Dressing(Selection( "at"your"fingertips(! Good!afternoon.!!My!name!is!Kim!Kaim!and!I!am!a!Clinical!Nurse!in!the!Wound!Management!
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1 Dressing(Selection( "at"your"fingertips( Goodafternoon.MynameisKimKaimandIamaClinicalNurseintheWoundManagement teamatthegoldcoast.iacquiredmypassionforwoundcareasanundergraduaternwheni wasfortunateenoughtobeabletospendayearandhalfwiththewoundhealingoutreach CommunityCentreinKelvinGrove.DuringmytimethereIbegantoseethetipoftheiceberg; howcomplexwoundhealingis andthereisstillsomuchforustolearn,howmanypeople sufferwithchronicwounds,andhowlittleattentionwoundcarereceives.butialsosawhow rewardingitwastohelpsomeonetoheal,soiwashooked. Ithenspentthreeandahalfyearsataruralhospital.WhileIwasthereIgottoseehowlittle ofourcurrent,evidencedbasedwoundmanagementprinciplesmakeitouttothispopulation. Supportforwoundcareeducationandadviceishoursaway.Somynewpassionbecame gettingwoundcaretothebush. ButIhavenotalwaysbeenaNurse.PriortoNursingIspent10yearsworkinginITandIhave beenaprogrammer(asahobby)sinceiwasinmyteens.soihadanidea Iamdesigningaseriesofmobileapplicationsthatprovideadviceonwoundcaretoclinicians basedonthebestevidencecurrentlyavailable.butwheretostart?woundassessmentand managementisincrediblycomplex.ideallyiwouldliketocreateatooltoleadcliniciansfrom assessmentanddiagnosisthroughtosettingclearhealingobjectivesandwoundcareplans, groundedinresearchandevidence,andfasttouseforcliniciansofallknowledgelevels (1T4). Butinreality,Ineedtostartwithsomethingmoretenable.Areviewofwoundassessment toolsbygreatrextwhiteandmoxey (5) indicatedthatthereisalackofguidancefortreatment incurrentlyavailabletools.thisisreflectedinmobileapplicationswherefortheandroid platformthereare13appsformeasurement/documentation,8foreducationandjournals,2 appwhichoffersguidelinesandtreatmentalgorithmsand8fordressingselection.ofthese8, 6aremanufacturerTspecific,oneisonlyinGermanandisnotfree(seeTable1)andoneis onlyoniphonesoiwasnotabletotestit.asapersonalobservationihavealsonoticedthat themajorityofquestioniamaskedareregardingwounddressings. Therefore,thefirstoftheseapplicationshasfocusedondressingselection.Thisappdoesnot replaceclinicaljudgment,itdoesnotaddressaetiologynordoesitconsidermedicaland psychosocialimpactsonwoundhealing.itusestheprinciplesofwoundbedpreparationand TIMEtomatchwoundrequirementstodressingsthatcanmeettheneed.Thebroad frameworkwasadoptedfromexistingnhsformulariesandadaptedwithinputfromthe AustralianandNewZealandClinicalPracticeGuidelineforPreventionandManagementof VenousLegUlcers (6),TheRoyalChildren shospitalmelbournewoundcareguidelines (7) and thepanpacificclinicalpracticeguidelineforthepreventionandmanagementofpressure Injury (8).ThisisshowninTable2.Thecompletelistofdressings,imagesanddescriptions arefromindependenceaustraliaaswellasmanufacturerwebsitesandmarketingmaterials.
2 Theappopenstoafrontpagewithanintroductionand caveats.fromhereyoucanselecttogotooneof5pages: Educationalsupportmaterials Linktopopularwoundrelatedresources supportandfeedback Searchfunction Thedressingselectionapplication Whenyouselectthebandageselectionapplicationyouare takentoascreenwhereyouselecttissuetype,moisturelevel andpresence/absenceofinfection.oncetheseareentered youpressthesuggestbandagesbuttonandyouaregivena listofthegenericdressingtypeswhichwouldbesuitablefor thewoundyouhavedescribed.ifyouwanttoknowmore abouttheparticulargenericdressingtypeclickonthe[?]. Onceyouhaveselectedagenericdressingtype,more specifictypevariantsaredisplayed.forexample,adhesive ornotadhesive,withorwithoutanadditive,specifically shapedorforcavities(rope).
