The NHS spends almost as much on wound care every year (£5.3 billion) as on cancer treatment (£5.6 billion). However, poor patient adherence to current treatments, such as compression therapy, has led to 15 – 20 percent of long-term chronic wounds remaining unhealed after a year, with few improvements in patient outcomes over this time period. The economic cost to the hard-pressed health care systems is unsupportable in the long-term – and the human cost and pressure on families of those living with non-healing wounds are huge.
At the heart of this issue are dedicated wound community nurses, who play a crucial role in supporting chronic wound patients through the healing process. These nurses make routine visits, provide regular social contact (for those who are house bound), to clean and redress wounds. However, with a myriad of challenges facing wound community nurses, it is becoming increasingly difficult to meet high demands which can lead to reduced quality of care while all the time trying to deliver better patient outcomes.
Managing The Complexity of Wounds
According to a recent study, one in 50 people in the UK is living with a chronic wound, many with comorbidities and this number is set to rise. The complexity of wound management, which involves a combination of hospital visits, at-home care and patient self-management, requires regular input and consultation from healthcare professionals. The mental and physical burden of living with chronic wounds makes treatment all the more challenging. Patients often experience feelings of embarrassment due to the appearance of wounds, causing distress and, in some cases, leading to depression.
However, wounds – particularly chronic wounds – can take months to heal, while some fail to heal at all. Patients often require daily dressing changes to prevent bacterial infection and promote healing. For those confined to the home setting, immobilised due to comorbidities and suffering feelings of shame, community nurses become a lifeline for both wound management and social interaction.
A well-functioning community nursing team is critical to successful and effective healthcare delivery. However, according to a recent study, key financial cuts have led to deteriorating working conditions for wound community nurses, resulting in demoralisation and a huge exodus of staff. In an already under-resourced workforce, the capabilities of wound community nurses are becoming overstretched, meaning it is difficult to not only provide quality care to patients but also deliver this in good time.
With fewer nurses available, pressure has increased on wound community nurses to deliver the appropriate standard of care. This has resulted in longer working hours to facilitate this gap, resulting in a greater chance of burnout. Working more unpaid hours also means community nurses are more likely to leave their current roles – something the healthcare system is already experiencing where, year on year, the vacancy rates for NHS nurses have jumped by 21 percent. To remedy this growing crisis, healthcare systems are looking towards innovation to help reduce the burden faced by wound community nurses, while enhancing the wound care pathway and improving patient outcomes.
Call for MedTech Innovation
The current standard of care to treat venous leg ulcers is compression therapy, which involves cleaning and redressing a wound to promote healing and avoid infection. Compression is effective, particularly in less complex and smaller wounds, but is too often associated with low patient adherence as it is also labour-intensive and expensive. By leveraging medical technology (MedTech) innovation, healthcare systems are able to alleviate some of the pressures facing the increasingly overstretched community nurse teams.
Non-invasive, wearable MedTech is driving change in wound care. For instance, the geko device – a small watch-sized device worn at the knee – is clinically proven to accelerate the rate of healing, by more than double, in venous leg ulcer patients when used in combination with compression therapy. Through its mechanism of neuromuscular electrostimulation, the geko device increases venous arterial and microcirculatory blood flow in the lower limb, providing a seamless addition to the current VLU pathway, empowering patients to both self-care without disruption to daily routines. This also enables VLU patients to share-their-care with family members and healthcare professionals – shortening the healing and care period, thereby freeing nurses to deliver more timely and effective care.
A Path to Sustainable Wound Care
Wound care poses a significant challenge for community nurses and the overall healthcare system, both functionally and financially. This is made more challenging by the high demand on wound care delivery and an ageing population. Through the adoption of innovation into care pathways, enhancements to standard of care can improve patient outcomes and alleviate pressures on the workforce. However, to foster a culture of innovation in the NHS – and healthcare systems globally – MedTech innovations must deliver significant clinical and health economic benefits but equally be met with a system with the capacity to embrace innovation. In wound care, MedTech is already having a positive impact on patient healing. Healthcare systems should continue this momentum to support community nursing teams in the delivery of life-changing care.
By Bernard Ross, CEO at Sky Medical
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