Reduced prevalence and severity of wounds following implementation of the Champions for Skin Integrity model to facilitate uptake of evidence-based practice in aged care

Aims: To evaluate the implementation of the Champions for Skin Integrity Model on facilitating uptake of evidence-based wound management and improving skin integrity in residents of aged care facilities Background The incidence of skin tears, pressure injuries and leg ulcers increases with age and such wounds can be a serious issue in aged care facilities. Older adults are not only at higher risk for wounds related to chronic disease, but also injuries related to falls and manual handling requirements. Design A longitudinal, pre-post design Methods The Champions for Skin Integrity model was developed utilizing evidence-based strategies for transfer of evidence into practice. Data were collected before, and six months after implementation of the model. Data on wound management and skin integrity were obtained from two random samples of residents (n=200 pre; n=201 post) from seven aged care facilities. A staff survey was also undertaken (n=126 pre; n=143 post) of experience, knowledge and evidence-based wound management. Descriptive statistics were calculated for all variables. Where relevant, Chi square for independence or t-tests were used to identify differences between the pre/post data. Results There was a significant decrease in the number of residents with a wound of any type (54% pre vs 43% post, χ2 4.2, p = 0.041), as well as a significant reduction in specific wound types, e.g. pressure injuries (24% pre vs 10% post, χ2 14.1, p <0.001), following implementation of the model. An increase in implementation of evidence-based wound management and prevention strategies was observed in the post-implementation sample in comparison to the pre-implementation sample. This included use of limb protectors and/or protective clothing 6% pre vs 20% post (χ2 17.0, p<0.001) and use of an emollient or soap alternative for bathing residents (50% pre vs 74% post, χ2 13.9, p=0.001). Conclusions Implementation of the model in this sample fostered an increase in implementation of evidence-based wound management and prevention strategies, which was associated with a decrease in the prevalence and severity of wounds. Relevance to clinical practice This study suggests the Champions for Skin Integrity model has the potential to improve uptake of evidence-based wound management and improve skin integrity for older adults.