Current issue

From the Editor

Dear Readers,

We herein present another issue of the journal, which is dedicated entirely to the promotion of Advanced Practice Nursing (APN) and its potential application in the management of wounds and fistulas.

Advanced Practice Nursing is a concept that assumes an expansion of the traditional nursing role to include new, highly specialised clinical and decision-making competencies. Its development began in the 1970s in the United States and Canada, and then later in European countries. According to the World Health Organisation, APN is becoming increasingly widespread internationally. In 2025, approximately 62% of the world’s countries reported having implemented APN within their healthcare systems. Currently, in Western European countries, 30–40% of primary healthcare services are delivered by APN nurses. Numerous scientific publications confirm the benefits of implementing APN in healthcare systems, including reduced care costs, improved patient access to care, and enhanced patient satisfaction with care – all of which contribute to the optimisation of healthcare delivery.

In Poland, the reform of the nursing education system was accompanied by discussions and initiatives to implement APN within the healthcare system. These efforts have produced tangible outcomes, including the adoption by the government in 2019 of the document Polityka wieloletnia państwa na rzecz pielęgniarstwa i położnictwa w Polsce (Resolution of the Council of Ministers No. 124/2029), the publication of nursing education standards on 25 July 2019 and 10 October 2024, the adoption on 17 May 2024 of the Deklaracja Gdańska, which confirmed the unanimity of the nursing community regarding the development of APN, and the appointment by the Minister of Health on 2 April 2025 of a working group tasked with defining the areas of practice for APN.

The implementation of the APN concept in Poland in the field of wound management was introduced in 2013 on the initiative of Professor A. Gaworska-Krzemińska, Associate Professor D. Kilańska, and B. Wieczorek-Wójcik, PhD, who obtained the endorsement of the then National Consultant in the field of surgical and operating room nursing, Professor M. Szewczyk, as well as the President of the Polish Wound Management Association (Polskie Towarzystwo Leczenia Ran, PTLR), Professor A. Jawień. The activities undertaken in this regard have been described in the article Działania na rzecz rozwoju pielęgniarki zaawansowanej praktyki w Polsce – projekt pilotażu APN w zakresie leczenia ran i przetok, published in Leczenie Ran 2024; 21 (3): 92–97, DOI: 10.60075/lr.v21i3.77.

Given the development of new systemic solutions in wound and fistula management within the framework of APN, we consider it essential to provide our readers with up-to-date information on this topic. Accordingly, the current issue of the journal has been devoted to this topic. We hope for the engagement of the entire medical community – and above all, physicians and nurses representing various clinical disciplines — in an open dialogue and collaboration aimed at implementing APN in the field of wound and fistula management.

The current issue contains the position statement of the Polish Wound Management Association (Polskie Towarzystwo Leczenia Ran) regarding APN in wound prevention and treatment in Poland, strategies for the effective implementation of APN, and examples of the application of APN in outpatient specialist care in wound and fistula management.

In its position statement, the Polish Wound Management Association justified the need to implement APN in wound prevention and treatment, while emphasising the need to introduce appropriate legal regulations, design and implement pilot programmes, and ensure adequate funding. The article also includes a comparative overview of the current and anticipated competencies of specialists in nursing and advanced practice nurses in wound and fistula management.

A review and conceptual article present strategies for the effective implementation of APN. The paper has been prepared based on the scientific literature and reports from international institutions on the implementation of APN, with particular emphasis on its importance for improving the quality of clinical care, including care for patients with chronic wounds.

Subsequent papers on this issue present examples of the use of APN in outpatient specialist care for wound and fistula management.

We hope that the content presented herein will serve as a valuable source of knowledge about APN and the potential to harness nurses’ capabilities within the Polish healthcare system to enhance patient access to healthcare and improve treatment outcomes.

We encourage you to share your achievements and research findings in our journal on wound and fistula management within the framework of APN development.

On behalf of Editorial Committee and Editorial Board
“Leczenie Ran | Polish Journal of Wound Management”

Prof. Maria Kózka
Member of the Editorial Board