Wound management in Primary Care

Join us twice a month for our insightful podcasts with leading expert guests, who will look at the latest 'hot topics' in wound care to update and inspire you.

This podcast will discuss the current challenges of wound care in the Primary health care setting, the role of the Practice Nurse and where to find resources to support.

www.smith-nephew.com/education The website may contain information and discussion (including the promotion of) methods, procedures or products that may not be available in certain countries or regions, or may be available under various other trade or service marks, names or brands.

Transcript
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SPEAKER:
Welcome to Smith & Nephew's CLOSER TO ZERO podcast by monthly podcast  with leading experts in wound care, hosted by Smith & Nephew, helping  healthcare professionals in reducing the human and economic cost of wounds.

00:00:01

RUTH TIMMINS:
Welcome to our podcast today. I'm Ruth Timmins from Smith & Nephew. And  it's our pleasure to welcome our special guest Suzanne Blackeby, who is a  Nurse Educator from the Australian Primary Health Care Nurses Association,  otherwise known as APNA. And today, we're discussing wound management in  primary care. And so, welcome, Suzanne, and thanks for joining us today.

00:00:15

SUZANNE BLACKEBY:
Thanks for having me, Ruth. This is pretty exciting stuff. We're really  pumped APNA to be doing some more work in an area that's everyday business  for nurses in primary care.

00:00:37

RUTH TIMMINS:
Yeah, that's right. And so, we know the primary care is often the first point  of call for patients with a wound, isn't it? And what are some of the  challenges that practice nurses and other healthcare professionals are  managing in wound care in that primary healthcare setting?

00:00:49

SUZANNE BLACKEBY:
I think there's probably three areas that are most challenging. The first  would be the wide variety of wounds. You see, in those first presentations,  as you mentioned in primary care. So, we get everything from the acute wound  walking through the door that's had no first aid applied and skin tears from  falls or accidents, injuries, those kinds of things. And it extends right  through to surgical wounds and post-operative wound care once people have  been discharged from hospitals or specialist services. And then we get those  chronic wounds, you know, really tricky ones that we see a lot of people in  primary care with chronic disease and that's their background. And then when  you add a wound into that, it becomes more complex to deal with.

So yeah, the first challenge  would definitely be that huge variety that you see in primary care of  presentations of wounds. So, that means you have to have a really global  approach to what you're doing and have a broad knowledge of what you're doing  with wounds. The second issue in primary care, particularly in the general  practice space is wound dressing costs and all those bits and pieces that we  need to look after people well with wounds. Their dressings can be expensive  and there isn't a clear pathway with the MBS that supports general practice  to recoup that. So, it's always a challenge for nurses in the treatment room  to manage the economic costs of the treatments they want to use when dealing  with wounds. And I think the third area that's a real challenge for nurses in  the primary care space is the referral process.

What happens with those  wounds that are become more complex over time, or have added negative impacts  over time, or are difficult to heal, or where infection is an issue? Because  primary care is such a big area, where nurses who work in general practice  and corrections and community and schools, there's not one clear referral  pathway to escalate wound care. And that can be really tricky for nurses to  navigate. So, that's some of the challenges that I see for primary care  nurses at the moment.

00:01:06

RUTH TIMMINS:
Yeah. That it is a lot of challenges, isn't it? And how do you see wound care  being managed in the future in primary care?

00:03:32

SUZANNE BLACKEBY:
Yeah. Great question. I think wound care will continue to be led by nurses.  Nurses have that really great assessment ability. They have an ability to  look at the whole patient who has a wound, not just a wound. And so, I think  that the leaders in this area will continue to be nurses. I think funding, as  I mentioned earlier, is definitely going to be an ongoing challenge. And the  funding model that we have, particularly for general practice at the moment,  is inadequate for wound care. And organisations like ours, like APNA and  other nursing organisations and specialist wound organisations as well will  continue to push for that to be re-evaluated in a different, better, or  changed funding model come into play.

