Showing papers in "British Journal of Community Nursing in 2015"
TL;DR: The authors outline the five stages of the CS NAT approach to assist practitioners wishing to implement the CSNAT in practice and the benefits for both carers and practitioners arising from using theCSNAT as a person-centred approach in practice.
Abstract: Community nurses play an important role in providing palliative care and support for patients and carers at home. The Carer Support Needs Assessment Tool (CSNAT) provides practitioners with an evidence-based comprehensive tool to use with carers in palliative home care. As a practice tool, the CSNAT uses a person-centred approach-that is, the process of carer assessment and support is facilitated by practitioners but is carerled. In this paper, the CSNAT research team provides an overview of the development of the tool and the benefits for both carers and practitioners arising from using the CSNAT as a person-centred approach in practice. The authors outline the five stages of the CSNAT approach to assist practitioners wishing to implement the CSNAT in practice.
55 citations
TL;DR: A need for training on physical activity-related counselling is highlighted, including awareness of the latest recommendations and strategies to promote physical activity, and health-care employers should also consider addressing nurses' barriers to the promotion of physical activity within their clinical practice.
Abstract: Many registered nurses (RNs) are not achieving the recommended daily levels of physical activity. This study collected data from 623 RNs about their personal health behaviours and their professional, physical activity-related health-promotion practices. The findings showed that 75% of the sample reported engaging in personal physical activity, 25% were at risk of hazardous drinking or active alcohol use disorders, 17% were past smokers and 11% were current smokers, 47% reported having a normal body weight-size, and 73% desired to be a normal body weight-size. Nearly half of the sample reported that they were promoting physical activity within their clinical practice. Personal physical activity behaviour, perceived health status, length of clinical practice, clinical specialty, and actual body weight-size were significantly related to the RNs' professional, physical activity-related practices. This study highlights a need for training on physical activity-related counselling, including awareness of the latest recommendations and strategies to promote physical activity. Health-care employers should also consider addressing nurses' barriers to the promotion of physical activity within their clinical practice so that all health-care contacts are able to maximise opportunities to promote active ageing.
48 citations
TL;DR: Assessment of dysphagia is explored in terms of multidisciplinary screening, speech and language therapist clinical swallowing evaluation and instrumental assessment, as well as issues regarding medication administration.
Abstract: Dysphagia impacts on the health and quality of life of individuals and contributes to the cost of health care. This paper summarises current literature regarding the nature, assessment and management of acquired oro-pharyngeal dysphagia in older adults. It examines the aetiology, prevalence and consequences of dysphagia, as well as issues regarding medication administration. Assessment of dysphagia is explored in terms of multidisciplinary screening, speech and language therapist clinical swallowing evaluation and instrumental assessment.
45 citations
TL;DR: The discussion and understanding of loneliness theoretical foundations provide useful insights toward the interpretation of its occurrence.
Abstract: Loneliness has been found to relate to a wide range of harmful health outcomes. The adverse effects of loneliness upon people's lives emphasise the importance of understanding its nature and process. A number of theoretical and conceptual foundations have been proposed by scholars and are discussed and reflected upon in this article. The discussion and understanding of loneliness theoretical foundations provide useful insights toward the interpretation of its occurrence.
38 citations
TL;DR: A significant difference was found between nurses' clinical practice setting and the EBNP scale where novice nurses were less likely to rely on experience and intuition, and expert nurses with a higher level of education reported being more skilful at synthesising and applying information from research findings into their nursing practice.
Abstract: Factors influencing the development of evidence-based nursing practice (EBNP) were examined in Prince Edward Island, Canada. An adapted electronic questionnaire was distributed to practicing registered nurses and nurse practitioners (n=68). An analysis of variance revealed a significant difference between nurses' clinical practice setting and the EBNP scale. Significant differences were also found between age and education level when compared with the EBNP subscales where novice nurses were less likely to rely on experience and intuition, and expert nurses with a higher level of education reported being more skilful at synthesising and applying information from research findings into their nursing practice.
37 citations
TL;DR: In this article, the authors investigated the views of 40 young people from four schools in the West Midlands regarding nursing as a profession and found that the stereotypical imagery of nursing continues to influence public thinking and interpretation of roles.
