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How is wound care organised in the Netherlands? And what is the role of the wound care nurse

Ellie Lenselink

In primary care in most cases the general practitioner delegated the wound care to the home care nurse. In the Netherlands there are hundreds private home care organisations of which only the largest organisations do have wound care nurses within their own organisations. Complex wound care is referred to Wound Expert Clinics (WEC). There exist several WEC in the primary care. However, most of them are located in the secondary care. In the hospitals WEC are multidisciplinary organised. Which physicians are involved and which of them is in the lead is different per hospital land also dependent by the cause of the wound? For example, for traumatic wounds a trauma surgeon is in the lead and for venous leg ulcers it will be the dermatologist. How many specialists are involved is also dependent on the facilities available in the hospital. The role of the wound care nurse is to take care of local wound treatment but also the organiser of bringing the right physicians together to the patient, so organising multidisciplinary care and he or she is also the communicator to patient, relatives and the home care nurse. The Dutch quality standard (guideline) for organisation of wound care, has wound care divided into four wound categories basic wound care and multidisciplinary specialised wound care, both divided in emergency and not emergency. The standard integrated primary and secondary care with existing guidelines for various wound types. There are several examples of mobile wound clinics and specialised homecare in the Netherlands. The level of nurses is divided in general nurse, wound care nurse, wound consultant nurse and nurse practisioner.