Improving clinical care for people with wounds
Across Wales there are 32 specialist tissue viability nurses ( see AWTVNF Membership ) and these individuals are members of the All Wales Tissue Viability Nurses Forum (AWTVNF). While providing a platform for sharing information and experience they foster collaborative working between AWTVNF members and other healthcare organisations, communities and individuals. The AWTVNF provide strategic guidance to facilitate a quality tissue viability service throughout Wales. This document sets out the constitution, past achievements and future strategic goals of the AWTVNF.
The idea of an All Wales tissue viability nurse group was generated following a formal meeting of the South Wales Tissue Viability Group with Rosemary Kennedy then Chief Nurse for Wales. Following informal discussion between tissue viability nurses from North and South Wales, the All Wales Tissue Viability Nurse Forum was formed in September 2003.
Tissue viability is an umbrella term covering skin health and wounding within people of all ages regardless of case setting and at any point along the patient's journey through their health care episode. Tissue viability skills include the holistic assessment of patients with actual or potential skin / tissue damage and the implementation of appropriate prevention and treatment strategies. It is a speciality that considers protection of tissue integrity alongside all aspects of skin and soft tissue injuries ranging from simple to complex wounds, across acute and chronic wounds, in addition to tissue damage consequential to underlying chronic disease e.g., venous hypertension.
The AWTVNF is accountable to the Chief Nurse for Wales, All Welsh Health Board Executive Nurses and to the NMC.
Our eight aims reflect the six key principles from the Institute of Medicine (Design for life 2005) that state care should be -
Safe, Effective, Patient Centred, Timely, Efficient and Equitable
Membership is free and open to Registered Nurses whose main role is that of Tissue Viability Nurse/Clinical Nurse Specialist in Wound Care/Tissue Viability and are accordingly contracted by a Welsh Health Board to deliver such services. Conflicts of interest will be taken into consideration.
All new members to the AWTVNF must fit the above criteria, be nominated by an existing member of the AWTVNF. To avoid doubt each vote for executive post and professional advisor (see AWTVNF Membership) must be conducted within a meeting of the AWTVNF that has at least 15 members present (quorum for the AWTVNF).
The executive post holder roles are the Chairperson, Vice Chairperson who will each hold office for a maximum of two years. Appropriate succession planning will enable the two executive posts to be filled with no break in continuity. An additional executive post is that of Forum and Web Site Administrator, the post is held for two years with an option of the post holder renewing the post for a further two years.
The executive post holders will have had to have met criteria for an executive post (see membership), be nominated by an existing member and their position decided through closed ballot. The proposed executive post holder will have to have agreed to their nomination.
The Vice Chairperson will automatically step up to the office of Chairperson, therefore, agreeing to a four year commitment to the AWTVNF. After the end of this period the member will not be eligible for re-election to an executive post for a period of two years.
The Quorum for a meeting will be 15 members.
Other professional advisors may be co-opted as required following a quorum vote, but they will have no voting rights (appendix two).
The AWTVNF member has a responsibility to make every effort to attend the meetings, and if not able must send an apology with fair notice to the secretary.
Each Health Board must be represented at least once each year.
Meetings will be held three times a year in a central location.
Industry will be invited to sponsor the meetings and in order to maintain the professional integrity of the group all companies will be asked to sponsor on a rotational basis. One hour will be allocated to the sponsor/sponsors at each meeting, to update the group on new clinical innovations.
The AWTNF will accept unrestricted educational grants from industrial colleagues for specific projects. The financial arrangements associated with the educational grants will be with the publishers of the projects and not with the forum.
The AWTVNF has no financial arrangements and is a non-profit making group.
Any monies received via awards shall be donated to a quorum agreed charity chosen by members.
All AWTVNF publications developed via a third party shall be dealt with by that third party with no financial involvement of the AWTVNF members with the same applied to commercial sponsorship of any meeting.
The AWTVNF has agreed a non-for profit arrangement with Wounds UK for publication of the best practice documents. This arrangement is subject to an annual review.
All members of the AWTVNF will submit any declarations of interest at the start of all meetings and minutes of the meeting will be taken. These minutes will be made available by email posted to the group and will be on the AWTVNF website following development.
The main vehicle for communication is e mail via the Forum and Web Site Administrator of the AWTVNF.
In the intervening time between the formal meetings, communication within the group is via e mail and disseminated by the Forum and Web Site Administrator of the forum. Minutes are circulated via e-mail and will be posted on the AWTVNF web site which will be hosted on the Welsh Wound Network web site. This will go live in February 2014 @ www.welshwoundnetwork.org
The members contribute to the curriculum planning and delivery of education and training with the universities based in Wales. In addition they participate in local health board internal training and induction programs. The group have developed clinical competencies to assist in standardising tissue viability practice in Wales; these have been validated by Agored Cymru.
Orthopaedic pressure ulcer prevalence audit, community hospitals pressure ulcer prevalence audit published as -
James J, Evans J A, Young T, Clark M (2010) Pressure ulcer prevalence across Welsh orthopaedic units and community hospitals: surveys based on the European Pressure Ulcer Advisory Panel minimum data set, International Wound Journal 7 (3) 147-152
Best practice guidelines - Faecal Management Systems (2010), Assessment and Management of Skin Tears (2011), All Wales Guidance for the use of larval debridement therapy (2013)
Clinical competences for qualified and unqualified nursing staff, validated by Agored Cymru - covering negative pressure wound therapy, pressure ulcer prevention and management, venous leg ulcer prevention and management, wound care, larval therapy
NWSSP wound management formulary; negative pressure wound therapy (NPWT) contract
All Wales Guidance for the Prevention and Management of Pressure Ulcers (2011)
Stakeholder for the following organisations: European Pressure Ulcer Advisory Panel, National Institute of Health and Clinical Excellence
Cooperating organisation - European Wound Management Association (on-going)
Members representation on national and international groups - European Pressure Ulcer Advisory Panel, European Wound Management Association, Leg Ulcer Forum, Lindsay Leg Club Foundation, Wound Care Alliance UK
Clinical audit – the use of honey dressings in wound management (symposium Wounds UK conference, Harrogate 2012)
Pressure Ulcer Reporting and Investigation - All Wales guidance 2013
Support to the introduction/implementation of the SKIN bundle across all Health Boards in Wales.
