Wound management is a tremendous clinical challenge for many health care professionals. The World Health Organization has recognized that wound management is a worldwide public health issue best managed by an interprofessional team.1
This interdisciplinary approach has been shown to increase healing and decrease wound recurrence. However, it requires shared decision making with many clinicians to create an optimal care plan.2 It is important to gather information from many sources, especially from other health professionals within the interdisciplinary team. When working with specialists, their input and assessment can be critical in identifying underlying factors that may be impacting healing. This information is vital in developing a care plan that can support positive patient outcomes.
One important aspect of care plan creation is communicating all relevant data to all clinicians who are members of the patient’s interdisciplinary team. This communication requires extensive documentation of clinical findings, as well as used and considered treatment options and their respective results.3 Accurate, rapid, and concise wound documentation is at the core of good wound care.
Additionally, a great care plan can be created only when sufficient information is available. Therefore, considerations for the care plan should include comprehensive information about not only the wound, but also any factors that affect the patient.4 Comprehensive information about the wound can involve health factors and parameters that may affect wound healing and management. This dimension of information can include:
Overall patient information and any comorbidities relevant to wound healing should also be included and factored into the overall care strategy. Assessment of the patient’s information includes:
This list of wound and patient information does not encompass all the factors that need to be considered for developing a plan of care. Clinicians should consult their facility’s protocols as they build the patient’s care plan and be vigilant of other factors that may affect wound healing. The use of technology can aid in the documentation and rapid communication of wound characteristics with the interdisciplinary team. Documentation technology may improve accuracy and access so that the plan of care can be developed for best outcomes.
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Wound images can be recorded and analyzed to give measures of surface area, depth, and other characteristic data. Many platforms that support wound documentation also have tools to encourage providers to implement appropriate measures for the wound. These systems can create an objective record of wound characteristics rather than relying on subjective descriptions. Documentation of wound characteristics should also include5:
Once information relating to a wound, as well as any patient factors, has been gathered and clinicians have reviewed their facility’s protocol, the wound management plan can be created. It is worth noting that information gathered must be shared with patient consent. Details of the management plan and any interventions should also be reported. Specifically, social information about the patient, including their ability to attend follow-up appointments or afford dressings or other required treatment, should be noted along with details about current strategies.
Using the foregoing information when developing a plan of care for wound management is aligned with the recommendation that a 10-step approach should be used for each wound. This strategy can be implemented when creating a care plan. The steps include6:
Once the care plan has been developed and implemented, clinicians should stay abreast of any factors that would call for the wound care plan to be modified. Wound management performance and outcomes should be reported and wound prevalence analyzed so that the strategy can be reassessed if necessary. When observing wound healing progress and changes to wound characteristics after interventions, you can identify specific factors that may require the care team to reassess the strategy. Wound stalling or healing, a change in the patient’s social circumstances, or the presence of infection and subsequent biofilm formation will require various plan modifications. Under these circumstances, the interdisciplinary team can modify the care plan to account for changing circumstances.
When working with wounds, one may maximize decision making by using a multidisciplinary and holistic approach that incorporates knowledge of the patient and clinical expertise. A one-size-fits-all approach is often ineffective. Having an understanding of patients’ preferences and past experiences may inform decisions.7 Wound care is complex, and getting to a point where a wound can make healing progress often requires individualized treatment plans that incorporate a broad range of data and information. However, when this process is implemented and is coordinated throughout the interdisciplinary team, it can lead to far more positive patient outcomes.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.