Improving patient outcomes by coaching primary health general practitioners and practice nurses in evidence based wound management at on-site wound clinics

Background: Wound management is frequently performed in the community and forms a large part of daily activities of General Practice health professionals. However, previous research has acknowledged a need for further education and training on evidence based wound management for these health professionals. Aim: The aim of this project was to develop and trial a Cooperative Wound Clinic model of care in General Practices, using a nurse led, interdisciplinary, holistic approach; including training and coaching to increase the wound management expertise and capacity of health professionals working in the primary healthcare environment. Methods: A longitudinal, pre-post design was used. Four Cooperative Wound Clinic pilot sites and nine wound clinics were established in General Practices across three Australian states with the intervention of the study being the model of care and incorporating a local wound expert employed to provide the training and coaching. Pre and post survey data were collected on wound management practices, health professional confidence in evidence based wound management, patient health, wellbeing and healing outcomes. Longitudinal patient data were collected for 24 weeks. Findings: Results included an increase in the confidence of health professionals to manage wounds. Utilisation of a repetitive coaching model over a six month period empowered the decision making process and assessment knowledge for a variety of wound types. A positive impact on patient outcomes for a variety of wound types was also observed. Conclusion: The potential for expanding this model will bring many benefits including: empowerment of nurses' confidence in managing wounds, promoting the role of nurse led clinics; improved wound related capability and confidence of health professionals; improved wound management, patient knowledge and better patient satisfaction and outcomes. (C) 2018 Australian College of Nursing Ltd. Published by Elsevier Ltd.