Regional Initiatives

Wound Care in Quebec

by Yvette Moulin

About the author Yvette Moulin, RN, BSc, MSc, currently works in the front-line services at a CLSC in a suburb of Montreal, after working in surgery, long-term care, health-care teaching and home care. In 1999, she attended the first International Interdisciplinary Wound Care Course at the University of Toronto, which was conducted in collaboration with Johns Hopkins University in Baltimore, U.S. and Cardiff University in Wales. She has had an interest in wound care for five years.

Working in the area of community health, I was deeply touched by the needs of individuals under my care. The increasing complexity of wound care, the disparity in practices and the lack of clinical support were the triggering elements of my reflections. I was being confronted with two dilemmas. Should I continue in this field of intervention or find another orientation? Should I provide only the prescribed care, while my clientele needed more, or increase my knowledge to better optimize healing while contributing to the improvement of my clientele’s quality of life?

That’s why I registered in 1997 for a session on wound care, offered by the University of Sherbrooke. In 1999-2000, I took the International Interdisciplinary Wound Care Course at the University of Toronto. During this last session, the 10th module consisted of completing a selective defined by a learning contract.

The purpose of my contract was to produce a paper about the healing process for potential publication. At that time, I wanted to share my knowledge with all the Quebec nurses. In light of the encouragement of Drs. Diane Krasner and Garry Sibbald during their evaluation of the work accomplished, I then made a proposal to the editorial team at the official journal of my professional association, the Ordre des infirmières et infirmiers du Québec (OIIQ).

Since the length of my paper was over the required criteria for publication, the chief editor proposed to split up the text into six parts and to produce a series of articles. Bimonthly publication was planned from September 2001 to August 2002.

The six articles were then published according to this proposal.
1. Understanding the healing process focuses on the biological process of healing and its advantages in a controlled moist environment.
2. Overview of wound classification addresses the classification of wounds as an invaluable communication tool between various practitioners in clinical practice.
3. Harmful factors to healing explains the main factors likely to adversely affect the healing of a wound.
4. Abnormal healing and skin complications puts the emphasis on infectious, inflammatory, degenerative, traumatic, neoplastic and proliferative complications.
5. Dressings describes the main classes of dressings and the basic rules for making an adequate choice.
6. Bioactive dressing is an overview of growth factors and skin substitutes as treatment of refractory wounds.

The main messages of these articles focus on a better quality of care and life for the patient. In particular, they underscore:

• The knowledge of the patient’s health and the progression of their wound, normal or abnormal.
• The active participation of the patient (and/or their caregiver) in the treatment of their wound (self-care) and their co-operation in reporting any abnormality or symptom that could interfere with the healing process.
• Effective communication between practitioners within the multi- or interdisciplinary team.

Members of the Council of Quebec Nurses have shown interest in this series on wound care and have recommended the publication of a reprint of the six articles. The Committee of the editorial board of the Ordre des infirmières et infirmiers du Québec has proceeded with this recommendation.

The document is currently available (in French only) at the office of the provincial order: 4200 Dorchester Blvd. West, Montreal, Quebec H3Z 1V4. The first two articles were included in the magazine contest of the journal L’Infirmière du Québec. They earned the first prize as the preferred articles published in 2001.

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Last modified: November 4, 2003