A Comparative Report on Wound Care Management Policies and Procedures

This report provides a comprehensive analysis of wound care management, focusing on policies, procedures, and protocols. It begins with an introduction to wound care, defining wounds and classifying them based on severity. The report then outlines the aims of wound care management policies, including standardization, appropriate wound management, cost-effectiveness, and patient comfort. Two distinct policies are compared: one from Doncaster and Bassetlaw Hospitals and another from NHS Walsall Community Health. The comparison highlights differences in the level of detail, particularly in assessment procedures and the provision of specific guidelines. The assessment section is thoroughly examined, covering general factors, the causes of wounds, local conditions, and the effects of the wound on the patient, including nutritional status, blood circulation, smoking habits, drug therapy, immunity, age, obesity, and psychological status. The report also assesses the environment surrounding wound healing. The second policy (NHS Walsall) is deemed superior due to its detailed procedures, the size of the target group, and the availability of resources. The report concludes by emphasizing the importance of a holistic approach to wound care management and the differences in content and explanations provided by the two policies.

Running header: Wound care management 1
Policies, procedures, and protocols for wound care management.
Student’s name
Institutional Affiliation

Wound care management 2
Introduction
According to Thomas, (1990 pp. 300-310) a wound is a break or a defect on/in the skin as
a result of mechanical, physical or thermal damage. It might also develop as a result of an
underlying physiological or medical disorder. Collier, (2002 pp. 55-63) it is an abnormal break in
the (skin) intact and normal covering of the body. A wound is a break in the dermis or epidermis
as a result of pathological changes or trauma on the skin or body, (Collins, Hampton and white
2002). Wounds can be classified according to their severity: acute, chronic, palliative, healed
wounds. McCulloch, (2014) wound management involves assessing both the wound and the
patient. Then planning intervention using the assessment data obtained. The third thing is regular
evaluation of these interventions and lastly educating the patient and the care giver on the wound
management after being discharged. The policy main aims are to guide the health care providers
on having a standardized way/method/approach towards wound care which will be within the
holistic framework of care. Wound healing process is one aspect of the body’s response to
trauma/injury, for complete healing the whole person (holistic care) needs to be attended to not
just the wound, (Dealey (2005).It was also developed so as to be of assistance to the nursing staff
when managing the wounds so that they can be able to choose the appropriate dressings. The
market has over 2000 types of wound dressing materials.
Policies, procedures, and protocols
Their purpose.
All the policies formulated on wound care management have similarities. They all
have similar targets. 1) Provision of a standardized approach within the holistic care framework
in wound care. 2) To ensure there is the appropriate management of surgical, acute and chronic

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wounds. 3) To make sure that the most appropriate product for wound care is being utilized so as
to achieve patient's comfort, cost effectiveness, and the most importantly optimum wound
healing. 4) It’s a guideline for the nurses to ensure that there are no omissions while managing
the wounds that can cause lead to delayed healing or even complications (Australian Wound
Management Association, 2010). 5) To help in promoting and having a coordination in
systematic approaches towards wound management and ensuring that the patient’s quality of life
is maintained while making it known to them that it is not always possible to achieve a complete
healing. 5) The last common purpose of the policies and procedures towards wound management
is to ensure that the wound care complies with all the requirements as dictated by the Health Act
(2006a). It states that there should be a specific Code of professional Practice aimed at reducing
the infections related/associated with healthcare (NWS Ministry of Health, Infection Control,
2007)
Two different policies, procedures and protocols on Wound care management.
I identified two policies on wound dressing addressing different institutions. The first
one is addressing the Doncaster and Bassetlaw Hospitals. Written by Sue Johnson who is the
leading nurse in wound care and Tracy Vernon who is the lead nurse tissue viability. This policy
was approved on 2012 and was recently reviewed in 2015. The second policy is the wound
management procedures and policy in the community setting. The target group was NHS Walsall
Community Health and Allied Health Care Professionals. It was written by Elaine Westwood
and directed by the lead nurse Tissue viability. Was published in 2013. As mentioned earlier
policies on wound management have similar aims although they all differ. Examples of the

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differences between the two policies. The first policy: the one addressing Doncaster and
Bassetlaw hospital is less detailed in the procedures of the wound management; assessment,
intervention, evaluation and the re-evaluation (Carville, 2014) It seems like it is a summary of
the procedures and protocols, unlike the second policy which gives detailed information on
wound management. The second difference is that the first policy has given the directives of
what is to be done and by who. For example to expound on that, in case of wound infection the
clinician has been directed to take samples for culture and tissue viability tests.
Comparison of the two policies.
Assessment
There should be a comprehensive assessment of the needs and in this regard the health
needs of the patient in regards to wound care. Provide a continuity of care on the wound
management, it has to be a collaborative care where different nurses meet the needs of this
patient. Ensure standardized approaches are the only ones used when it comes to wound care
management. Have utilization of the most appropriate and optimum products in wound
management which provides patients comfort and are cost effective. For patients with non-
healing wounds, the priority in wound care management should be geared towards patient's
comfort, pain relief, get rid of malodor and prevent hemorrhage. All these policies aim at a
holistic patient and wound healing.
The differences between the two are the details on assessment. The second policy is
more detailed giving the protocols/procedures to be used in each step for example. ). Assessment
can be classified into four major areas, (Morison, 1992). General factors (patient assessment) that

