,
the knowledge about the stabilization of severe burned patients is weak . For this
reason we want to give some support by creating a website with some useful help
topics for the stabilization and the wound care for burns. We want to develop a
referral document, which can be filled with data from the patient before taking
contact with a burn center . 2

3. Creating an organization for burn injuries after care
Results
So the communication can go smoothly and the need for a transfer to a burn center
can be made ​​clear. With the right information burns specialist can make the correct
judgment and make clear to the referrer which mode of transport and hemodynamic
support they can start. For this pilot project we will work together with some
emergency departments and burn centers.
For the general practitioners there is a need to inform them about basic burn care
and to explain them the possibilities for burn care by the reference nurses in the burn
care network.
4. An important task in a good continuity for burn care lies with the function of the
care coordinator in burn centers. This person, who prepares and monitors each
patient in the burn centers, may well be in contact with the nurses from the burns
network. For patients who have never been in the burns and were treated by their GP
or in a hospital, there is also a need for supervision once they are send back to home.
Here the wound care specialist in home care plays an important role. He can
supervise the home care nurses /GP’s and give them the right information to do a
good burn wound care. In the study of the KCE was seen that patients who were not
admitted in a burn center in the most of the severe cases didn’t receive a good burn
after care.
If we want to improve the prevention and the cost effective wound care we need to
collect data from all the burned patients in the burn network. We have to try to
develop a database and wound care file to collect this data. So we can improve the
burn care and could we show the benefits of a good burn care by using the system as
proposed above.
3
Burn
after
care
Home care
nurses / FT
GP and ER
Burn centers
WOC nurses
coordinators
Belgian Burn
foundation
Others

4. Creating an organization for burn injuries after care
Discussion
Is there a need for specialised caregivers or do we need to improve basic education?
The government needs to support or create projects like our organization is doing for
the moment , to change easily some practical things in daily care. For this they need
an consensus with all the key role players, as the burn centers/ home care/GP’s and
more. For the part of aftercare concerning pressure clothing and physical therapy
there is already a good system going on. Wound care is for the moment very cheap,
10 to 15 € for each care, and there is no space to raise this amount for the next
coming years. There is also a lot of differences between caregivers in the burn centers
and the home care. A standard approach is necessary, but will cost a lot of time and
investment, to come to a satisfying result.
Conclusion
Our initiative can quickly effect change, but will not achieve the desired result if we
can’t get the full support of the government and burn centers. Given the small
number of patients, it is even harder to get enough expertise in this area, so
supervising by a wound care specialist or burn care coordinator is needed. Also a good
publicity of the project is useful, otherwise all the caregivers didn’t know about the
possibilities for a good burn care. For the government a good burn care as proposed
could give a lot of financial benefits. One day hospitalization in a Belgian burn center
cost approximately 1850€ a day. So it is useful to admit only the necessary patients
and to send the others to a good burn after care. A good burn after care at home cost
approximately 60€ a day, a great difference for the government, but also for the
quality of life of the patient. This project was funded by the Belgian Burn foundation
and the non profit organization Wondzorg
Author information
Balliu Kristof
Wound Care specialist npo Wondzorg and Brussels Burn Center Queen Astrid
Bree- Brussels, Belgium
Email: info@wondz.org
Website : www.wondz.org
4
Electronic
Poster n° 429