Abstract
The nurse practitioner is emerging as a new level and type of health care. Increasing specialisation and advanced educational opportunities in nursing and the inequality in access to health care for sectors of the community have established the conditions under which the nurse practitioner movement has strengthened both nationally and internationally. The boundaries of responsibility for nurses are changing, not only because of increased demands but also because nurses have demonstrated their competence in varied extended and expanded practice roles. The nurse practitioner role reflects the continuing development of the nursing profession and substantially extends the career path for clinical nurses.
This paper describes an aspect of a large-scale investigation into the feasibility of the role of the nurse practitioner in the Australian Capital Territory (ACT) health care system. The paper reports on the trial of practice for a wound care nurse practitioner model in a tertiary institution. In the trial the wound care nurse practitioner worked in an extended practice role for 10 months. The nurse practitioner practice was supported, monitored and mentored by a clinical support team. Data were collected relating to a range of outcomes including definition of the scope of practice for the model, description of patient demographics and outcomes and the efficacy of the nurse practitioner service.
The findings informed the development of clinical protocols that define the scope of practice and the parameters of the wound care nurse practitioner model and provided information on the efficacy of this model of health care for the tertiary care environment. The findings further suggest that this model brings expert wound care and case management to an at-risk patient population. Recommendations are made relating to ongoing research into the role of the wound care nurse practitioner model in the ACT health care system.

Abstract
Chronic sinusitis is a very common condition requiring surgery if medical treatment fails. In fact, diseases relating to the nose and paranasal sinuses are one of the most common health care complaints in Australia and the USA (18 per cent). Although a proportion of these infections respond well to medical treatment, there remain a significant number of patients who develop chronic sinusitis requiring surgery.
After endoscopic sinus surgery (ESS) it is common practice to place nasal packing material in the operated area to prevent adhesions from forming. Although many different packs have been used clinically, there is little evidence of their effects on the repair of the nasal mucosa or on the formation of adhesions. This paper examines a sheep model developed for ESS which shows that different packing materials can affect the re-epithelialisation of wounds created in the nasal mucosa. The incorporation of bioactive agents into these packing materials could offer significant advantages in the healing of the nasal mucosa and may also help to reduce adhesions from forming. Improved healing would lead to reduced numbers of patients with recurrent chronic sinusitis.

Abstract
This paper describes a multi-site evaluation of the Alfred/Medseed Wound Imaging System (AMWIS). The evaluation comprised laboratory testing followed by trials at 34 clinical sites in five Australian states over a 12 month period. The aim was to determine its planimetric accuracy and clinical utility. AMWIS was developed to improve the precision of measurement and documentation of wounds through the use of digital still imaging and processing techniques. AMWIS allows the clinician to measure a wound and its component areas at the millimetre level as well as calculating wound volume, and document a range of wound characteristics and treatment.
A total of 79 patients had wound measurements performed and tracked on 100 wounds, generating data on 440 wound images. This enabled the determination of the system’s accuracy and efficacy in wound surface area measurement and clinical utility. Results of laboratory planimetric testing produced a measurement error rate of +1.28 per cent in repeated measures of standard geometric two dimensional objects (n=360, p<0.01). Planimetric accuracy in clinical use was 94.9 per cent (n=440). Clinician evaluations indicated that AMWIS provided more accurate wound measurements, improved documentation, decreased the time required for wound assessment and increased the capability for conducting wound care research.

Abstract
This article has been drawn from a workshop presentation of the same name given at the First World Wound Healing Congress in Melbourne, September 2000. The thoughts and concepts presented within this article are offered as a means of assisting clinicians who work primarily within the community to marry the theoretical management of venous leg ulceration (VLU) with the reality of clinical practice. When it comes to assessing each individual patient, adjustments to clinical practice guidelines sometimes need to be made in order to provide individualised patient care. This article is a selection of handy hints gained from clinical experience that may be useful for other clinicians to consider in the management and education of patients with VLU. In this article, the causes of lower leg ulceration, venous ulceration and the principles of VLU management and compression therapy will be discussed. Handy hints related to the use of moisturisers, padding under bandages, itchy skin, zinc impregnated bandages and ways to facilitate easy donning of compression stockings will also be discussed.