The Angior Trial: Community Nurse Perceptions of Wound Best Practice Initiatives

A survey of nurses from two community nursing services in two Australian States was undertaken to examine the experiences of being involved in a randomised controlled trial (RCT) using the trial intervention of two antimicrobial wound dressings – cadexomer iodine and nano-crystalline silver. The experience of using multi-layer compression bandaging as well as the impact of providing all these wound products at no cost to the client was also considered. Nurses rated the performance of the antimicrobials and compression bandaging for a number of dimensions and provided additional free text comments. Nurses at one study site answered additional questions regarding the impact of the provision of funding, sourced during the trial to provide wound products at no charge to participants who usually pay for their products. The data were analysed using chi-square tests for independence. Both products were rated by nurses as performing well. Acticoat [Smith & Nephew] was rated as performing better than Iodosorb [Smith & Nephew] for maintaining the integrity of the periwound skin, the management of wound odour and obtaining bacterial balance. However, Acticoat was not as highly regarded by nurses compared to Iodosorb for its ability to manage wound exudate. Ratings of the acceptability of compression bandaging were high overall, particularly for its capacity to manage oedema and in avoiding trauma to the wound bed during removal. The findings also suggest that cost is a substantial barrier to the provision of best practice compression bandaging among persons who ordinarily pay for these products themselves.