Polymeric Membrane Dressings Cultivate Trust and Wound Management Adherence while Facilitating Healing in Patients Living with Mental Illness- 7 Patients Successes!

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Abstract

Clinical problem

We manage many wound patients in our home health agency that are challenging to care for due to their psychiatric diagnosis. Because of behavioral and coping skill issues, the patients are slower to trust. Pain related to dressing changes contributes to their wound care non-adherence. Seven patients with psychiatric diagnosis and wounds are being presented; a patient with partial thickness skin loss on their right below the knee amputation; a patient with stage IV pressure ulcer related to vasculitis; three patients with venous ulcers; a patient with a left upper thigh wound; and patient with a left 2nd toe injury; five of the patients had prior advanced wound care before being seen by the home health agency. Six patients had pain ranging from 3 to 10 (0-10 scale).

Clinical treatment approach

Each patient had a wound consult with admission to the home health agency. Polymeric membrane dressings (PMDs), with and without silver, were applied. Frequency of dressing changes depended on amount of exudate. Wounds were initially cleansed with normal saline and a skin barrier cream was applied as needed.

Patient outcomes

Cleansing during dressing changes was not needed since the PMDs provide continuous cleansing so the fear of pain related to cleansing was removed. With the use of PMDs, patients saw wound healing progress and this further encouraged adherence. As a result all wounds reached wound closure. With PMDs all pain levels decreased.

Conclusions

With the use of PMDs, procedural and persistent pain was reduced and often eliminated. This allowed the patients to build trust with wound care approach, with the health care providers and encouraged wound treatment adherence and resulted in wound closure. This is the preferred standard of care at this home care agency for wounds.

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