Complex Wound Management: NDIS High Intensity Daily Personal Activities


Published: 31 August 2021

Note: This article is intended for NDIS workers and providers. For a more clinically-focused article on wound care, see Wound Care: A Guide to Practice.

National Disability Insurance Scheme (NDIS) workers may need to care for NDIS participants who require assistance with complex wound care and management.

All support workers performing wound care must complete relevant training, and work under the direction of an appropriately qualified health practitioner (NDIS 2018).

This article will outline the wound care responsibilities of workers under the NDIS.

What are Complex Wounds?

Complex wounds are wounds that meet at least one of the following criteria:

  1. Unable to heal within three months
  2. Infected
  3. Compromised viability of superficial tissues, necrosis or impaired circulation
  4. Association with a systemic disorder, which impairs normal healing.

(WoundSource 2019; Tricco et al. 2015)

Types of complex wounds include:

  • Pressure injury
  • Diabetic foot ulcer
  • Venous insufficiency ulcer
  • Infected wound
  • Wounds related to vasculitis and immunosuppressive therapy, which have not healed after simple treatment.

(WoundSource 2019)

complex wound care pressure injury
Pressure injuries are a type of complex wound.

Risk Factors for Complex Wounds

Workers should be able to identify risk factors for the development of complex wounds, which may include:

  • Massive skin loss
  • Severe burns
  • Comorbidities such as peripheral vascular disease, metabolic disease (e.g. diabetes) or being immunocompromised
  • Taking certain medicines
  • History of local tissue injury, e.g. from radiation therapy or surgery
  • Sustained pressure, changes in temperature or moisture
  • The presence of other wound-related conditions including osteomyelitis, necrosis, gangrene, peri-wound dermatitis, oedema or hematoma.

(WoundSource 2019)

Complex Wound Management in the NDIS Practice Standards

Complex wound management is a requirement of the NDIS Practice Standards under the High Intensity Daily Personal Activities Module.

This Practice Standard aims to ensure that NDIS participants who require complex wound management receive appropriate support that is relevant and proportionate to their individual needs (NDIS 2020).

Under these standards, NDIS providers must meet the following quality indicators:

  • Participants are enabled to engage in the assessment and development of a complex wound management plan. This plan identifies possible risks, incidents and emergencies, and what actions need to be taken to manage these situations, including an escalation of care, if necessary. The participant’s health status is reviewed regularly (with their consent)
  • Workers who provide complex wound care are informed by appropriate policies, procedures and training plans. These relate to the supports being provided to each participant
  • Workers who provide complex wound care have received all necessary training that relates to each specific participant, either from a qualified health practitioner or another appropriately qualified individual.

(NDIS 2020)

Responsibilities of NDIS Workers

NDIS workers who are involved in complex wound management may be responsible for:

  • Recognising the risks and symptoms of pressure injuries
  • Knowing when to escalate care to a health practitioner
  • Following the participant’s wound management plan in order to inspect and replace dressings - this must be performed under the supervision of a health practitioner.

(NDIS 2018)

Required Knowledge

NDIS workers who provide complex wound care are required to have knowledge of:

  • Common risks to skin integrity
  • Common signs of infection and how to respond to them
  • The risks associated with prolonged or worsening infection
  • The purpose of, and methods for, positioning and turning the participant to manage pressure and choking risks
  • The implications of wound management in the delivery of other daily supports such as showering, toileting, mealtime assistance and mobility.

(NDIS 2018)

Additional Resources



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