Digitising Wound Assessment, Management, Documentation within an Irish Public Health Nurse Setting- a Proof of Concept Evaluation.

Background
• The advanced nurse practitioners (clinical leads) identified variations in wound care assessment and documentation including inconsistent approach to wound care and assessment, no continuity of care, poor wound care knowledge, limited access to measuring equipment and subjective documentation of wound care through prevalence studies and research
• These findings were in contrast to the recommended wound assessment and documentation advocated in the Irish National Wound Care Guidelines (HSE, 2018).
• Both clinical leads were working in 2 large rural geographical areas in the eastern region of Ireland with limited access to tissue viability, vascular and dermatology services all of which were hospital based.
• A key challenge was the lack of a standardised objective wound assessment and documentation tool that could provide the transfer of patient assessment, management and progress across care settings such a solution would provide a a seamless and quality driven wound care service.
• The clinical leads recognised that the implementation of a digital technology solution could provide an effective, efficient and value driven approach to wound imaging, wound documentation and wound consultations.
Aim:
• Facilitate efficient, reliable digital wound imaging, wound measurement and digital monitoring of chronic and acute wound progress on one data platform to provide clinicians access to real time wound status data.
Objectives:
• Procure a digital solution that supports system-wide evidence based wound care.
• Evaluate the suitability for expanding the concept of digital wound assessment for wider adoption

Methods: 8 steps in the proof of concept
• Ideation
• Clinical Leadership and Governance
• Innovation funding
• Business Planning including market engagement
• Organisational preparedness, planning and preparation
• Training and support
• Implementation
• Evaluation

Outcome/Results of the initiative:
• Questionnaires were developed for data collection and they were administered via a digital survey platform providing anonymous and self-reported data from the participants.
• The pre-intervention questionnaire established a baseline of current practice in relation to wound assessment and documentation. It also provided us with staffs’ accessibility to and confidence with the current digital technology available in their work place.
• The post -evaluation questionnaire captured both qualitative and quantitative data which measured the usability and feasibility of the digital solution in clinical practice 67% of staff reported that the input of assessment information on the digital app was easy. Further benefits reported included 83% of users reporting that the digital application improved continuity of care, enhanced their communication with fellow clinicians and more notably patients, improved their documentation and had a positive impact on their clinical workflow