Abstract: Young people's perceptions of nursing and, in particular, community nursing, do not reflect the realities of the profession. Community nursing needs to promote a realistic and positive image to young people who may consider nursing as a future career pathway. Strategies to increase awareness and understanding of community nursing roles are urgently required to halt the dissonance between the political drivers influencing changes in community care services, the advancing complexities of nursing roles, and the stereotypical imagery of nursing that continues to influence public thinking and interpretation of roles. The article draws on research that investigated the views of 40 young people from four schools in the West Midlands regarding nursing as a profession.
35 citations
TL;DR: It is suggested that biofilms are a major player in the chronicity of wounds and they are a complex concept to diagnose and management needs to be multifactorial.
Abstract: A biofilm can be described as a microbial colony encased in a polysaccharide matrix which can become attached to a wound surface. This can affect the healing potential of chronic wounds due to the production of destructive enzymes and toxins which can promote a chronic inflammatory state within the wound. Biofilms can be polymicrobial and can result in delayed wound healing and chronic wound infection resistant to antibiotics, leading to prolonged hospitalisation for some patients. There appears to be a correlation between biofilms and non-healing in chronic wounds. It is suggested that biofilms are a major player in the chronicity of wounds. They are a complex concept to diagnose and management needs to be multifactorial.
29 citations
TL;DR: Results of phase 1 pilot results using the Cassandra Matrix activity tool indicate that the tool has significant potential for capturing the complexity and multiple dimensions of nursing work in community contexts, and phase 2 work has led to a community version of the tool being piloted on a larger scale across six community organisations.
Abstract: The need to effectively promote safe staffing levels in community settings challenges commissioners and providers of services to find rigorous methods of capturing workforce evidence that can be systematically used to shape effective services and skill mix for the future. This article presents a brief review of current approaches and challenges to measuring community nursing workload activity in England. Specifically, it shows phase 1 pilot results using the Cassandra Matrix activity tool and review of ongoing developments and progress to demonstrate scalability for national implementation. As part of a much larger practice development project to develop community nursing, the pilot used mixed methods to collect 10 days of workload activity data from a self-selected sample of band 5–7 nurses working in general and specialist community nursing roles in three community organisations, and to evaluate their experiences of using the tool via an electronic survey. The findings indicate that the tool has significant potential for capturing the complexity and multiple dimensions of nursing work in community contexts, and phase 2 work has led to a community version of the tool being piloted on a larger scale across six community organisations.
25 citations
TL;DR: The range of self-management techniques that community nurses can discuss with patients, including healthy eating, low-impact exercise, compression garments, self-lymphatic drainage, and counselling are described.
Abstract: At present, there is no proven cure for lipoedema. Nevertheless, much can be done to help improve symptoms and prevent progression. Many of these improvements can be achieved by patients using self-management techniques. This article describes the range of self-management techniques that community nurses can discuss with patients, including healthy eating, low-impact exercise, compression garments, self-lymphatic drainage, and counselling.
23 citations
TL;DR: How nurses and health professionals can promote wellbeing by assessing a person's need for incontinence pads, enabling the person to use the appropriate type of pad and minimising risks of skin damage, odour, embarrassment, and leakage is examined.
Abstract: Urinary incontinence is a symptom that should be investigated and whenever possible treated in order to enable the person to regain continence. Sometimes, it is not possible or appropriate to promote continence, and the focus shifts to that of managing incontinence sensitively to enable the person to maintain dignity and avoid the complications of poorly managed urinary incontinence. This article examines how nurses and health professionals can promote wellbeing by assessing a person's need for incontinence pads, enabling the person to use the appropriate type of pad and minimising risks of skin damage, odour, embarrassment, and leakage.
22 citations
TL;DR: The review found that students' experiences of learning in community settings are variable, and perceptions of students and mentors are misaligned in terms of what a quality placement should look like.
