Abstract

Development of a community-based skin integrity service

Sara Burr, Rachel Sweeney. JCN 2019, Vol 33, No 3.

A review of how specialist community nursing services were functioning in a community healthcare trust has led to the development of a skin integrity team. Composed of dermatology, tissue viability and lymphoedema nurses, as well as assistant practitioners and support workers, this team works alongside the community nursing teams. Amalgamating three smaller services has improved patient care and created advantages for staff within the team and their colleagues. This article explores this development and uses a patient case study to illustrate its benefits.

Main findings

• It was recognised that staff skills could be optimised through amalgamating smaller services into one team. The formation of the skin integrity team within a local community NHS trust has reduced several areas of concern. Clinical pathways for lower limb oedema, leg ulceration, tinea pedis and hyperkeratosis have been developed and implemented for use in primary and community care. Wound and skin care formularies have been reviewed, with supporting material produced for dressing choice guidance and an emollient pathway to support appropriate product usage.
• A training programme for registered and unregistered staff involved in the care and management of patients with lower limb issues has been embedded within the trust, supported by the skin integrity team.
• The team was named the skin integrity team to reflect the fact that maintaining the integrity of the skin is the cornerstone of best practice in all of these specialist areas.
• The aim of the skin integrity team leads was to standardise practice for skin and wound care and provide training opportunities across the locality using a coordinated approach.