3 Selectingoneofthesemorespecificvariantswillthen provideyoulistofallnamebrandsthatfitthatdescription. Eachdressingcanbeselectedtoshowminimumand maximumcosts,minimumandmaximumsizes,animageand descriptionasprovidedbythemanufacturer,thenameof themanufacturerandalinktothatproductinthe IndependenceAustraliawebsite. Datainthetableswillbeupdatedregularly.MeetingswereheldwithIndependenceAustralia whoareprovidingtheirdatafortheproject.eachtimetheyupdatetheirwoundcare productscataloguetheywillsendanewdatafiletoupdatetheapp,thisisapproximatelyonce ayear. CurrentlytheapplicationhasonlybeendevelopedfortheAndroidoperatingsystem.Android waschosenbecauseandroidstillholdsalmost80%ofthetotalsmartphonemarketshare worldwide(seefigure1).inaustraliaisitclosertohalf,sharingthemarketmainlywithios. IftheappiswellreceivedthenanAppleiOSversionwillbeconsidered. IfyouhaveanAndroidphoneandwouldliketohelpustestthebetaversion,gotoGooglePlay anddownloaditnow(permission). Beta meansit snotactuallyfinishedyet,butit sclose enoughthatitshouldperformallthefunctionsexpectedofit, howeverwecan tguaranteeitwon tcrashyourphone.youare trialingthisatyourownrisk.pleaseusetheintapp to providefeedbackandmakesuggestionsoryoucan me directly. Thisdressingselectionapplicationandthe at$your$fingertips seriesofapplicationstocomearefree,andwillremainfree.they arebeingdevelopedtomakeusefulwoundcareinformationquick andeasytoaccess,andtofillagapinthecurrentlistofmobile
4 application(woundcare)offerings. OncefeedbackisincorporatedintoWoundDressings at$your$fingertipsandthefinalversion isreleased,workwillcommenceonthenextphase:woundcarealgorithms at$your$ fingertips.again,thiswilltakequitealotoftimeinresearchingguidelinesandevidence.if youhaveaspecialtywithinwoundcareandwouldliketoofferyoursupporttothisproject yourassistancewouldbegreatlyappreciated.also,asyoucanseebytheimages,i mnota graphicdesigner.ifyouhaveartisticflairandthinkitwouldbefuntooffersupportonartistic direction,colour/fontschemesorartworkbyallmeanspleasehelp Ifyouwouldlikeacopyofthistalkwithfulltablesandreferencesplease meandI ll sendyouthepdf. Thankyouforyourtime,anyquestions?
5 Table1 Focusof Measurement/Documentation Education/Journal Guidelines/Algorithms/Treat DressingSelection theapp mentrecommendations Name (cost) +WoundDesk(subscription) WoundCentral(free) Wounddoctor($) Enluxtra(freeGManufacturer specific) MOWA($) OMNIO($) EvidenceGBasedWoundCare GuidelinesandFecalOstomy D+WoundSolution(freeG Manufacturerspecific) BestPracticeMobileApp($$) MobileWoundCare (subscription) JournalofWoundCare(app freebutarticles$) NAWA(freeGManufacturer specific) WoundRight(free) WoundCareNursingGCWCN ($) WoundWatch($,notin English) WoundAnalysis(free) Wounds(free) DressingSelectionApp(freeG Manufacturerspecific) AbbottWoundMonitor(free,not inenglish) OWM(free) DRACOWundApp(freeG Manufacturerspecific,notin English) WoundEZ(subscription) ionhealing(freeg Manufacturerspecific) SuprasorbWoundNavigator (freegmanufacturerspecific) WoundMapPump(free) WoundCareNotebook(free, WoundCare(freeGiOSonly) iosonly) WoundMatrix($?) EyeSight($$$) WoundZoom($$$) WoundCam($) WoundSmart($) Summary Severaloptions,feebased servicesdoappearmore comprehensive.+wounddeskis inbetabutlooksverypromising. Verywellcovered.Wound centralhasalargecollection ofbrief,informativepieces includingimagesandvideos. Onlyoneoffering,notfree. Appindicatesitprovides treatmentalgorithms, howeverthiswasnottested. Theonlyappthathasthe potentialtoofferunbiased dressingselectionoptionsis ingerman.
