Stephanie qualified in 2007 and whilst over the past 18 years her career has taken her down many paths, the delivery of evidence based wound care has always been at the core of her professional values.

She was a Tissue Viability Nurse from 2009 – 2013 in a busy acute hospital before embarking on her Advanced Clinical Practice journey. During this time, she has had many opportunities to drive quality improvements in enhanced recovery, spinal surgery and the youth custody service. The highlight of Stephanie’s career prior to the opportunity to work with SoTV, was winning a Nursing Times Award for Children’s Services for implementing an annual health review for young offenders.

Stephanie feels very fortunate to be working in her dream role as an ACP in Plastic Surgery with a focus on quality improvement in the management of complex wounds. She works in close collaboration with the Tissue Viability team to streamline pathways for wound management which historically have not always aligned.

As a Professional Nurse Advocate and as an ACP, Stephanie feels in a privileged position to not only be able to apply current best practice into the services that she leads, but also to be able to drive quality improvement whilst supporting the workforce.

Presentation at Burns and plastics wound care study day

Plastics intervention for lower limb trauma

Introduction: It is widely accepted amongst wound care specialists and expert led agenda that early compression therapy is the gold standard for managing wounds on the lower limb at risk of delayed healing.  A retrospective audit of the types of wounds presenting in the plastic surgery dressings clinic over a 2-week period highlighted that patients with lower limb wounds were amongst those with the highest number of clinic appointments per patient.  In addition to this, there was lack of holistic lower limb assessment and structured wound assessment. The aim of this quality improvement initiative was to align lower limb wound care in the plastic surgery dressings clinic to national wound care standards for lower limb assessment and management.

Method: The commissioning of a wound care specialist role into a plastic surgery service presented an opportunity for quality improvement for this patient cohort.  A referral pathway was developed to support early intervention following haematoma, pre-tibial laceration and failed split thickness skin graft following skin cancer removal.

Results / Discussion:  Collaboration with the expert lower limb group and development of an early intervention pathway resulted in efficiency, productivity and application of evidence-based practice for this cohort of patients with a 50% reduction in outpatient appointments, early intervention with compression therapy and timely onward referral.

Conclusion: Through expert leadership the dressings clinic activity was aligned to evidence-based practice thus improving patient experience and outcomes, efficiency and productivity.  Future service development has been proposed to further reduce outpatient clinic appointments for this patient group, this includes an outreach service to emergency portals, an education programme and recruiting lower limb champions to embed this pathway into practice.