Assessing the use of dressings in practice.

An audit was carried out in an NHS trust to identify the degree to which wound management products were being selected and used appropriately. Fifty patients with various types of wounds were involved; observers noted the condition of wounds at dressing changes and the procedures used, then studied each patient's hospital documentation (medical notes, nursing care plan and drug chart). Nursing staff were interviewed to ascertain the input of various disciplines in dressing choice. The 'correct' choice of dressing was made in only 48% of wounds, and correct choice and use were identified in just 20%, with wide variations between different products. A quarter of patients reported pain associated with their wounds, but none received analgesia before dressing changes. As a result of the audit, new guidelines on dressing choice and use have been produced, with others in preparation, and the hospital formulary has been amended.