So, we can do exactly what  Smith & Nephew and other companies teach us. And that's to apply best  practice principles. And it can be tricky with that funding model. So, I  think we need to continue to look at that, review that, put up alternatives.  Keep having conversations with nurses on the ground about how we best can  achieve an adequate funding model, whether that ends up being funding  attached to the patients that's portable, whether that ends up a different  way of funding the work that nurses do in general practice, whether it means  a shake-up of the existing MBS, I'm not sure. But there's lots of key leaders  in the field continuing to look at that. And I think we need to not drop the  ball. I think we just need to keep pushing for change to make that stuff  happen well.

00:03:41

RUTH TIMMINS:
And you mentioned obviously your organisation, perhaps you could tell us a  little bit more about APNA and its role in supporting nurses in primary care.

00:05:32

SUZANNE BLACKEBY:
Sure. So, APNA is 20-years-old this year, Ruth. So, we're pretty excited.  We've got a birthday to celebrate. Yeah, we've been around for a while.  Originally, started by nurse founder, Sam Moses, as a practice nurse  association back in day. And over the years as the primary care space has  broadened and the work that nurses do in that space has broadened, we now  encompass all areas of primary care. So essentially, if you're a nurse in  Australia and you don't work in a hospital, you're part of our patch.

So, we look after nurses  right across the country, rural and remote nurses, the general practice  nurses, community health, school nurses, aged care. It's an exciting space to  being our occupational nurses as well. Let's not forget them. We have, we  think around 82,000 nurses working in the primary care space across the  country at the moment, according to the Australian health and welfare data.  And within APNA, we do a range of activities, I guess, to support nurses.

So, we are a membership  organisation, nurses can join, student nurses can join, organisations and  corporations can join up in if they want to. And we try to provide, I guess,  a two-pronged approach to supporting nurses. So, we have our great nurse  support line. So, that's a phone number and an email that you can contact an  experienced primary care nurse to get advice around all sorts of things from  clinical issues to workplace issues. And we also do lots of stuff like this  podcasts, and education, and online learning, webinars.

We have our Roadshow  Conference coming up at the back end of the year, which Smith & Nephew  are a really big part of. And we're excited about that. We also look at what  we can do for primary care nurses from the top end as well. Advocacy is  really important for APNA. So, we have primary care nurses through our nurse  advisory panel who sit and represent nurses on advisory committees, interest  groups.

We have a lot of our  leadership, our board, our CEO, and our President who's Karen Booth, who  represent nurses in government. And we need nurses to have that chair at the  table when government is talking about health policy and how it affects the  delivery of patient care on the ground. And we need nurses to be a part of  that conversation. So, we're advocating for nurses at the top end. We're also  coming in and supporting nurses one-on-one. We're also providing education.  And the other thing I think is communication. That's become really important,  especially during the pandemic, government trusted us to get fast messaging  out to nurses when they needed it around all the different things that  happened at the front end of the pandemic around PPE and precautions, and how  to manage patients in clinical settings, and then later with the COVID  vaccine rollout.

So, APNA has been a big part  of those things as well. We do a lot of projects. And, I guess, one that's  really exciting to me is the transition to practice project, supporting  nurses coming from undergraduate studies into primary care or nurses coming  from the tertiary space into primary care. And that's an excellent mentoring  program that we've had lots of nurses be a part of. And it's really highly  valued. Our chronic disease management, healthy ageing program that runs over  12 months, that's awesome as well. And that's partly funded by government.

So, we have lots of these  other projects that we do with state health departments, the federal  department of health, and also with PHNs. We have some great relationships  with PHNs right across the country. So, at APNA, we're really busy.
(LAUGHS)

00:05:41

RUTH TIMMINS:
Yeah. It sounds like you're really busy. And there's a lot of support out  there for nurses in primary care. And you mentioned a little bit there about  some of the education and the roadshows that you're facilitating this year.  And that's really exciting 'cause they're face-to-face events, aren't they?  So, perhaps you can tell us a little bit more about the program of that  roadshow.

