Abstract
In today’s health system, nursing has broadened its considerable expertise, resulting in an increase in the number and variety of specialities within clinical practice. Two essential practices that have been affected by this need for increased specialist knowledge are wound management and infection prevention and control. In many facilities both speciality practices are managed by nurses and midwives who hold speciality qualifications and are considered experts in their practice areas. However, if this level of expertise is not available, it is the responsibility of the ward clinicians to assess and manage wounds and prevent and control infections.

Abstract
Pressure ulcers are a significant iatrogenic cause of morbidity and mortality in the aged care population, with prevalence reported to be as high as 43% in some aged care facilities. The PRIME trial was a 15-month pre- and post-intervention study designed to investigate the effectiveness of an integrated pressure ulcer management system consisting of pressure ulcer risk assessment tools, Australian Wound Management Association (AWMA) guidelines, digital imaging and clinical education in reducing pressure ulcer prevalence in residential aged care facilities. A total of 1228 residents from 23 residential aged care facilities were enrolled in this Commonwealth-funded study.

The findings suggest that the PRIME intervention significantly reduced pressure ulcer prevalence risk by 52% (p<0.001) and highlighted the association between cachexia, Braden sub-scales for activity, nutrition, friction/shear and pressure ulcer risk. The study also demonstrated that following the PRIME intervention, the use of appropriate pressure ulcer risk reducing equipment was significantly increased. Overall, the results suggest that an integrated approach combining the elements of the PRIME intervention is effective in reducing pressure ulcer prevalence in the frail elderly population in residential aged care facilities.

Abstract
There is a dearth of experience and sharing of experiences by community nursing agencies in the conduct of clinical trials in the community. The objective of this research was to explore and identify the challenges and opportunities that arose when two community nursing services implemented a randomised controlled trial (RCT) in the community. An exploratory study was undertaken with the nurses responsible for implementing the trial at the operational level. Three focus group discussions were convened with the nurses. Key themes from the data were extracted and summarised. The eight key themes emerging from the analysis of the focus group data were – being part of a trial, expectations versus the real RCT experience, benefits associated with implementing the trial, responses to the trial of other nurses not directly involved in the RCT, clients’ responses to the trial experience, challenges, strategies to refine research processes and further involvement in research.

This study offers insights into the experiences of clinicians and researchers involved in implementing a clinical trial in community settings. These include what worked well, what the pitfalls were and how they might have been avoided, and strategies for organisations wishing to undertake a clinical trial or to refine their existing research processes. Additionally, some lessons for everyday practice were identified as requiring follow-up as impacting not only on the conduct of a RCT but clinical care at all times.

This paper provides guidance as to how to actively involve nurses in research not just to gather data and find study recruits, but as significant contributors to decisions about research design and implementation so that they are better equipped to inform and lead future research endeavours.

Abstract
Maggot debridement therapy (MDT) is an old form of wound care treatment that was used prior to the introduction of antibiotics. Maggots nurse a wound by the processes of debridement, disinfection, cleansing and healing. In the modern healthcare arena, new innovative methods that are being developed overseas for MDT are proving to be more acceptable to clinicians and patients – many wound care workers that have used MDT for the treatment of some chronic wounds in Australia have said they would recommend this therapy to their colleagues.

Abstract
The prevention and management of pressure injuries (ulcers) is a major concern to those involved in healthcare. Improving knowledge about pressure injuries, including the correct use of a pressure risk tool, is one way to improve overall patient care and decrease the number of hospital-acquired injuries. A staff survey identified gaps in nursing staff knowledge and so an education programme incorporating a newly devised mnemonic ‘RED FRAMES‘ was introduced. RED FRAMES reminds the clinician of various risk factors associated with pressure injury and prompts appropriate action.

Education was designed as small informal sessions held on the wards which allowed for active interaction. Sessions were reinforced by an education board which was also accessible to patients and their carers. A lanyard was produced for staff which included RED FRAMES and a description of the different pressure ulcer stages. After the introduction of these initiatives a pressure ulcer point prevalence survey conducted by the hospital showed that the number of hospital-acquired pressure ulcers had dramatically decreased. These findings may be due to factors other than the intervention and so further research is needed, including the use of RED FRAMES at other health facilities. This article describes the events