Joint Multi-Disciplinary Evidence Based Practice Complex Wound Care Guideline


Name: Michele Kane

Rank: CDR

Organization: The Geneva Foundation

Performance Site: Walter Reed National Military Medical Center, Bethesda, MD

Year Published: 2012

Abstract Status: Final


Background: The purpose of this multi-phase project is to develop a joint multidisciplinary complex wound care management guideline that supports the continuation of the evidence based practice (EBP) culture of inquiry at Walter Reed National Military Medical Center (WRNMMC).  This project will utilize rigorous scientific processes to create a clinical practice guideline intended to improve patient, nursing and organizational outcomes.  Problem focused, knowledge focused and organizational triggers for this topic included:  identification of inconsistent processes in the treatment of complex wounds in our Wounded Ill and Injured (WII), retrospective identification of battlefield acquired fungal infections data which indicate an increase prevalence rate of WII returning with these type of dermatological issues, anincrease of repeated operating room serial residual limb revisions, increase in use of silicone based pseudo skin grafts, increase in support surface expenditures over previous years and verbalized staff knowledge deficits in complex wound care management  Further, the Nurse Practice Council (NPC) has requested a revision of the current complex wound care management process.  This EBP guideline development will foster future implementation of an integrated joint approach for complex wound care management at WRNMMC.  This project will result in a clinical practice guideline (CPG) for consistent care for complex wound care management across the National Capital Area (NCA) and may provide a model guideline for all medical Treatment Facilities (MTF) within the Department of Defense (DoD). Especially this project will develop a comprehensive, joint, multi-disciplinary evidence-based, complex wound care management protocol that supports an integrated practice at WRNMMC. Purpose:The primary purpose of this Evidence Based Practice project is to conceptually develop a joint multi-disciplinary complex wound care management CPG for wounded ill and injured (WII) 18-35 y/o with sustained complex wounds returning from OIF/OEF by identifying the best practices and state of the science for identification / classification, and management of complex wound care that supports the continuation of the evidence based practice (EBP) culture of inquiry at Walter Reed National Military Medical Center (WRNMMC). 

Results: Through education and guideline development, the CPG can improve clinical outcomes by ensuring the appropriate treatment of complex wounds is appropriate, consistent, and timely thus reducing mortality and morbidity among our service members.


Final Report is available on NTRL: