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.

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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)