RCNi Primary Health Care; Enabling supported self-management of wound care

Primary Health Care: Enabling Supported Self-Management of Wound Care in the  Community Setting to Increase Quality and Efficiency of Service Delivery 

Supporting citizens to be a more active partner in their care is part of a national, regional and local strategy for quality and sustainability of the NHS, acknowledging the impact that patients can have on their own health care if supported, educated and enabled to self-manage.  By focusing on improving patient adherence, clinical outcomes can improve at a faster rate.

Pennine Care Adult Community Nursing Services identified opportunities to promote self-management in the wound care pathway, utilising persona based text-messaging technology (Florence) to provide support and extend best practice self-management guidance to patients in between direct face-to-face contacts.

Florence offered previous evidence of supporting clinically driven behavioural change in patients to improve their clinical outcomes, the methodology of which could be realistically applied locally.

Evaluation mechanisms were put in place as follows:- 

  • Patient experience was captured through a paper questionnaire  
  • Staff experience was captured by paper questionnaire pre- and post-project 
  • Service utilisation data was captured through collation of individual patient data, collated into spreadsheet 
  • Patient outcomes were collated through case studies and analysis of planned and unplanned care.

Commencing in Summer 2015, the first patient experiences and outcomes were evaluated with 100% providing positive patient experience feeding back that they would recommend Florence.  

Service capacity was created by a 53% reduction in required nursing contacts for those patients supported via Florence, enabling the team to focus on more complex patients.

No unplanned visits were required, supporting safe practice.  Staff reported positively regarding the revised care pathway, appreciating the support that Flo offered with improvements to the patient experience.  Staff felt it released more time to care and improved their job satisfaction.  

In summary, supporting self-management has been shown to increase quality and efficiency of service delivery.  Using Florence technology has been popular and it is believed this has increased confidence from nurses to “let go”, and patients to be “let go”, when ongoing support was available through Flo.

This project has required shifts in staff and patient culture from two perspectives; firstly in adopting novel technology in practice; and secondly in recognising and using patients’ own skills and abilities to manage care previously delivered by nurses.

Adoption will now spread across further community nursing services within Pennine Care Foundation Trust incorporating lessons learned and opportunities identified to further enhance the care pathway.

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