00:09:46

SUZANNE BLACKEBY:
Yeah. Roadshows are going to be amazing. And we want to invite all of you.  Come along, it's going to be terrific. So, most people that know about APNA  would be aware that we usually have one big annual conference every year.  It's the largest scientific conference for nurses across the country. Last  year, like many organised events that had to be cancelled due to the pandemic  and the restrictions that were in place at the time.

So, this year by way of risk  management, instead of having nurses cross borders and come to one central  place for a big conference, we're going to take APNA team on the road and  we're going to cross the borders and wear that risk, so nurses don't have to.  So, through September and November, we're going to nine destinations around  the country. And we're going to bring a two-day program of learning and  plenaries and workshops. And I did mention, it's our 20th birthday. So, we're  going to have a birthday party at every event, which is great. You know, you  can't get too many cupcakes.

00:10:09

RUTH TIMMINS:
No, never.

00:11:10

SUZANNE BLACKEBY:
That's just not a thing. Yeah.

00:11:11

RUTH TIMMINS:
That sounds really exciting program and very busy. And I know we're very  excited to be involved with supporting these roadshows and facilitating the  wound education session on the second day. So, why did you feel that this was  important to include in the program, 'cause obviously, especially in general  practice and primary care, there's so many areas that nurses are involved  with? So, why did you feel it was important to include wound education?

00:11:14

SUZANNE BLACKEBY:
Wound care is everyday business for primary care nurses. There isn't a  primary care nurse that wouldn't see a wound or a patient with a wound in a  week, I'm sure, no matter what setting they work in. So, it's always been an  area of interest for nurses. I think it's important to recognise that the  technology in wound care is always changing and being updated. And we have  some really great organisations in Australia who work on the standards, the  clinical standards for wound care, to keep them current and best practice.  And so, nurses on the ground need to know that stuff. We need to learn about  it. We need to keep our, I guess, currency of what we're doing.

So, it was a bit of a no-brainer  to include wounds in the program. But just to reassure everybody, we actually  took the program options out in focus groups at the back end of last year.  And we actually asked nurses what they wanted. And wound care came up really  high across all the different focus groups that we did. So yet, we're always  going to have something in there around wounds. What it has turned out to be  is, I guess, a little bit beyond what I was hoping for.

So, it's really exciting to  actually have the afternoon devoted to wound care on day two of the program,  and to have the elements of theory around clinical standards and updating our  practice and giving us, I guess, the academics behind what we're doing when  we're looking after patients with wounds is important. And we've got that in  there. But the interactive workshops gonna be awesome. And that's exciting,  nurses like to see and do and feel and touch and test stuff out. And the  interactive workshops are gonna let that happen. So, yeah, we're excited to  have Smith & Nephew on board who are gonna bring all their fancy gear for  us all to have a play with and try out. And yeah, it's gonna be exciting. I  think nurses are going to be really happy with it.

00:11:44

RUTH TIMMINS:
Yeah, we really look forward to it.

00:13:50

SUZANNE BLACKEBY:
The other part is now that we're talking about this pre-learning that nurses  can do through the Smith & Nephew's CLOSER TO ZERO platform. So  personally, I mean, I came across CLOSER TO ZERO some years ago when a rep  led wound session that I do with my local PHN. And it was the first one. The  first time I saw it, I went, "Oh, my goodness, look at all this  stuff." This is sort of the go-to, there was lots of learning and  different formats and ways to interact with the platform and get a little bit  more concrete under my clinical practice.

So, that was my first  experience with CLOSER TO ZERO. And then when we started working with Smith  & Nephew on the Roadshow program and how we were going to work the  fundamentals of wound care into also those tertiary kinds of high-level  devices and things that we can use now in wound care that are portable and  single-use and all of that stuff, it became clear that we actually could just  do two days on wounds.

(LAUGHS)

And we just couldn't do it.  So, we had to find other ways. So, having the access to the speed learning  modules, I think it's filling that gap. So, for nurses new to primary care,  or for nurses that haven't done any formal learning in wound care for a  while, the speed learning I think is going to be great.

