{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T13:10:19Z","timestamp":1756300219931,"version":"3.44.0"},"reference-count":13,"publisher":"Mark Allen Group","issue":"Sup9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Community Nurs"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Chronic wounds are highly prevalent among older adults in care homes and place significant demands on healthcare systems. This article reports on the design, implementation and early impact of a new tissue viability nursing referral pathway for care homes in NHS Lothian, developed through quality improvement methodologies. <\/jats:p><\/jats:sec><jats:sec><jats:title>Aims:<\/jats:title><jats:p> The initiative aimed to increase direct access for registered nurses in care homes to specialist tissue viability nursing advice via a secure e-clinic referral process, supported by training, standardised equipment and a bespoke data tracker. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Using the model for improvement and plan-do-study-act cycles, a collaborative team developed a governance-compliant process that included the provision of secure email, wound cameras and structured guidance. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Following pathway implementation in February 2024, annual referral rates from care homes rose from under 150 to approximately 280, suggesting a previously unmet need for tissue viability nursing support. Most referrals were for pressure ulcers and venous leg ulcers, reflecting previously known wound burdens in long-term care. Evaluation data also suggested a potential reduction of 262 district nursing visits in the first year, with care home staff reporting improved responsiveness, confidence and resident outcomes. Challenges included digital infrastructure compatibility and ongoing staff support. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The project demonstrates how collaborative quality improvement approaches can enhance community wound care, improve integration between health and social care sectors, and optimise use of specialist nursing resources. With an ageing population and increasing wound complexity in care homes, such models offer scalable solutions to address workforce pressures and improve equitable access to tissue viability expertise. <\/jats:p><\/jats:sec>","DOI":"10.12968\/bjcn.2025.0112","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T12:42:26Z","timestamp":1756298546000},"page":"S30-S37","source":"Crossref","is-referenced-by-count":0,"title":["Creating connections: a new referral pathway for tissue viability nursing in care homes through quality improvement"],"prefix":"10.12968","volume":"30","author":[{"given":"Helen","family":"Ramsay","sequence":"first","affiliation":[{"name":"Lead Nurse Tissue Viability, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Galbraith","sequence":"additional","affiliation":[{"name":"Associate Quality Improvement Advisor, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Newman","sequence":"additional","affiliation":[{"name":"Quality Improvement Advisor, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynsay","family":"Ward","sequence":"additional","affiliation":[{"name":"Tissue Viability Nurse Specialist, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Pringle","sequence":"additional","affiliation":[{"name":"Team Lead, Quality Improvement and Standards for Care Homes and Primary Care, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleanor","family":"Wakenshaw","sequence":"additional","affiliation":[{"name":"Tissue Viability Nurse Specialist, NHS Lothian, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikki","family":"Brash","sequence":"additional","affiliation":[{"name":"Tissue Viability Nurse, NHS Lothian UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Scott","sequence":"additional","affiliation":[{"name":"Tissue Viability Nurse, NHS Lothian"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliet","family":"MacArthur","sequence":"additional","affiliation":[{"name":"Chief Nurse Research and Development, NHS Lothian; Honorary Professor of Practice, Queen\u2019s University, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2005.016527"},{"key":"B2","first-page":"14","volume-title":"ABC of quality improvement in healthcare","author":"Evans K","year":"2020"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009283"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045253"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2017.26.6.292"},{"issue":"1","key":"B6","first-page":"1","volume":"2","author":"Ilie G","year":"2010","journal-title":"Manag Res Pract."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2023.06.001"},{"key":"B8","volume-title":"The improvement guide: a practical approach to enhancing organizational performance","author":"Langley GJ","year":"2009","edition":"2"},{"issue":"5","key":"B9","first-page":"30","volume":"37","author":"MacDonald J","year":"2023","journal-title":"J Community Nurs"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13325"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2023-016674"},{"issue":"3","key":"B15","first-page":"44","volume":"104","author":"Posnett J","year":"2008","journal-title":"Nurs Times"},{"key":"B20","volume-title":"Quality with compassion: the future of nursing education","author":"Willis Commission","year":"2012"}],"container-title":["British Journal of Community Nursing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/bjcn.2025.0112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T12:42:29Z","timestamp":1756298549000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/10.12968\/bjcn.2025.0112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":13,"journal-issue":{"issue":"Sup9","published-print":{"date-parts":[[2025,9,1]]}},"alternative-id":["10.12968\/bjcn.2025.0112"],"URL":"https:\/\/doi.org\/10.12968\/bjcn.2025.0112","relation":{},"ISSN":["1462-4753","2052-2215"],"issn-type":[{"value":"1462-4753","type":"print"},{"value":"2052-2215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]}}}