Given the broad range of potential causes of wound disruption, clinical and system reviews should be conducted to identify latent causes and determine appropriate recommendations.
Occurrences of harm are often complex with many contributing factors. Organizations need to:
- Measure and monitor the types and frequency of these occurrences.
- Use appropriate analytical methods to understand the contributing factors.
- Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.
- Have mechanisms in place to mitigate consequences of harm when it occurs.
To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the Hospital Harm Improvement Resource.
If your review reveals that your cases of wound disruption are linked to specific processes or procedures, you may find these resources helpful:
- Agency for Healthcare Research and Quality (AHRQ) www.ahrq.gov
- American Journal of Health-System Pharmacy https://academic.oup.com/ajhp
- Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283. doi:10.2146/ajhp120568 http://www.ajhp.org/content/70/3/195.long
- Bone Joint https://online.boneandjoint.org.uk/loi/bjj
- Canadian Journal of Infectious Diseases and Medical Microbiology https://www.hindawi.com/journals/cjidmm
- Canadian Patient Safety Institute (CPSI) www.patientsafetyinstitute.ca
- Centers for Disease Control and Prevention www.cdc.gov
- Diabetes Care
- Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologist and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009; 32 (6):1119-1129. doi: 10.2337/dc09-9029. http://care.diabetesjournals.org/content/32/6/1119
- Institute for Healthcare Improvement (IHI) www.ihi.org
- National Institute for Health and Care Excellence (NICE) www.nice.org.uk
- Society of Obstetricians and Gynaecologists of Canada www.sogc.org
- The Society for Healthcare Epidemiology of America (SHEA) https://www.shea-online.org/
- Wound Care Canada www.woundscanada.ca
- Wounds Australia : Wounds Australia Homepage - Healing Wounds Together
- Wounds International www.woundsinternational.com
- Ousey K, Djohan R, Dowsett C, Ferreira F, Hurd T, Romanelli M, Sandy-Hodgetts K. World Union of Wound Healing Societies (WUWHS) Consensus Document. Surgical wound dehiscence: improving prevention and outcomes. Wounds International, 2018. https://www.woundsinternational.com/download/resource/7394