{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:26:02Z","timestamp":1787703962586,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Hard\u2010to\u2010heal wounds place a major burden on patients and the Canadian health system, underscoring the need to strengthen workforce capacity in skin health and wound management. This mixed\u2010methods program evaluation examined two education programs implemented in Ontario home and community care: one for regulated interprofessional providers and one for personal care providers. Quantitative data were collected through pre\u2010, mid\u2010 and post\u2010program surveys, and qualitative data through open\u2010ended survey responses and focus groups. Between 2022 and 2025, 164 regulated providers and 203 personal care providers graduated. Across both programs, participants reported increased confidence in prevention, assessment, treatment, communication, teamwork and application of best practices. Importantly, confidence was interpreted as a proxy indicator for readiness to change practice rather than a stand\u2010alone endpoint. Survey and focus group findings indicated that participants applied learning in practice through earlier identification of skin concerns, more effective escalation and communication with interprofessional colleagues, increased use of best practices and greater attention to prevention. Confidence gains ranged from 30% to over 50% in the regulated\u2010provider program and 20% to 45% in the personal care provider program. Qualitative findings reinforced the impact of increased confidence in practice and included improved prevention focus, communication and changes in practice. Thus, these programs, by increasing confidence and self\u2010reported changes in practice, enhanced learners' capacity to deliver quality skin health and wound care. Practice capacity was operationalised in this study as a multidimensional construct that includes role\u2010appropriate knowledge, confidence, readiness to apply evidence\u2010informed practices, communication and escalation behaviours and participation. These programs offer a scalable model to enhance wound care capacity and support health\u2010system sustainability in Canada. Economic outcomes, while not formally measured in this work, should be examined in future studies, as the findings reflect a promising approach to cutting the cost curve in skin health and wound care.<\/jats:p>","DOI":"10.1111\/iwj.70999","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:58:40Z","timestamp":1786006720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Building Practice Capacity in Skin Health and Wound Management in Canada: A Mixed\u2010Methods Evaluation of Two Education Programs in Home and Community Care"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0801-2749","authenticated-orcid":false,"given":"Janet L.","family":"Kuhnke","sequence":"first","affiliation":[{"name":"Cape Breton University  Sydney Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Botros","sequence":"additional","affiliation":[{"name":"Wounds Canada Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irmajean","family":"Bajnok","sequence":"additional","affiliation":[{"name":"Wounds Canada Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darian T.","family":"Cheng","sequence":"additional","affiliation":[{"name":"North York General Hospital  North York Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Rey","sequence":"additional","affiliation":[{"name":"Registered Nurses' Association of Ontario  North York Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Wounds Canada Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Grinspun","sequence":"additional","affiliation":[{"name":"Registered Nurses' Association of Ontario  North York Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/00091383.2014.896705"},{"issue":"3","key":"e_1_2_11_3_1","article-title":"Wound Care Respondents' Voices During COVID\u201019: Canadian Qualitative Serial Survey\u2014Final Results","volume":"14","author":"Kuhnke J. L.","year":"2023","journal-title":"Wounds International"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14522"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.56885\/032346qumxzp"},{"key":"e_1_2_11_6_1","unstructured":"Registered Nurses' Association of Ontario \u201cWounds Canada and RNAO Join Forces to Launch New Interdisciplinary Wound Care Champion Program Aimed at Regulated Health Professionals in Ontario \u201d2022 https:\/\/rnao.ca\/news\/media\u2010releases\/wounds\u2010canada\u2010and\u2010rnao\u2010join\u2010forces\u2010to\u2010launch\u2010new\u2010interdisciplinary\u2010wound\u2010care."},{"key":"e_1_2_11_7_1","volume-title":"Best Practice Recommendations for Skin Health and Wound Management 2025","author":"Kuhnke J. L.","year":"2025"},{"key":"e_1_2_11_8_1","volume-title":"Pressure Injury Management: Risk Assessment, Prevention and Treatment","author":"Registered Nurses' Association of Ontario (RNAO)","year":"2024"},{"key":"e_1_2_11_9_1","volume-title":"Diabetic Foot Ulcers: Prevention, Assessment and Management","author":"Registered Nurses' Association of Ontario (RNAO)","year":"2024"},{"key":"e_1_2_11_10_1","volume-title":"People\u2010centred Care","author":"Registered Nurses' Association of Ontario (RNAO)","year":"2025"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.47"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2022.08.003"},{"key":"e_1_2_11_13_1","article-title":"Leading Change Through Social Movement","author":"Grinspun D.","year":"2020","journal-title":"Registered Nurses' Association of Ontario (RNAO)"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/3462928"},{"key":"e_1_2_11_15_1","volume-title":"Best Practice Champions Network: Nursing Knowledge in Action","author":"Registered Nurses' Association of Ontario","year":"2023"},{"key":"e_1_2_11_16_1","unstructured":"Wounds Canada RNAO \u201cAccredited Wound Care Champion Program: Description of Program Standards of Quality and Graduate Competencies \u201d (2025)."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010020\u20100975\u20102"},{"key":"e_1_2_11_18_1","unstructured":"Institute for Healthcare Improvement \u201cQI Essentials Toolkit \u201d(2015) https:\/\/www.ihi.org\/resources\/Pages\/Publications\/default.aspx."},{"key":"e_1_2_11_19_1","volume-title":"The CIPP Evaluation Model: How to Evaluate for Improvement and Accountability","author":"Stufflebeam D. L.","year":"2017"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732318821692"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_11_22_1","volume-title":"Qualitative Research in Psychology","author":"Braun V.","year":"2020"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/qup0000196"},{"key":"e_1_2_11_24_1","volume-title":"Wound Care Champion Program: Ontario 2022\u20132025 Final Program and Evaluation Report","author":"Wounds Canada and the Registered Nurses' Association of Ontario (RNAO)","year":"2025"},{"key":"e_1_2_11_25_1","volume-title":"Transforming Nursing Through Knowledge: Best Practices for Guideline Development, Implementation Science, and Evaluation","author":"Bajnok I.","year":"2018"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70999","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.70999","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:15:11Z","timestamp":1787703311000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/iwj.70999"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70999","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70999"}}