6 Table2 NonetoLow LowtoModerate ModeratetoHigh HightoVeryHigh Epithelial Film Interface Simpledressing Foam Hydrocolloid HighAbsorbent HighAbsorbent Antimicrobial/interface Antimicrobial/simple Antimicrobial/interface Antimicrobial/Foam Medicatedbandage Medicatedbandage Granulating Film Hydrogel Interface Foam Hydrocolloid Alginate GellingFiber Foam HighAbsorbent Antimicrobial/Hydrogel Antimicrobial/Foam Antimicrobial/interface Antimicrobial/Hydrocolloid CadexomerGIodine Antimicrobial/Alginate Antimicrobial/Gelling Fiber Antimicrobial/Foam Antimicrobial/interface Antimicrobial/High Absorbent Slough Hydrogel Foam Alginate GellingFiber Foam HighAbsorbent CadexomerGIodine Antimicrobial/Hydrogel Monosaccharide Antimicrobial/Hydrogel CadexomerGIodine Antimicrobial/Foam HypertonicSaline Monosaccharide Antimicrobial/Alginate CadexomerGIodine Antimicrobial/Gelling Fiber Antimicrobial/Foam Antimicrobial/interface Antimicrobial/High Absorbent Necrotic Hydrogel Isotonic Hydrocolloid Foam Alginate HighAbsorbent Antimicrobial/Isotonic Antimicrobial/Hydrogel Monosaccharide CadexomerGIodine Monosaccharide CadexomerGIodine Antimicrobial/Foam Antimicrobial/Alginate Antimicrobial/interface Antimicrobial/High Absorbent This%table%has%been%modified%from%those%used%in%the%NHS%
7 Figure1 AustraliaOnly International%Data%Corporation% ( Statista%Statistics%Portal%( operatingcsystemscforcsmartphonecsalescincaustralia/)%
8 References( 1. Kennedy,C.andD.Arundel,District'nurses''knowledge'and'practice'of'wound' assessment:'2.britishjournalofnursing(markallenpublishing),1998.7(8):p.481g Hess,C.T.,The'art'of'skin'and'wound'care'documentation.AdvancesinSkinWound Care, (1):p.43G Gray,D.,etal.,Using'the'wound'healing'continuum'to'identify'treatment'objectives,in Applied'wound'managment'supplement.'Part'2'Implementation,D.Gray,R.White,andP. Cooper,Editors.2005,WoundsGUK:Aberdeen. 4. Best'Practice'Statement:'Optimising'wound'care.WoundsUK, GreatrexGWhite,S.andH.Moxey,Wound'assessment'tools'and'nurses''needs:'an' evaluation'study.internationalwoundjournal, AustralianWoundManagementAssociationIncandNewZealandWoundCareSociety Inc,Australian'and'New'Zealand'Clinical'Practice'Guideline'for'Prevention'and' Management'of'Venous'Leg'Ulcers.,2011,CambridgePublishing. 7. TheRoyalChidren'sHospitalMelbourne.Wound'Care.2012[cited2014November8]; Availablefrom: 8. TheAustralianWoundManagementAssociation(AWMA)PanPacificGuideline DevelopmentSteeringCommittee,Pan'Pacific'Clinical'Practice'Guideline'for'the' Prevention'and'Management'of'Pressure'Injury.2012,OsbornePark,WA:Cambridge Media.
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