This joint issue of Advances in Skin & Wound Care and Nursing Management was designed as a practical resource for both healthcare leaders and clinicians. Using an evidence-based approach, the authors discuss complex topics of concern to the global healthcare community.
Building a business case for hiring wound, ostomy, and continence nurses and Who should assess and stage pressure injuries in hospitalized patients? address wound care costs, prudent use of resources, and a business case for investment in wound care nurse specialists' expertise. The authors raise important questions about long-debated and controversial topics, including who should stage PIs and if staging is even necessary.
Other "how-to" articles discuss starting and growing essential programs. A patient navigation model to improve complex wound care outcomes demonstrates that minimal changes in home care improved or healed previously unhealable wounds through community-based interprofessional teamwork, continuity, and patient-centered care coordination. Capturing essentials in wound photography past, present, and future: A proposed algorithm for standardization presents the technologic, scientific, artistic, and legal concerns of using photography in wound care.
Important for all who care for patients and loved ones at end of life, Seven strategies for optimizing end-of-life skin and wound care provides guidelines for individualizing goals of care and staff education. Creating a comprehensive hospital-based skin and wound care program to improve outcomes and decrease pressure injuries details my journey in designing, implementing, and leading an interprofessional program resulting in significant care improvements and fewer pressure injuries.
This issue highlights the imperative for interprofessional clinical and administrative collaboration to provide cost-effective care and optimize outcomes. Resources are key: time, money, and people. Evidence-based strategic planning requires flexibility and inclusion, involving all stakeholders (including frontline staff) in decision-making and resource allocation.
Experts, providers, and leaders must create an environment that not only establishes policies and standards but empowers those in direct care, providing evidence-based tools to effectively do their jobs. In wound care that means having: a formal structure to give interprofessional staff a voice in shared decision-making, including selection and use of evidence-based products and equipment; nurse, physician, and allied health wound specialists to consult, assess, classify, and guide care; the needed products, supplies, and equipment available across the continuum of care; and patient-centered, practical home-care models.
Healthcare systems and policy makers must break the bureaucratic paralysis and culture of blame that often create the biggest barriers to change and improvements. Today, many healthcare systems are large, billion-dollar, multifacility enterprises. Decisions must be informed by and made in concert with those on the front lines of care. As clinicians and administrative leaders, we need to commit to using research and evidence, empowering staff, fostering interprofessional collaboration, evaluating outcomes, and sharing findings.
This joint issue is a first for both journals. Special thanks to the publishers and editors for their vision creating this collaborative issue; to the authors for their knowledge translation; and to the readers, both clinical and administrative, whose partnership can create cost-effective, quality skin and wound care. I hope readers find this special joint issue interesting and valuable in their practice and policymaking.