Jacqui Fletcher has just returned from a trip to Malaysia where she delivered a wound assessment and management course to local nurses. We asked Jacqui to describe some of her experiences
Q. How does wound care in Malaysia compare with the UK?
A. Wound care in the UK and Malaysia is very different. Malaysia is probably 5 – 10 years behind us in terms of practice.
Q. What does this mean in practice?
A. There are wound teams in some hospitals but the range of products they have access to is limited. They may use piped oxygen locally on wounds. They also use wall suction and a plastic bag or plastic film to create topical negative pressure therapy as they can not afford the commercially available options.
Q. Do these marked differences in practice present problems when you are delivering a wound care course?
A. The nurses are mainly trained at certificate or diploma level and are now topping up to degree and the standard of English was very good.
In terms of delivering UK courses internationally there is always a lot to consider. In the class room the nurses were very similar to UK students, however the practice is at a different stage of development. This can create a dilemma when marking. For example, putting oxygen directly on a wound would be viewed as professionally unacceptable in the UK but you have to view the Malaysian nurses practice in the context of where they are now. This has to be reflected in the way assignments are marked which can create problems for markers who have not been to Malaysia. They need to be aware of what is accepted practice in that country.
Q. Will the course change practice?
A. The nurses on the course are really committed and motivated they have already changed policies and practice. For example, chlorhexidine, povidone-iodine and EUSOL were used for wound cleansing but nurses are now using saline. Links between pain and wounds have not always been made but they now are including pain assessment in their wound care. Wound swabbing practices have been changed in one hospital.
Doctors have taken the lead role in wound care in Malaysia and at the end of the course we held a seminar and the students brought their surgeons and senior nurses to it. By the end of the session half of the surgeons had agreed to support a Malaysian Wound Care Society and a Malaysian Wound Care conference.
Q. How did the nurses fund their course?
The Malaysian government is keen to fund professional development. Nurses pay for their course place and then claim it back from a human resource development Fund. However if they receive funding then they are bonded to work in their hospital for two years.
The University of Hertfordshire runs two clinical nursing BSc Programmes and one International nursing Programme in Malaysia. Jacqui Fletcher visited the KDU college, Penang.