Published July 2023. Next review 2028.
This capability framework describes the knowledge, skills and management practices needed by NSW Health staff to reduce the risk of chronic wounds, and to provide effective and collaborative management for people living with a chronic wound.
Scope of the framework
The complex nature of managing chronic wounds requires a workforce that can respond and adapt to unpredictable scenarios. Improving capability is important to achieving this. The NSW Health chronic wound management capability framework (the framework) describes capability for the management:
- of all types of chronic wounds on all parts of the body, regardless of cause
- in any setting where NSW Health staff provide clinical or personal care
- by healthcare and other workers from all clinical disciplines and with varying levels of experience.
Purpose of the framework
- Guides NSW Health organisations in the essential capabilities for preventing and managing chronic wounds – organisations can determine the most appropriate way to develop these capabilities within their services.
- Complements the requirements of professional registrations, scopes of practice and policy directives.
The framework does not:
- replace local clinical procedures, business rules, professional standards or other compliance and legal requirements
- describe the specific multidisciplinary scope of practice requirements for each capability. However, it does indicate where there are likely to be scope of practice considerations related to discipline, education level or competence that need to be determined within services.
Download the full framework and development report
Chronic wound management capability framework (PDF 505.3 KB)
Chronic wound management capability framework: Development report (PDF 379.5 KB)
Using the framework
The framework has been developed for the NSW Health healthcare workforce who provide clinical and personal care to consumers with, or at risk of developing, chronic wounds.
As chronic wound management occurs in, and across, many healthcare and home settings, the framework may also be used and adapted by healthcare workers and organisations in other parts of the health system in NSW.
The framework is designed to be used in the following ways by healthcare and other care staff, managers and organisations (health services) and education and training providers.
- To identify current level of knowledge and skill to manage chronic wounds and consider how proficiency aligns with the needs of their current role and consumers
- To identify areas for professional and personal development, to set new learning goals and monitor their progression.
- As a service-level analysis tool to map the level of capability required to meet local chronic wound management needs against current workforce capability, including identifying gaps and strengths.
- To determine workforce education needs, plan development opportunities for staff, or identify the need for new or modified positions.
- As a performance development tool with individual clinicians.
- To identify learning outcomes and design curricula for chronic wound management education and training. This can include the provision of learning in pre-service education courses, clinical post-graduate courses, workplace clinical assessment and professional development programs.
Proficiency levels
Each capability in the framework is described across three progressive levels of proficiency: Foundational, Adept and Advanced.
Healthcare or other worker who:
- provides clinical or personal care to consumers, demonstrating baseline knowledge and skills required to identify and respond to altered skin integrity or wounds
- may require support to address impaired skin integrity, and wound assessment and management
- appropriately seeks assistance and escalates care to meet consumer needs.
Clinician who:
- meets all Foundational capabilities
- independently manages impaired skin integrity and chronic wounds within their scope of professional practice
- demonstrates an appropriate degree of critical analysis in the capability to assess a wound, differentiate wound types and determine treatments
- seeks expert input appropriately for complex decision-making and uses referral and escalation pathways as required.
Clinician who:
- meets all Foundational and Adept capabilities
- displays a high degree of autonomy and decision-making capability in complex chronic wound management
- may have advanced, specialist knowledge and skills
- provides leadership for wound management services.
Domains and capabilities
The framework has 6 domains, incorporating 26 capabilities in total. The capabilities describe the knowledge, skills and actions required from the health workforce to provide high quality and effective chronic wound management to consumers.
For the full matrix of capabilities and proficiencies, download the Chronic wound management capability framework (PDF 505.3 KB).
Knowledge about skin anatomy and physiology, the pathophysiology of wounds and wound healing mechanisms that underpin the ability to provide evidence-based chronic wound management.
Capabilities | Sub capabilities |
1.1 Skin anatomy, physiology and function | 1.1.1 Knowledge of skin anatomy 1.1.2 Knowledge of skin physiology |
1.2 Wound types and aetiologies | 1.2.1 Knowledge of wound types 1.2.2 Knowledge of wound aetiologies |
1.3 Wound healing and chronic wounds | 1.3.1 Knowledge of wound healing 1.3.2 Knowledge of when a wound is chronic 1.3.3 Knowledge of strategies to support wound healing |
Describe actions to identify consumers at risk of developing a wound and to prevent chronic wounds in individuals and across the community.
Capabilities | Sub capabilities |
2.1 Skin integrity and risk screening | 2.1.1 Performing skin integrity assessment 2.1.2 Performing wound risk screening |
2.2 Maintaining skin integrity | 2.2.1 Delivering skin integrity interventions 2.2.2 Collaborating with other healthcare team members for skin integrity and wound prevention |
2.3 Addressing lifestyle risk factors and co-morbidity | 2.3.1 Addressing lifestyle risk factors 2.3.2 Addressing co-morbidity |
2.4 Community awareness of wound prevention | 2.4.1 Community awareness of wound prevention |
Describes actions to ensure that consumers have comprehensive, timely, regular and responsive assessments of their wound, co-morbidities and wellbeing, and they receive an accurate diagnosis of their wound.
Capabilities | Sub capabilities |
3.1 Accurate and comprehensive assessment | 3.1.1 Observation and documentation of wound characteristics 3.1.2 Health assessments 3.1.3 Mental health and wellbeing assessment 3.1.4 Social assessment 3.1.5 End of life assessment |
3.2 Collaborating for specialist assessment | 3.2.1 Referring for specialist assessment 3.2.2 Actioning referral for specialist assessment 3.2.3 Developing specialist referral pathways |
3.3 Wound diagnosis | 3.3.1 Diagnostic testing 3.3.2 Identifying the wound diagnosis 3.3.3 Documentation of wound diagnosis 3.3.4 Consumer awareness of their wound diagnosis |
Collaborating with the consumer, their family and carers and the wider wound management team to develop and communicate an evidence-based, person-centred chronic wound management plan, and to deliver interventions for wound, lifestyle and co-morbidity management.
Capabilities | Sub capabilities |
4.1 Chronic wound management goals | 4.1.1 Identifying the consumer’s goals 4.1.2 Monitoring attainment of the consumer’s goals |
4.2 Chronic wound management plan | 4.2.1 Identifying the consumer’s preferred management options 4.2.2 Identifying evidence-based treatments 4.2.3 Accommodating personal needs in the management plan 4.2.4 Identifying service providers |
4.3 Providing chronic wound treatment | 4.3.1 Use of clinical pathways 4.3.2 Infection prevention and control 4.3.3 Wound bed preparation 4.3.4 Selection of dressings and products 4.3.5 Application of dressings and products 4.3.6 Delivery of other wound therapies |
4.4 Collaborating for chronic wound treatment | 4.4.1 Referring treatment to other clinicians 4.4.2 Referring to interdisciplinary wound management teams for treatment |
4.5. Management of co-morbidities and consumer wellbeing | 4.5.1 Management of pain 4.5.2 Supporting activities of daily living 4.5.3 Supporting mental health 4.5.4 Addressing lifestyle risk factors 4.5.5 Management of co-morbid health conditions |
4.6 Managing wound deterioration | 4.6.1 Responding to wound deterioration 4.6.2 Managing infection |
4.7 Preventing wound recurrence | 4.7.1 Advice to consumers about preventing wound recurrence 4.7.2 Follow-up care after wound closure |
Person-centred and collaborative practices underpin all interactions and stages of the chronic wound journey and experience. A focus on empowering consumers to engage in their chronic wound management and meeting the needs of consumers from priority populations are important. This involves promoting partnership between the consumer, their family and carers, communities and clinicians across healthcare settings.
Capabilities | Sub capabilities |
5.1 Health literacy, information and communication | 5.1.1 Assessing the consumer’s health literacy 5.1.2 Providing health information 5.1.3 Checking the consumer’s understanding 5.1.4 Addressing communication needs |
5.2 Enabling consumer involvement | 5.2.1 Shared decision making 5.2.2 Self-management |
5.3 Culturally safe services | 5.3.1 Learning about Aboriginal cultural safety 5.3.2 Learning about cultural safety for other priority communities 5.3.3 Collaborating with cultural workers and communities to provide culturally safe care |
5.4 Virtual care | 5.4.1 Providing clinical care using virtual care modalities 5.4.2 Communicating with the care team using virtual care modalities |
5.5 Clinical partnerships | 5.5.1 Awareness of and relationships with other chronic wound management providers 5.5.2 Coordination of care with other chronic wound service providers |
Describes a range of learning and improvement approaches required to maintain and enhance individual and service chronic wound management capability and to sustain delivery of contemporary, evidence-based services to consumers.
Capabilities | Sub capabilities |
6.1 Reflective practice | 6.1.1 Reflection on values and experiences 6.1.2 Making changes to practice based on reflection |
6.2 Learning in the workplace | 6.2.1 Seeking feedback from colleagues 6.2.2 Responding to feedback 6.2.3 Workplace clinical education |
6.3 Professional development and maintaining contemporary practice | 6.3.1 Identifying learning needs 6.3.2 Maintaining contemporary clinical practice 6.3.3 Keeping up to date with evidence-based guidelines |
6.4 Service improvement | 6.4.1 Clinical audits 6.4.2 Consumer feedback 6.4.3 Research |
Self-reflection tool
This comprehensive self-reflection tool aims to support healthcare workers to reflect on and document current capability against the Framework, and to help build confidence, capability and future development. Services are welcome to modify this tool to better meet their specific needs regarding self-reflection and capability building.
Healthcare workers can complete the tool in any of the following ways:
- all at once or focus on a few domains at a time
- individually for your own personal learning
- with a mentor
- as part of professional development with your manager.
Download the self-reflection tool (DOTM 192.1 KB)
Education map
After completing the capability self-reflection tool and identifying the wound management capabilities you wish to develop, use the capability and education map to find training.
Related resources
- Leading Better Value Care chronic wound management resources
- Wounds Australia Standards for Wound Prevention and Management (2023)
- NSW Health Services Aboriginal Cultural Engagement Self Assessment Tool
Many other clinical practice guidelines and policies cross over with chronic wound management, for example:
How was the framework developed?
The ACI collaborated with a working group of chronic wound management experts, consumer representatives and the Health Education and Training Institute (HETI) to develop the framework. Chronic wound management clinicians, consumers and education experts provided direction and content for the development of the framework, which was progressed by the ACI Chronic Wound Management project team.
Learn more about how the framework was developed:
Chronic wound management capability framework: Development report (PDF, 379.5 KB)
Acknowledgements
Thank you to the members of the Chronic Wound Management Capability Building Working Group for leading the development of this resource. The group is represented by clinicians, health managers and consumers across NSW local health districts, specialty health networks, the ACI, HETI and the Clinical Excellence Commission (CEC).