Patient Outcomes

Kathy Gallagher's picture
Acute Surgical Wound Service

By Kathy Gallagher, DNP, APRN-FNP, CMC, UMC, BC, WCC, CWS, FACCWS

In 2010, Christiana Care Health System, a 1,000 bed Level I trauma center in Wilmington, Delaware, introduced an acute surgical wound service (ASWS) integration plan in with a single dedicated nurse practitioner, trauma surgeon, and administrative leader. Subsequently, trauma patients with complex wounds experienced decreased morbidity and length of stay. Closely aligned with these numbers, their patient days of negative pressure wound therapy fell from 11+ days in 2010 to 8.2 days in 2018, representing one of the lowest in the nation.

Christine Miller's picture
Patient Noncompliance

Christine Miller, DPM, DMM, PhD, FACCWS

One of the most difficult aspects of patient care is dealing with non-compliance. How do we help those who refuse to help themselves? This question is very convoluted indeed! The best treatment protocols in the world will be unsuccessful if the patient does not follow the recommendations. Patients with chronic wounds are usually those with multiple comorbidities such as uncontrolled diabetes, autoimmune disease, and uncontrolled hypertension. This complex medical picture is challenging enough for all of us trying to heal them, but add the patients' lack of concern for their own health and it is quite frankly maddening. I find myself often saying, "Help me help you" or "Healing is a team event," although mostly my genuine pleas for partnership fall on deaf ears.

Christine Miller's picture
Coordination of Care

By Christine Miller, DPM, DMM, PhD, FACCWS

One of the gratifying aspects of being a wound care physician is the ability to develop such rich relationships with our patients. The frequent and consistent contact with the same provider lays a strong foundation of open communication and trust. I work in an urban safety net hospital’s ambulatory care center, which sees a high volume of high-acuity patients. It is not uncommon for me to see patients with venous leg ulcerations with concomitant uncontrolled hypertension or diabetic foot ulcerations secondary to uncontrolled blood glucose levels. Patient education is a vital part of my clinical encounters, particularly focusing on the systemic nature of wound healing. I always emphasize that while we are treating your wound, it is the full body well-being that is needed for ultimate success.

Paula Erwin-Toth's picture
Keywords: 
Communication

Paula Erwin Toth, RN, MSN, FAAN, WOC nurse

Northeast Ohio is now being enveloped by a polar vortex. The subzero temperatures put everyone at risk, but our patients with chronic wounds are especially vulnerable. Neuropathy can desensitize them to the cold and result in frostbite, inadequate shelter and heat, and an inability to go to health care appointments, shop for food, or pick up (or even afford) prescriptions and wound care products. This can have devastating effects.

Janet Wolfson's picture
Patient-Centered Communication

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

Last spring, I encountered that specific type of patient we sometimes meet, the one who has been through the chronic wound care revolving door so many times that he or she sets out on his or her own path and refuses any byways diverting from it.

Tissue Analytics's picture
wound care assessment system

by Amanda Steinhauser, LVN, WCC

Everyone has heard the numbers; wound care costs in the United States are reported to be in excess of fifty billion dollars annually. Moreover, more than six million Americans suffer from chronic wounds. According to the American Diabetes Association, over one million Americans are diagnosed with diabetes every year. Despite these jaw-dropping statistics, wound care assessment techniques remain, for the majority, one of the most antiquated parts of health care.

Blog Category: 
Janet Wolfson's picture
preventing-pressure-injuries

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

As I read through wound care articles on pressure injuries and treatments, I keep going back to one thought: why are they still occurring? They are preventable! Staff are educated, have certifications and equipment, and have been oriented on policy to prevent pressure injuries. I think it comes down to opportunities and choices.

A culture of care – bottom to top and back down again – can drastically reduce incidence.