Abstract: In the face of the UK-wide policy shift to increased home care, inspiring and enabling the next generation of community nurses is more urgent than ever. The quality of the pre-registration practice learning experience is highly influential on career choices at the point of qualification. Given that 50% of learning by pre-registration students takes place in practice, mentors have a crucial role to play in preparing the next generation of nurses to work in the community. This article discusses the findings of a systematic and critical literature review of pre-registration placements that was funded by the Queen's Nursing Institute Scotland. The review found that students' experiences of learning in community settings are variable, and perceptions of students and mentors are misaligned in terms of what a quality placement should look like. Although there is no clear definition of what constitutes a community placement and there is some underuse of learning environments in areas such as general practice nursing, there are also a number of examples of new and imaginative placements. While these innovations provide 'whole experience' placements, they are currently lacking robust evaluation, despite their potential usefulness on a larger scale. Mentors have the opportunity to provide students with a range of learning opportunities that increase preparedness for working in the community, allowing final year students in particular greater influence over their learning experience. Students undertaking community practice learning, where they have a managed level of autonomy, are more likely to feel confident to take on community nursing roles.
TL;DR: The experiences of informal carers in Ireland are explored and strategies to support carers have been identified but now require a uniform implementation that must be translated into practice.
Abstract: Informal carers provide vital input to maintain the health and social care needs of older adults. A more in-depth understanding of the experiences of informal carers, their value to society, and the support required to assist them is necessary to ensure the future care of older adults. The aim of this study is to explore the experiences of informal carers in Ireland and to identify the support required in caring for older adults at home. Informal carers' experiences are critically discussed under four main themes: time is not your own, duty of care, burden of caring, and support for informal carers. It is evident that informal carers of older adults provide the majority of care in the home with inconsistent or no support. Strategies to support carers have been identified but now require a uniform implementation that must be translated into practice.
TL;DR: As part of an annual foot review, trained and competent personnel should examine patients' feet to detect risk factors for ulceration and inform the person with diabetes of their risk score.
Abstract: As part of an annual foot review, trained and competent personnel should examine patients' feet to detect risk factors for ulceration. Foot examination with shoes and stockings removed should include: palpation of foot pulses; testing foot sensations using 10g monofilament or vibration; inspection for significant callus or deformed nails; inspection for any structural deformity; asking about any previous ulceration; checking for signs of ulceration; asking about any pain; and inspecting footwear. Following assessment, a foot risk classification score should be given. The person with diabetes should then be informed of their risk score, with education offered regarding future foot-care management. Diabetic foot complications include ulceration, Charcot foot, painful neuropathy, gangrene and amputation. Risk factors for ulceration include non-palpable pulses, insensate foot, significant callus, deformed nails, history of previous ulcer or amputation, tissue damage or signs of ulceration, foot pain and unsuitable footwear.
TL;DR: In clinical practice, the assessment and documentation of woundExudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings.
Abstract: The management of wound exudate remains a clinical challenge despite technological advances in products with better exudate-handling capacities. This clinical challenge is occasionally encountered when thick exudate (viscous exudate) is present, and when most modern dressings do not possess the capabilities to manage the viscosity while enabling exudate absorption. Maceration to the peri-wound area poses another challenge, irrespective of the number of topical barrier application products on the market and the innovation of dressing products that lock exudate away or those that encourage vertical wicking. In addition to all the above, in clinical practice, the assessment and documentation of wound exudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings.
TL;DR: The study set out to determine the effect of a topical oxygen therapy on wound size and identified wound healing progression in all 18 wounds and wound size reduction in 17 of the 18 wounds.
Abstract: The effect of pressure ulcers on patient quality of life have been recognised as a real problem for many years, and the need for robust and effective management of pressure ulcers is now a prominent national health-care issue. Myriad different interventions exist for the treatment of pressure ulcers, including clinically effective dressings and pressure-relieving devices, yet many pressure ulcers still do not heal and often become a chronic wound. This is the second of a series of articles (Norris, 2014) discussing the clinical evaluation of a topical oxygen therapy in practice. It describes a small evaluation involving 18 patients with pressure ulcers. The study set out to determine the effect of a topical oxygen therapy on wound size. The therapy comprises a canister that sprays pure haemoglobin in a water solution into or onto the wound. The haemoglobin spray needs to be used at least once every 3 days, does not require training on its use and can be used in any care setting. Overall, results identified wound healing progression in all 18 wounds and wound size reduction in 17 of the 18 wounds.
