Challenges of a Wound Care Center: Compliance and COVID-19

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Abstract

Patient compliance can mean the difference between optimal wound healing or negative health issues and outcomes.1 Communication and continued access to medical care can positively or negatively impact this compliance. In our experience, lack of communication between the patient and wound care team, difficulties obtaining off-loading and compression accessories, and the reduced non-essential medical care during the COVID-19 pandemic have all been roadblocks to treatment compliance. To reduce noncompliance, our wound care center staff performs monthly insurance checks on our patients and requires patients to re-register with updated health insurance information as needed. As the COVID-19 pandemic has progressed, we experienced difficulties in obtaining referrals for off-loading and compression accessories due to the reduction in non-essential medical care. To resolve this issue, we coordinated with the different vendors to schedule the patient’s referrals as soon as possible. If these entities were at limited capacity, we offered to have vendor representatives meet the patients at our wound center. Additionally, our hospital center required more advanced patient screening prior to admittance to the wound care center. To ensure that our patients could continue their wound care treatments, our staff contacted patients and home health agencies to confirm appointments and give instructions on the hospital screening criteria. With the COVID-19 outbreak, our facility’s case load increased to provide hyperbaric oxygen therapy (HBOT) for COVID-19 patients with respiratory distress to reduce the need for mechanical ventilation. We established a protocol with the hospitalists and the critical care pulmonologist to safely administer HBOT to COVID-19 patients. Patient compliance is multifactorial and involves the dedication and commitment of many stakeholders. Our wound care center worked to improve patient communication, obtain physician referrals, and create a protocol to safely administer HBOT to COVID-19 patients with respiratory distress.

References
1. Hallett CE, Austin L, Caress A, Luker KA. Community nurses’ perceptions of patient ‘compliance’ in wound care: a discourse analysis. J Adv Nurs 2000;32(1):115-123.

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