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WOUND CARE

nurse. Therefore, a question posed to expert consultants was, “How can consistency in wound

assessment and dressing management be facilitated?” A Radiation Oncologist responded,

“Team discussion and have discussion based on sound physics and radiation principles”

(personal communication, August 25, 2013).

Other factors such as resource management (e.g., dressing availability and cost) also

influence wound care practices during radiotherapy. Common barriers to change, such as the

use of new wound care products encompass organizational, structural and systemic limitations

that may include accountability gaps in the mode of resource allocation (Pearson, Field, &

Jordan, 2007, p. 121). Expert A. Hughes explained,

When an area of clinical care is under researched, we rely on foundational information
such as the principles of moist healing and this is open (and vulnerable) to a very broad
interpretation. Organizational practices should be clearly articulated and grounded in
available evidence or theory. Education (as always) is key and employees should be
adequately supported to practice in a manner conducive to good patient care (having
knowledge of available products and their use and a clear understanding of practice
expectations are examples). Opportunities for education and discussions with nurse
leaders when observed practice does not conform to best or evidence based practice are
essential. (personal communication, August 29, 2013)

Expert M. McQuestion also reiterated similar recommendations in this regard:

Consistency can be improved by ensuring that education is provided, monitoring and
supporting nurses’ practice during a change process. Developing criteria for the type
and frequency of assessment and building it into electronic (or paper) documentation
systems improves adherence to a standard. (personal communication, August 30, 2013)

In summary, there is inconsistency in practice in relation to radiating through dressings across

Canada with no standard policy regarding when to remove or radiate through dressings.

Developing specific guidelines will assist in delivering standardized practices. It is applicable to

have educational events, workshops or in-services related to new wound care products based on

clear guidelines. Communication between the inter-professional team is also crucial for

members to be on the same page with the implementation of knowledge into practice. Often,