TL;DR: The findings show that community matrons consider prescribing-related knowledge to be essential in fulfilling their role and that the ability to prescribe speeds patient access to medicines, and in some instances it may be instrumental in preventing hospital admission.
Abstract: Community matrons prescribe medications and treatments for arguably the most complex patients in the community setting, yet little is known about their experiences of prescribing. Drug events and inappropriate prescribing are known to account for around 16% of hospital admissions. With a remit of reducing unplanned admissions to hospital, it is important to understand community matrons' experiences as prescribers and to examine the role of prescribing in fulfilling this agenda with consideration given to the adequacy of the prescribing support available. In this study, a qualitative research design was used and a purposive sample of seven community matrons from the south of England took part in the study. Semi-structured interviews were carried out and analysed using Braun and Clarke's six phases of thematic analysis. The findings show that community matrons consider prescribing-related knowledge to be essential in fulfilling their role and that the ability to prescribe speeds patient access to medicines. In some instances it may be instrumental in preventing hospital admission. Community matrons prescribe a limited range of medicines regularly, while referring to GPs for other prescribing that they consider outside their competency. Community matron prescribers mostly access their support from GPs and this is considered adequate in supporting them in their prescribing role.
TL;DR: This month's article considers the key concepts of accountability, which protects the public by imposing standards on district nurses and holds them answerable for their acts and omissions.
Abstract: Public trust and confidence in district nurses is essential to the nurse-patient relationship that underpins effective care and treatment. That trust and confidence has even greater focus for district nurses who care for patients in their own homes. Those patients need to be able to count on the professionalism and probity of their district nurses. The professionalism and probity of district nurses is based on their accountability, which protects the public by imposing standards on district nurses and holds them answerable for their acts and omissions. This is the first of a series of articles on accountability in district nursing practice to mark the introduction of the revised Nursing and Midwifery Code on the 31 March 2015. This month's article considers the key concepts of accountability.
TL;DR: Wounds decreased in size and healed more quickly under NWPT treatment than under standard treatment, and additional NPWT costs can be quickly offset by faster healing and a shortened treatment period.
Abstract: Objective The treatment of non-healing wounds accounts for a high proportion of wound care costs. Advanced technology treatments, such as negative pressure wound therapy (NPWT), could be cost-effective if they result in faster healing. The objective of this study is to assess the effect on healing and the cost-effectiveness of a single-use NPWT (i.e PICO by Smith & Nephew) when used on hard-to-heal wounds in a community setting. Method This was a cohort case study in which wounds were treated with NWPT for 2 weeks. Wounds were assessed every 2–4 weeks to a healed state. The weekly cost of treatment prior to intervention, that is, the products used and nurse time, were compared with treatment costs associated with NWPT and after a return to standard treatment. Results The study included 9 patients with leg ulcers or pressure ulcers that had been slow healing or non-healing for at least 6 weeks. While treated with NPWT, the average weekly reduction in wound size was 21%. The wound size achieved with NPWT wa...
TL;DR: Positive effects from implementation include the generation of reliable data to inform planning decisions, identification of issues around nursing time spent on administrative tasks, clarification of school nursing roles, and information being fed back to teams on various aspects of performance.
Abstract: This article describes the development and early application of the Scottish Community Nursing Workload Measurement Tool, part of a suite of tools aiming to ensure a consistent approach to measuring nursing workload across NHS Scotland. The tool, which enables community nurses to record and report their actual workload by collecting information on six categories of activity, is now being used by all NHS boards as part of a triangulated approach. Data being generated by the tool at national level include indications that approximately 50% of band 6 district nurses' time is spent in face-to-face and non-face-to-face contact and planned sessions with patients, and that over 60% of face-to-face contacts are at ‘moderate’ and ‘complex’ levels of intervention (2012 data). These data are providing hard evidence of key elements of community nursing activity and practice that will enable informed decisions about workforce planning to be taken forward locally and nationally. The article features an account of the e...
