Reducing variance in wound care: a cross-sectional study of chronic wounds in one district nursing team's caseload

Background: Pressure ulcers, leg ulcers and slow-healing surgical wounds are the most prevalent chronic wounds. Variance in care of such wounds has frequently been documented in the literature. This study investigated the local landscapes for such variance. Aim: This article discusses the findings of a cross-sectional study of variance in care of chronic wounds, undertaken with one district nursing team's caseload in a large city in the North East of the UK. Methods: The workload of one district nursing team (n=6 staff) was examined over a 2-week period using electronic records. Where variance was identified, patients were visited at their home by a tissue viability nurse for further investigation. Results: Thirty-four patients with chronic wounds were reviewed. While pressure ulcers and slow-healing postoperative wounds were treated according to standard guidance, there was significant variation in the care of leg ulceration in all patients. Conclusions: This study supports the view that there is variance in wound care, and reducing this variance and optimising wound care should be prioritised. This could be achieved by increasing input from tissue viability services. Implications for practice: Implementing standardised protocols based on best practice guidelines could improve consistency and outcomes in wound care. The increased involvement of tissue viability nurses in wound assessments and care planning could help reduce variance in care.