Improving Chronic Wound Healing in the Home Health Setting

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The management of chronic wounds and their sequelae is a significant challenge within healthcare systems in the United States and globally. Chronic wounds negatively impact quality of life and are associated with numerous comorbidities such as diabetes, obesity, hypertension, and vascular disease. Chronic wound management is complex because it is affected by social, economic, clinical, and systems factors that exacerbate challenges in achieving positive healthcare outcomes. To address chronic wound care requires vital stakeholders to come together in a collaborative effort to meet this need (Sen, 2021). The number of patients with chronic wounds cared for in the outpatient and home health settings is increasing (Sen, 2019). According to Mahmoudi and Gould (2020), challenges to healing chronic wounds include lack of provider knowledge regarding broad principles of wound healing, an aging society with complex comorbidities, a lack of standardized treatment regimens, an overwhelming market with competing wound care products, and a lack of care coordination and collaboration. Key stakeholders must meet these challenges, such as durable medical equipment suppliers (DME), home health nurses, primary care/wound care providers, and insurance case managers. If the healthcare system fails to address these multiple factors, adverse outcomes in overall wound healing will continue to be observed (Mahmoudi & Gould, 2020). The mission of this project is to improve wound healing for patients with chronic wounds by enhancing home health nurses' wound care knowledge base and the care coordination and collaboration among home health nurses, physicians/wound care providers, and durable medical equipment suppliers. The vision is to improve acute and chronic wound healing and quality of life for patients while efficiently utilizing health care resources and improving care coordination and collaboration among stakeholders in the home health setting. Translational project objectives include: a) decreasing the delay in obtaining appropriate wound care supplies for patients, b) improving patient status updates to at least biweekly between home health agency nurses and primary providers/wound care providers, c) improving wound healing by increasing nursing knowledge on current wound care management principles, utilizing a validated wound measuring tool to assess wound progression and d) providing a wound care education resource for home health agency use for sustained success in the wound care program. The project scope included improving the collaboration and coordination among all stakeholders so that wound care outcomes and healing could be enhanced. Methods to streamline communications with each stakeholder were developed and implemented. Educational resources were created, implemented, and evaluated. Validated wound measurement tools were utilized for measuring wound characteristics. Wound care supply products and supply chains were considered for standardization of use. Individual nurse and facility-based wound care education were developed and provided to home health nurses and the home health facility.
Submitted in partial fulfillment of the requirements for the degree Doctor of Nursing Practice
Nursing, Health Care Management