Optimising resources: an evidence-based pathway using UrgoStart for community-based patients with wounds

Providing a coordinated and strategic approach to the assessment, treatment and management of chronic wounds is central to the provision of effective nursing practice. Approximately 2.2 million patients are living with a chronic wound in the UK (Guest et al, 2015; 2017; 2018), and improving the assessment of chronic wounds is a national priority (NHS England, 2018a). From the patient perspective, there are demonstrable negative consequences of living with a wound, including the psychological and emotional impact associated with increased pain, reduced mobility and physical impairment owing to the wound itself (Fearns et al, 2017). Patient quality of life (QoL) is also impacted by the clinical complexities associated with delayed healing and extended hospital care (MacDonald, 2009).

Wound care in the UK is estimated to cost the NHS £5.3 billion per year (Guest et al, 2015). On the current trajectory, these costs are expected to rise significantly, due to an increase in the number of people living with a wound and an ageing population with comorbidities, which increase the possibility of developing complex wounds that are difficult to heal (Guest et al, 2017). Data obtained from a retrospective cohort analysis of 2000 patients from The Health Improvement Network (THIN) database found that, from approximately 11 200 wounds, 48% were defined as being chronic (Guest et al, 2015). The number of people living with a chronic wound has led to inconsistencies in care across healthcare services. Gray et al (2018) conducted a survey across eight services within five community trusts in England, using data obtained from a population of 3179 patients with a total of 5632 wounds. The results showed marked variances in wound care treatment strategies, highlighting inconsistencies in care and the heightened demands and challenges placed on health professionals dealing with wound care.