Best practice statements
Hyperkeratosis – by May 2014
Moisture lesions (in conjunction with The Association for continence advice professionals united in continence care) – by March 2014
NPWT – 2014
Dissemination and implementation strategy – 2014
All Wales Pressure Ulcer Data Collection Standardisation
The AWTVNF will continue to work in collaboration with the Chief Nursing Officer for Wales, and the All Wales DATIX Group to develop a standardised data collection process across Wales - ongoing
Wound Management Formulary
NWSSP has established a sub group to maintain and develop an all Wales wound management formulary. The AWTVNF is an active member of this sub group – on-going
Welsh Wound Innovation initiative
The Welsh Wound Innovation Initiative (WWII) are supporting the AWTVNF with specific projects which include development of educational material to support the wound care competency portfolio, potential development of a TVN specific MSc course, development of a AWTVNF web site (which will be hosted by the Welsh Wound Network) – on-going
AWTVNF – tissue viability service database
The AWTVNF are presently working to develop a data base of tissue viability services in Wales – ongoing
The AWTVNF are reviewing the data collection process and consequent statistical information of their clinical workload - 2014
Consolidating and standardising wound care nurse education in conjunction with Agored Cymru and potentially with the universities within Wales - 2017
Journal of Community Nursing roadshow (Llanelli 5/3/14), Wound Care Alliance study day (Swansea, 11/4/14)
Hours worked in brackets after each member's name.
Julie Evans (37.5), Pam Taylor (37.5), Karen Kembery (37.5), Sian Edwards (PUPIS 22.5), Mari Clarke (24), Marilyn Jenkins (37.5), Sue Flavin (PUPIS 30), Helen Dawkins (37.5)
Alison Chandler (25), Annie Clothier (37.5), Tracey Morgan (37.5), Jayne Warren (37.5), Trudie Young (7.5)
Barbara Pritchard (37.5), Brigitte Price (30), Fran Whitehurst (7.5 PUPIS, 22.5), Eleri Gittins (22.75), Denise Roberts (37.5), Rhian Parry-Ellis (22.5), Karen Doleman (15)
Cardiff and Vale
Ceri Harris (32), Helen Crook (30), Kirsty Mahoney (37.5), Christina Harris (37.5), Evelyn Frowen (37.5)
Sue Reed (37.5), Karen Bevan (37.5), Julie Usher (37.5)
Jane James (37.5), Gwenda James (22.5), Claire Williams (30)
Jackie Griffin (25), Delia Keen (22.5), Faye Campbell (30)
AWTVNF sub groups
Jane James - Lead
Helen Crook- Lead
Formulary sub group
Jane James - Lead
Karen Bevan/Sue Reed
Tracey Morgan/Jayne Warren
Pam Taylor/Karen Kembery
NPWT sub group
Helen Crook/Ceri Harris
Helen Crook - lead
Ann Yates – Continence
Data collection group
Professional Advisors to the AWTVNF
Professor Sue Bale, Professor Michael Clark, Pat Roberts, Ann Yates
The AWTVNF have much strength however they acknowledge that in certain areas they require additional input. Professors Sue Bale and Michael Clark provide strategic advice and guidance. Pat Roberts and Ann Yates provide condition specific advice (lymphoedema, continence).
The AWTVNF have agreed with Wounds UK that they will be the preferred company for the publication of guidelines/best practice statements produced by the Forum.
The content of the document will be provided by the forum.
The copyright to the document and its contents will remain with the AWTVNF.
Wounds UK will take the written content and offer design and typesetting service.
Wounds UK will only charge for the time taken to design, typeset and print the publication, it will be a not for profit agreement.
Wounds UK will liaise with the industry sponsor regarding financial arrangements for the publication and will recoup costs as described above from the sponsor.
Wounds UK will circulate the publication with/within the appropriate Wounds UK journals (no cost involved – these costs will be covered by the sponsor and arranged by Wounds UK), and to the relevant associations e.g. ACA Wales, All Wales Continence forum.
Wounds UK will provide on-line publication via their Wounds UK and/or Wounds International web site free of charge. The publications will be downloadable PDF format from a dedicated AWTVNF section (see current associations link on Wounds UK web site).
The publication will also be available to download from the Welsh Wound Network web site.
The AWTVNF editorial sub-group will undertake proof reading prior to sending the document to Wounds UK.
A news story will run on the Wounds UK home page for each new publication with a link to the AWTVNF section.
The rationale for the input/support from Wounds UK:
Wounds UK wants to work closely with the wound care community to develop journals, events and educational opportunities that are relevant and practical. The relationship with the forum ensures Wounds UK brand remains a positive link with forum members.
The on-going relationship will assist Wounds UK in developing closer relationships with forum members and to work with future conference presenters, authors and key opinion leaders of the future.
The documents being placed on the web site will attract hits/visits to the web site.
The collaboration may be the platform for future opportunities for the mutual benefit of both parties.