The implementation of the ‘Malignant Fungating Wound Guidelines and Pathway’ and its evaluation

Objective: There is a lack of research on malignant fungating wounds (MFWs), particularly their management and their impact on patients' quality of life. Therefore this study investigated the effectiveness of ‘Malignant Fungating Wound Guidelines and Pathway’ implemented in the author's NHS trust following the impact of COVID-19, an evaluation of health professionals' knowledge and, most importantly, understanding of the patient experience. Method: This quality improvement study comprised three stages. In stage 1, a literature review was conducted, which was predominately based upon online data, published articles and information gained from contacting neighbouring health trusts; this formed the guidelines and pathway. In stage 2, a pre- and a post-questionnaire were conducted, aimed at health professionals, to establish a percentage knowledge increase following the implementation of the ‘Malignant Fungating Wound Guidelines and Pathway’. Stage 3 involved interviewing 10 patients and their caregivers in order to gain an insight into the lived experience with an MFW. Results: ‘Malignant Fungating Wound Guidelines and Pathway’ was implemented and disseminated via email to external users, such as GP practices and care homes, as well as the author's NHS trust intranet. Among the 243 health professionals contacted, 100 nurses participated in an evaluation questionnaire, the results of which demonstrated an increase in knowledge of 32%. The 10 patients who were interviewed highlighted that exudate and malodour were their main issues of concern. Conclusion: An information leaflet, aimed at patients and their caregivers, was created to draw together a shared-care approach, which will ultimately enhance outcomes for service users, including community and acute settings, in the management of patients and their caregivers.