00:13:52

RUTH TIMMINS:
Yeah. So, as you say, we've made that available as pre-learning, hopefully,  just to support and the fundamentals, I guess. So, when people do come to the  workshops, yeah, there can be lots of discussion and hands-on sort of  practice. Yeah. So, what's the best way to find out more than to register for  the roadshow Suzanne?

00:15:26

SUZANNE BLACKEBY:
Yep. So, APNA has a landing page. You can Google 'APNA Roadshow' and you will  get there. And you can register there for the roadshow events. And it gives  you all the dates and venues across all the different cities that we're going  to. We'll also include a link for that in the resources and the transcript of  this episode of the podcast to make it easy for people to get to us. https://www.apna.asn.au/education/roadshow

And just for the speed learning modules as  well, if you're a subscriber to APNA's The Connect Newsletter, even if you're  not a member, you can subscribe to the newsletter for free, just go to our  home page and click on subscribe for free. And that newsletter goes out to  nurses every Monday, drops into your inbox Monday evenings.

And over the next 12 weeks  or so, you will see a link in that newsletter for the speed learning modules.  So essentially, what we're presenting here is 12 different modules on 12  different topics around the fundamentals of wound care that are really quick  and easy to do. I think we all recognise that now more than ever nurses in  primary care are time-poor. So, if they're going to have opportunities to  learn, they need to get what they know in, down, locked away nice and tight.

So, the speed learning  modules, you know, five to 15 minutes is totally doable. If you know, not all  of us have the time to do a post-grad in wound care over a couple of years  right now. So, this is a great option. And I really like the topics as well.  There's some basic skin anatomy stuff, but there's also some stuff around  what to do with those hard-to-heal wounds and what to do with wound beds that  are problematic. And it covers off on the whole gamut. So, I'm really excited  about the speed learning. So, each module will come up in the Connect  Newsletter, get subscribed to that, and it'll drop into your inbox every  Monday.

00:15:51

RUTH TIMMINS:
Great. So hopefully, we'll see lots of people attending the roadshows. And  Smith & Nephew, we're looking forward to meeting people face-to-face as  well. So, thanks so much for joining us today, Suzanne. And we look forward to  being part of the roadshows as I said, and hearing more from the nurses in  primary care and what their challenges are, and so on. But thanks again. And  we look forward to seeing you soon.

00:17:48

SUZANNE BLACKEBY:
Thanks so much for having me.

00:18:19

RUTH TIMMINS:
Bye for now.

00:18:22

SPEAKER:
Give patients the confidence to take ownership of their wound. Only ALLEVYN™  Life dressings have the EXUMASK™ change indicator. So, they know when a  change is necessary. For more information, contact your local Smith &  Nephew representative, or email us at ProfEd.ANZ@smith-nephew.com.

The information presented in  this podcast is for educational purposes only. It is not intended to serve as  medical advice. Products listed outlined of care are examples only. Product  selection and management should always be based on comprehensive clinical  assessment. With detailed product information including indications for use  contraindications, precautions and warnings, please consult the product's  applicable instructions for use prior to use. Helping you get CLOSER TO ZERO  human and economic consequences of wounds.

00:18:23

 

APNA link

https://www.apna.asn.au/education/roadshow

 

 

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Speakers

Suzanne Blackeby

Nurse Educator, Australian Primary Health Care Nurses Association (APNA)

Suzanne is a registered nurse, committed to meaningful education opportunities for all primary care nurses. She has over 30 years’ experience, working in a variety of clinical, advocacy and management roles, across private and public sectors in both urban and rural Australia. In her role as Nurse Educator at APNA, she supports primary care nurses to ensure they deliver patient care that is based on current, evidence-based education.

Suzanne has a special interest in and is driven to see change in how health systems treat marginalised groups when requiring health care. She is also a consultant for individuals and organisations, creating goal-orientated, flexible health care delivery processes in the primary care space.

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