TL;DR: How older people experience being in an IC unit after hospital discharge and before returning to their home is explored to explore how the knowledge of the patient perspective is sparse and contradictory.
Abstract: In the UK, intermediate care (IC) is conceived as a range of service models aimed at ‘care closer to home’ and involves the expansion and development of community health and social services. Intermediate care in Denmark is more clearly defined, where approximately 45% of all the counties in Denmark have established a community-based IC unit in which public health-care services are offered to older people who have completed their hospital treatment. The impact of this organisational initiative is yet to be explored. In particular, the knowledge of the patient perspective is sparse and contradictory. The aim of the study was to explore how older people experience being in an IC unit after hospital discharge and before returning to their home. Data were drawn from 12 semi-structured interviews. Transcripts were analysed using a phenomenological approach. The essence of being in an IC unit was envisioned as ‘moments of conditional relief’ that emerged from the following constituents: ‘accessible, embracing ca...
TL;DR: The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
Abstract: Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
TL;DR: It seems that self-management with exercise and counter-pressure/compression is very effective and the requirement for manual lymph drainage is reduced and there is increased patient engagement with effective self-care.
Abstract: A retrospective review of all head and neck cancer-related lymphoedema (HNCRL) referrals from 1 October 2009 to 30 September 2013 was undertaken. HNCRL referrals significantly increased over a 4-year period. Lymphoedema clinic records were manually examined for the presentation of HNCRL, treatments provided, and outcomes. Some 207 HNCRL referrals were received, increasing by 251% from 2009 to 2013. A total of 110 men and 50 women were assessed and treated over the 4 years; 67% were discharged, 26% continued treatment/monitoring by clinic; 8% are deceased. The average time to discharge reduced from 16 to 5 months. From the results, it seems that self-management with exercise and counter-pressure/compression is very effective and the requirement for manual lymph drainage is reduced. There is increased patient engagement with effective self-care. Provision of appropriate education and information facilitated simple, effective self-management. This reduced treatment time, shortened time to discharge and released valuable practitioner time to treat patients with complex oedema.
TL;DR: The development of an appropriate partnership between the health professional and the patient is needed to address the present gap in management options for male lymphoedema.
Abstract: Lymphoedema and chronic oedema are managed through multiple interventions forming the two key stages of lymphoedema management. In the field of lymphoedema and chronic oedema research, the male perspective has received limited attention when compared with the female equivalent. Further research is needed within the UK and globally to address the present gap. Despite this limited focus, management options available to male patients do not differ significantly from female patients, with compression therapy being the main management option. The success of compression therapy and other interventions such as skin care and exercise depend on the patient's acceptance of the condition and the management options made available. This requires the development of an appropriate partnership between the health professional and the patient.
TL;DR: The importance of the cold chain, what should be done both to maintain it, and the actions to be taken, should a break be noted are discussed.
Abstract: Vaccination is an effective public health measure to prevent and control a number of infectious diseases. However, since vaccines are biological products and are sensitive to both heat and cold, they need to be maintained within a narrow range of temperatures, often referred to as the 'cold-chain'. This range, which is between +2°C and +8°C with a target +5°C, does not allow for refreezing or storage at room temperature. This paper discusses the importance of the cold chain, what should be done both to maintain it, and the actions to be taken, should a break be noted. It is important to note the product information supplied with vaccines, which is taken from the summary of product characteristics that forms part of the licensing requirements for each vaccine, and which will state how it should be stored. Using a vaccine that has not been stored according to these instructions constitutes off-label use, for which the individual practitioner must take responsibility. It also emphasises the fragile nature of many public health interventions, maintenance of which require constant vigilance and close cooperation between many groups and individuals.
TL;DR: The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate and it was observed that the dressing can assist in autolysis and support improvements in peri-wound status.
