T.I.M.E. clinical decision support tool (CDST)

The prevalence of chronic wounds is growing, with clinicians facing increased expectations – despite time and budget restrictions – and more patients treated by non-specialists who need additional guidance. When inconsistencies and limited involvement from other specialists may result in delayed wound healing, there’s a need to structure and simplify clinical practice1-3

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Systematic consistency in wound care practice

Currently, in current chronic wound care:

  • 24% of patients live with a chronic wound for at least 6 months3
  • Increasingly, generalist nurses are treating complex wounds with limited training2
  • Specialist team referral and treatment changes vary from 0 days to over 2 months4

T.I.M.E. CDST offers holistic wound and patient assessment, facilitating multidisciplinary team involvement to promote systematic consistency and confidence for even non-specialist clinicians.

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Evolving the T.I.M.E. concept

The T.I.M.E. concept began in 2003 with a group of wound management experts who sought a rational, systematic approach to guide wound bed preparation and address non-healing wounds by identifying and removing barriers to healing.7

Seeking a wider, multi-disciplinary and holistic approach that reviewed all patient circumstances, the T.I.M.E. CDST considered other developments, such as:6-12

  • The need for repetitive wound cleansing, maintenance and debridement
  • Bacterial continuum, biofilm concepts and antibiotics resistance
  • Moisture balance, advanced dressings for exudate management and novel treatment modalities for epithelial advancement

The result is a framework that’s easy to implement, teach and use for consistent wound assessment and evidence-based decision-making.4-12

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Download T.I.M.E. CDST

Implementing and using T.I.M.E. CDST

Achieve simplification and systematic consistency in practice by implementing the five-step framework:8-11

Evidence and case studies

Clinical experts continue to analyse the contribution of T.I.M.E. CDST in building systematic consistency and confidence in clinical practice.

Related technologies

Disclaimers

The products used in the T.I.M.E. clinical decision support tool may vary in different markets. Not all products referred to may be approved for use or available in all markets. Please consult your local Smith+Nephew representative for further details on products available in your market.

Citations

1. Guest et al. JWC. 2017 26(6): 292-303.

2. Guest JF, et al. BMJ Open 2020;10:e045253.

3. Rossington A, et al. Wounds UK. 2013;9(4):91-95).

4. Ousey K, et al. Wounds International. 2018;9(4):58-62.

5. World Union of Wound Healing Societies. Consensus document. Strategies to reduce practice variation in wound assessment and management: The T.I.M.E. Clinical Decision Support Tool. Available https://www.wuwhs.com/web/index.php?option=comcontent&view=article&id= 51. Accessed March 2020.

6. Moore Z, et al. J Wound Care. 2019;28(3):154-161.

7. Schultz GS, et al. Wound Rep Reg 2003; 11:1-28.

8. Swanson T, et al. Wounds International. 2019;10(2):38–47.

9. Jelnes R, et al. Wounds International. 2019;10(3):40–44.

10. Woo K. Wounds International. 2019;10(2):38–47.

11. Walters S, et al. Wounds International. 2019;10(4):32-39.

12. Blackburn J, et al. Wounds International. 2019;10(4):40-49.

13. Atkin L. 2014; 23, pp. S10-5

14. Wilcox JR, et al. JAMA Dermatol, 2013; 149(9)

15. Grothier L. British Journal Of Community Nursing, 2015; 20, Sup9, pp. S25-31.

16. European Wound Management Association (EWMA). Position Document: Wound Bed Preparation in Practice. London: MEP Ltd, 2004

17. Schultz G, et al. Wound Repair Regen,2005 13, S1–11.

18. Chamanga E. British Journal Of Community Nursing, 2015; 20, Sup9, pp. S8-S10.

19. Leaper DJ, et al. Int Wound J 2012; 9 (Suppl. 2):1–19

20. World Union of Wound Healing Societies (WUWHS). Principles of best practice: Wound exudate and the role of dressings. A consensus document. London: MEP Ltd, 2007.

21. Pudner R. Dermatological Nursing, 2015; 14, 2, pp. 32-36.

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