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could cause a delay in the healing of the wound. The immediate cause of the wounds (the
pathophysiology behind it and also the environmental events that may have led to it). The local
conditions at the wound site that is the assessment of the wound. Lastly, the effects the wound
will be having on the patient that is an assessment of possible outcomes. With this assessment,
the health care provider is able to identify the healing capacity of the patient, come up with a
treatment plan, know and eliminate factors that delay healing of the wound. The patient
assessment is thorough, as they assess all the factors that can cause a delay in wound healing. For
example, the nutritional status is assessed as good nutrition provides the raw materials for
healing. Gray, D et al (2011); Medline, S (2012 pp. 12-26) states that minerals for example zinc
are required for wound healing. Blood circulation is also considered as good circulation in the
wounded area causes fast wound healing as there is a good supply of oxygen and nutrients to
wound. Smoking habits of the patient as the chemicals in the cigarettes destroy the cells
responsible for the wound healing (Krueger and Rohrick 2001). The drug therapy that the patient
is on is evaluated. The immunity. Age is evaluated as older people cell replication is lower than
cell death. Obesity is examined as in adipose tissues there is very poor vascularity (Mulder et al.,
1998; Melling et al., 2001). The psychological status is also evaluated as in stress situations a lot
of stress hormones are released causing a delay in wound healing. Anderson, (2014 pp. 84-91)
diabetes, low immunity, smoking, use of corticosteroids facilitates wound healing delays. The
second assessment is the environment or the events surrounding the wound healing. The second
policy sufficiently exploits this sector unlike the first one. Further mechanical injuries that can
cause more harm on the granulation of the cells for wound healing (Pulman 2004), presences of
tumors and poor hygiene. The third assessment is on the wound itself. Both policies explain how

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it should be assessed the first policy explains more. (Watret, 2005 pg. 18-26) it explains what to
look for when assessing the wound.
Wound cleansing, Wound infection, Wound dressing and selection of materials,
There are similarities and differences on the guideline of how to do the above. The two
agree that wound cleansing is to be done so as to remove contaminants with minimal pain to the
patient and also prevent trauma to the healing tissue. The second policy explains more on
cleansing. Expounds on debridement both the one that can be done at the bedside and also the
surgical one. Unlike the first policy, it expounds on the exudate management from the wound.
On wound infection, the second policy helps the health care provider in having a distinction
between wound infection and wound colonization. Wound infections are a common hospital
acquired infections (Bruce et al 2001 pg. 1-194). It explains on the dressings that are ideal for
use. The choices of dressings. It has more explanation on auditing and education to the health
care providers. The second policy is more comprehensive compared to the first one. It digs
deeper on wound care leaving nothing unexplained. It is more rigorous than the first policy.
Interpretations of the results above.
The second policy(NHS Walsall Community Health and Allied Health Care
professionals) is superior to the first policy(Doncaster and Bassetlaw Hospitals) as it is a
continuation of the first policy that was developed in 2004 later on amended on 2007 and now

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this is the polished policy. This policy was developed after the Walsall manor hospital merged
with Walsall Community Health. This increased the size of the firm and also the size of the
target group, unlike the first policy that serves only two hospitals (Doncaster and Bassetlaw
hospitals). With a huge pool of patients, it means a presentation of more complex conditions.
This could be the reasons as to why the policy is more expounded. It also covers all types of
wounds and their specific wound care as the patient conditions/ presentation are more and more
complex. It has a huge responsibility. The second reason as to why their policy is more superior
is because more resources are available to the Walsall health care organization. They run a
Walsall health fundraising committee which gathers funds to be used for patient care. The
second policy is more rigorous than the first policy.
Conclusion
Wound care management requires a holistic approach. Treating not only the wounded
part but also the whole body. Wounds are caused by several causes and without proper care, they
can cause more harm to the body. There are policies, protocols, and procedures that have been
formulated to aid the health care provider in wound care management. Doncaster and Bassetlaw
Hospital policy (the first policy) and NHS Walsall Community Health and Allied Health Care
professionals' policy which is the second policy. From the above, it is clear that both policies
strive to achieve the same goals the differences are on the content and the explanations on the
procedures, protocols, and policies. From the two policies, they address the same issues when it
comes to wound care management. The second policy is more superior and more vigorous than

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the first policy as it addresses more wound type and their care. It also expounds more on wound
care and management.

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