Chronic wounds place a significant strain on patients and the healthcare system. They account for around 1 in every 20 euro spent on public health in Ireland. Internationally, they are among the most common types of long term wounds. If not managed properly they can carry serious risks including:
- infection
- amputation
- decline in quality of life
Preventing these wounds and managing them early using evidence based approaches can:
- reduce avoidable harm
- improve healing outcomes
- lead to savings for the health service
About the Programme
The National Improvement Programme for Wound Management (NIPWM) was established in 2023. The programme was developed under the National Quality and Patient Safety (NQPS) team. It is co-sponsored by NQPS and the Office of the Nursing and Midwifery Services Director (ONMSD), who bring key nursing and midwifery leadership and expertise. This collaboration between NQPS and ONMSD is critical to the programme to ensure both patient safety and nursing practice excellence.
The aim of NIPWM is to enable services to optimise the quality of care and outcomes for people with, or at risk of, chronic wounds within the Irish healthcare service.
Gillian O’Brien is the Clinical Lead for the programme and is a Registered Advanced Nurse Practitioner Tissue Viability and Dermatology at Naas General Hospital.
Phase 1 of NIPWM was delivered over a two-year period from 2023 to 2025. Phase 2 is scheduled to take place from 2025 to 2027.
Access the NIPWM Phase 1 Project report (PDF, 26 Pages, 505 KB).
NIPWM Clinical Resources
In line with national guidelines, the NIPWM team developed a series of tools and resources to support staff. These tools support evidence based, safe high quality wound care.
- Pressure Ulcers Clinical Resource Pack (PDF, 43 Pages, 28 MB)
- Lower Limb Ulcers Clinical Resource Pack (PDF, 79 Pages, 4.7 MB)
The resources were co-designed with clinical experts, patient partners, and national professional bodies. They were successfully piloted across 18 services. Feedback showed that these Clinical Resource Packs are practical and easy to use. They help staff make better decisions and provide consistent care. They support timely, safe, and high quality wound treatment in line with the HSE Patient Safety Strategy 2019–2024.
The Pressure Ulcer Clinical Resource Pack has been reviewed and endorsed by the Tissue Viability Nurses Association of Ireland (TVNAI). The Lower Limb Ulcer Clinical Resource Pack has been endorsed by the TVNAI and the Irish Vascular Society.
Further clinical resources will be developed as part of NIPWM Phase 2 (2025 to 2027).
Information Leaflets for Patients and Carers
The programme team have developed a series of information leaflets. The leaflets were designed in partnership with staff, patients and carers. These leaflets include:
aSSKING Care Bundle
The aSSKINg care bundle is a tool to guide and document the prevention and management of pressure ulcers. It aims to reduce the risk of patient harm, which is often preventable. It is an evidence-based approach which is useful across a range of care settings. aSSKINg is an update to the original five-step SSKIN care bundle pressure ulcers. The NHS Improvement Pressure Ulcer Core Curriculum team recommended this update in 2018.
aSSKING stands for:
- Assess risk
- Skin assessment and skin care
- Surface selection and use
- Keep patients moving
- Incontinence and care
- Nutrition and hydration assessment or support
- Giving information
The 2 new elements are 'a' for assess risk and 'g' for giving information.
The NIPWM team is revising existing documents on the SSKIN bundle to the new aSSKINg bundle. As part of this, the team developed an infographic to explain the aSSKINg bundle.
aSSKINg care bundle infographic (PDF, 245KB, 1 page)
Patient Safety Supplement
The NIPWM Programme team contributed to the development of Patient Safety Supplement on Medical Device Related Pressure Ulcers (MDRPU), published in June 2024. The Patient Safety Supplement aims to support healthcare staff and patients/service users to identify the risk factors for developing MDRPU, and reiterate how everyone can be proactive in helping to prevent these often avoidable injuries.
Patient safety supplement (PDF, 970KB, 3 pages)
Contact
For more information on this programme, please contact our QPS Improvement team at QPS.Improvement@hse.ie