title: Wound care in primary health care: district nurses' needs for co-operation and well-functioning organization.
abstract: Most patients with leg- and foot ulcers are managed within non-institutional care. The aim of this study was to investigate the district nurses' wound management, including wound appearance, assignment of responsibility, guidelines for wound treatment and co-operation with other professional groups. The study has a descriptive quantitative approach. Data was collected using a wound registration form and a questionnaire. The selection of participants was made by random sampling. District nurses (n = 26) in five health-care centers situated in central Stockholm and two of its suburbs, participated in the study. The results show that the wound appearance is dominated by traumatic wounds. Approximately 40% of the wounds were not medically diagnosed. The area of responsibility of different professional groups was not defined and guidelines for wound treatment were mostly lacking. The decision about wound management was generally made by the district nurse. Co-operation with the general practitioner was lacking and when a consultation with dermatologist was required, the routines concerning referral were undefined. Co-operation with the assistant nurses consisted of redressing the wounds in home care. Interprofessional co-operation was regarded as important for wound healing. The paper provides insights into the district nurses' wound management and co-operation in wound care.
authors.affiliation: Department of Neurobiology, Care Sciences and Society Division of Nursing, Karolinska Institutet, Stockholm, Sweden. anne.friman@ki.se
authors.forename: Anne
authors.initials: A
authors.lastname: Friman
authors.forename: Birgitta
authors.initials: B
authors.lastname: Klang
authors.forename: Britt
authors.initials: B
authors.lastname: Ebbeskog
mesh_terms: D000328:Adult; D003625:Data Collection; D005260:Female; D006767:Hospitals, District / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D020380:Needs Assessment; D015279:Organizational Culture; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013548:Sweden; D014945:Wound Healing; D014947:Wounds and Injuries / Q000451:nursing*