Abstract: This article discusses the use of a foam dressing for exudate management in both chronic and acute wounds, such as surgical wounds, pressure ulcers, diabetic ulcers, trauma wounds, and leg ulcers The primary objective of the study was to observe patients' wound progression in terms of wound size and the condition of the wound bed, when using this foam dressing as either a primary or secondary dressing The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate It was also observed that the dressing can assist in autolysis and support improvements in peri-wound status Choosing an appropriate dressing to manage a wound is essential Clinicians working in the NHS are under pressure to deliver good-quality clinical outcomes, and the ActivHeal Foam Contact dressing supports this outcome
TL;DR: The 82% healing rate achieved at 3 months and the fact that most patients continued to receive the same standard care as they had in the 4 weeks before recruitment into the evaluation increases the likelihood that the clinical outcomes observed here can be attributed to the haemoglobin spray.
Abstract: A published evaluation ( Tickle, 2015 ) of the use of a topical haemoglobin spray plus standard care in 18 patients with pressure ulcers showed that, following 4 weeks of treatment, the wound size reduced in 17 wounds and there was a progression toward healing in all 18. All but one of the wounds were over 2 months in duration at baseline. This article reports the results of the healing rates at 3 months of the 11 patients who continued to be treated with the haemoglobin spray. Nine of the 11 wounds healed, and 2 reduced in size by week 12 (i.e. 1 wound reduced from 30 cm(2) at baseline to 7 cm(2), while the other reduced from 6 cm(2) to 4 cm(2)). Of the 10 patients who were experiencing wound pain at baseline, 9 were pain free by week 8. Rapid elimination of slough was observed in all patients. The 82% healing rate achieved at 3 months and the fact that most patients continued to receive the same standard care as they had in the 4 weeks before recruitment into the evaluation increases the likelihood that the clinical outcomes observed here can be attributed to the haemoglobin spray. Topical haemoglobin shows promise in terms of its ability to accelerate healing in chronic pressure ulcers.
TL;DR: Bereavement care was understood to be part of the district nurse role, but the findings suggest that some nurses get too involved and no end date could be standardised, as each case is dependent on need.
Abstract: Background: The district nurse is one of the main providers of palliative care, which includes bereavement care. However, previous evidence shows a lack of education and training, as well as time management, as important factors in the delivery of bereavement care. Aim: This qualitative study aimed to explore the provision of bereavement care from a district nurse's perspective. Method: Data were collected from five participants using semi-structured interviews, and thematically analysed to produce the findings. The interviews were conducted within the author's and participants' working environments to maintain a professional stance between both parties. Findings: The results suggest an awareness of bereavement care, but a lack of training and education into the theoretical aspects of the care. Knowing the types and stages of bereavement would be beneficial, both in the delivery and the identification of the most effective time to refer on. Conclusion: Bereavement care was understood to be part of the dis...
TL;DR: In order to promote concordance with ongoing management, it is important that practitioners are aware of the options available in terms of design, structure, colour and size of compression hosiery.
Abstract: Compression hosiery is used to help prevent leg ulcer recurrence by controlling venous backflow and the build-up of lower-limb oedema. The therapy is effective, but only if it is worn consistently by patients. In order to promote concordance with ongoing management, it is important that practitioners are aware of the options available in terms of design, structure, colour and size of compression. It is also vital for practitioners to consider a range of strategies to help patients apply and remove the hosiery.
TL;DR: Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.
Abstract: The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.
TL;DR: The administration of a haemoglobin spray solution on patients presenting with sloughy wounds resulted in positive healing outcomes of slough elimination and wound reduction alongside positive self-care and product satisfaction.
Abstract: Aim: This evaluation aimed to determine whether the use of a haemoglobin spray solution expedited sloughy wound healing. Method: A descriptive evaluation was undertaken within a community setting exploring 25 patients presenting with sloughy healing and non-healing wounds, and the effects of 8 topically administered haemoglobin treatments over a 4-week period. Standard wound cleansing and dressing management were continued, with no changes to pre-evaluation regimens, and care being provided by the patients themselves or by a carer. Data were collected weekly with regard to primary outcomes of slough reduction, wound surface area reduction, patient ease of use (self-care), and overall product experience. Results: At 4 weeks, all wounds demonstrated positive measured endpoints of slough elimination and continued wound-size reduction. Patients and carers found the product easy to use (self-caring) with an overall positive wound care experience. Conclusion: The administration of a haemoglobin spray solution o...