Advice Support Tool

Theme: Wound and Pressure Care Supports Sub-Theme(s): Consumables, Nursing Supports References: [include any relevant referenced documents] NDIS Act 2013 Section 34 1. (a) - (f) and 2. NDIS Support for Participant Rules 2013 Recent wound assessment and/or management plan completed by RN/CNC Product Estimate/Quote for Consumables Wound and Pressure Care Supports. OG

Note: All criteria need to be met for the supports to be funded through the NDIS.

Criteria for reasonable and necessary	Is criteria	Considerations (including evidence used)
34.1(a) Enabling the participant’s goals and objectives (supports will assist the participant to pursue the goals and objectives in their plan)	Yes →	The participant may not have a specific goal regarding wound care, however, consider how the management of wounds and pressure may underpin and assist the participant to pursue their stated goals. `s47E(d) - certain operations of agencies`
34.1(b) Assist the participant’s social and economic participation (supports will assist the participant to undertake activities to facilitate their social and economic participation)	Yes →	Wounds and Pressure Injuries are `s47E(d) - certain operations of agencies` With adequate wound and pressure management supports and wound prevention the participant’s opportunities to access and engage in social and economic participation increases. `s47E(d) - certain operat`

Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)

34.1(c) Value for money	Yes >	Has there been a recent wound management plan and/or wound assessment provided by a Registered Nurse or Wound Clinical Nurse Consultant outlining wound management plan, including dressings required, frequency and cost of dressings?

Do the dressings quoted/cost estimated match the dressings, quantities and frequency outlined in the wound management plan? Is the request for, or quantity of, each consumable supported by evidence in the wound management plan or wound assessment? S47E(d) - certain operations of agencies

Does the wound assessment/management plan outline the ongoing management or expected timeframe the wound management will be required?

Are there comparable support options which would achieve the same outcome at a substantially lower cost? What alternative supports were considered?

Is there evidence that the support will substantially improve the life stage outcomes and be of long-term benefit to the participant?

Is there evidence that funding support is likely to increase independence and reduce funded support costs in the long-term?

Is there evidence the support will increase the participant’s independence and reduce the participant’s need for other kinds of supports?

Are the recommendations for appropriate delegation of care realistic in a community setting? For example, S47E(d) - certain operations of agencies

Is there evidence the quoted support cost is comparable to expected cost of same kind of supports? S47E(d) - certain operations of agencies |

Criteria for reasonable and necessary

supports

Is criteria met?

Considerations (including evidence used) s47E(d) - certain operations of agencies

Is there evidence that the participant can manage their pressure prevention and wound management themselves or with informal support? s47E(d) - certain operations of agencies

34.1(d) Support is effective or beneficial for the participant (supports will be, or are likely to be, effective for desired effect and beneficial for the participant, having regard to current good practice) Consider NDIS Support for Participant Rules 2013 Part 3.2 and 3.3 What are the expected benefits of the support provision? How will effectiveness of achieved outcome be measured? When will effectiveness of achieved outcome be achieved? Are there other supports required to achieve or maximise the reported support outcomes for participant?

Has the participant’s wound management been recommended by an appropriate clinician (RN, CNC)? Has support for wound management been provided previously? redacted Is there evidence that the participant has had wound prevention AT and consumables in place? redacted Has the participant requested continence consumables which include s47E(d) - certain operations of agencies

Criteria for reasonable and necessary supports

Criteria for reasonable and necessary supports	Is criteria met?	Considerations (including evidence used)

s47E(d) - certain operations of agencies
Has evidence been provided of management of the participant’s wounds in the acute phase?
If the participant is unable to manage their wound management/pressure management independently,
34.1(e) Support coordinates with but does not replace informal support (funding or provision of supports takes account of what it is reasonable to expect families, carers, informal networks and the community to provide)
Consider NDIS Support for Participant Rules 2013 Part 3.4
Yes	Informal supports may be able to provide some support (particularly for children) in regard to support with repositioning and basic wound prevention and management.
However, as wounds become more severe or the participant requires more s47E(d) - certain operations of agencies


34.1(f) Support is most appropriately funded by the NDIS (supports are not more appropriately funded or provided through other general service systems or universal service obligations)
Consider NDIS Support for Participant Rules 2013 Schedule 1.
Yes	If the participant is an inpatient in hospital and the wound is acute or chronic, or the wound is in its acute phase (<12 weeks present) or not disability related, it is the responsibility of the health system to manage the participant’s wounds. Note: at times, chronic wounds may be considered acute due to their high risk of infection, deterioration, changing status or risk of harm to the participant and while they have been present for >12 weeks may be more appropriately managed and overseen by mainstream health teams.

Criteria for reasonable and necessary supports

Is criteria met?

Considerations (including evidence used)

Maintenance of skin integrity and pressure prevention where it is disability related is the responsibility of the NDIS, s47E(d) - certain operations of agencies

Support will not cause harm

(Supports will not be funded if it is likely to cause harm to the participant or pose a risk to others, or the support would be contrary to a law of a jurisdiction)

Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.3

Yes →
No →

Has there been risk of infection or harm to the participant identified in the wound assessment that may identify this support being better managed by health. At times chronic wounds may be considered acute due to their high risk of infection, deterioration, changing status resulting in an increased risk of harm to the participant and while they have been present for >12 weeks may be more appropriately managed and overseen by mainstream health teams.

Consumables and AT such as Vacuum-Assisted Closure (VAC) dressings should be prescribed by a medical team or CNC and the oversight of this should remain with the medical team.

| Criteria for reasonable and necessary Is criteria Considerations (including evidence | supports met? used) | Support is directly related to the & Yes > | Has evidence been provided that directly links the wounds to the participant’s disability? (supports will not be funded under the NDIS |EINo —>| Participant’s disability if they do not relate to the participant’s disability or are day-to-day expenses or income replacement) Consider NDIS Support for Participant Rules 2013 Part 5.1 and 5.2 Is the wound disability related and Support does not duplicate other Yes ~~ | Has the participant requested does not duplicate other supports continence consumables which (supports do not duplicate other supports O No — ee beateetirbes ae wis delivered under alternative funding through idered duplicati f rt? the NDIS such as Information, Linkages and ver ere Cee Cae Capacity Building (ILC) funding.) Consider NDIS Support for Participant Rules 2013 Part 5.1 Are all of the above criteria met for all Yes ~~ supports? ONo —~>

Version Control

Version #	Status	Date	Modified by	Brief Description of Modification
V1.0	Cleared	01/09/2023	KIM222	Production of initial V1.0
V1.0	Cleared	05/09/2023	JIF775	Transferred to Key Advisor Advice Resources repository

Note: Document uncontrolled in hard copy