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A duty to reflect on practice

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VOL: 97, ISSUE: 35, PAGE NO: 39

Louise Gibson, BSc, RGN, DipHE, PGCertEd, is lecturer at the Florence Nightingale School of Nursing and Midwifery, King's College, London

There has been a lot of government interest in wound care this year, as demonstrated by the publication of The Essence of Care benchmarks (Department of Health, 2001), the release of some of the first guidelines to be issued by the National Institute for Clinical Excellence which focus on pressure ulcer risk assessment and prevention (NICE, 2001a) and the publication of the technology appraisal Guidance on the Use of Debriding Agents and Specialist Wound Care Clinics for Difficult-to-Heal Surgical Wounds (NICE, 2001b), among others.

There has been a lot of government interest in wound care this year, as demonstrated by the publication of The Essence of Care benchmarks (Department of Health, 2001), the release of some of the first guidelines to be issued by the National Institute for Clinical Excellence which focus on pressure ulcer risk assessment and prevention (NICE, 2001a) and the publication of the technology appraisal Guidance on the Use of Debriding Agents and Specialist Wound Care Clinics for Difficult-to-Heal Surgical Wounds (NICE, 2001b), among others.

All these publications reinforce the message that practitioners must take responsibility for their practice, particularly when examining the evidence available for wound care interventions. The guidance on the use of debriding agents (NICE 2001b) provides one example of the need for further research to strengthen the evidence base underlying treatment decisions.

Taking action in this respect is of paramount importance if nurses are to deliver a quality wound care service, but it is often difficult to know how to improve a service or initiate and implement change.

The acquisition of knowledge - through further education, attending conferences and reading journals, for example - can play a part in helping the practitioner to maintain or improve standards, but is such knowledge always put to good use? In some instances it is probably compartmentalised and never used again, or perhaps nurses want to bring about change but are unable or afraid to do so. Alternatively, they may be motivated to explore and reflect on their practice.

The average response is probably a combination of all three, but it is the latter that should be encouraged. Nurses have a duty to reflect on all aspects of practice, no matter how insignificant some areas may seem. Such activity will help highlight areas that require change and encourage realistic and achievable goals. It will also call attention to areas for nursing research.

The annual wound care conferences reach a peak next month with a unique event that combines the UK 'Wound Care in Context' conference and the 11th European Tissue Repair Society annual conference. A plethora of subjects will be covered during the week, including information on how your research can make a difference. I hope this event encourages delegates to share and disseminate good practice and that it motivates them to take up the gauntlet, challenge practice and influence the future direction of wound care.

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