Retrospective Study of an Electronic Wound

Retrospective Study of an Electronic Wound Documentation and Reporting System
on Facility-Acquired Pressure Ulcers in a Long Term Care Setting
Beth Florczak, RN, MS, WCC, RAC-CT1; Anne Scheurich, RN, CWOCN2; Jennifer Kleinert WCC, LPN2; John Croghan, MD2; Philip Sheridan, Jr., MD,MBA2;
Debra Kurtz, BA, BS, MBA2; William McGill, PhD2
1
Provena Heritage Village, 51-bed skilled nursing facility in Kankakee Illinois, 2WoundRounds®
Background
Documentation of pressure ulcer (PrU) care is important for patient
wound healing. Despite the importance of care standardization and
documentation, many long-term care facilities struggle with paper
systems based on subjective methods. This study was designed to
test the effectiveness of an electronic wound management system*
to enable skilled nurses to provide better outcomes.
Methods
Data were collected over a seven-month period at a 51-bed skilled
nursing facility among 56 residents with a Braden Risk Assessment
and with a Stage 1 or greater PrU. Clinical data and digital images
of each PrU was documented using a camera-enabled, mobile
device for electronic wound management.*
Number of Pressure ulcers
Oct
Nov
Baseline
Next 6 Months
Jan
Feb
Mar
Apr6 Month (mean)
Facility-acquired 32
24
New 24
12
Existing 812
24
8
16
17
3
4
5
0
5
4
1
3
513
2 4
3 7
Present-on-admission 37
New 27
Existing 48
33
15
53
17
36
24
5
19
12
4
8
9
3
6
2829
2214
615
Avg Patient days/month 42
40
45
47
48
48
53
60
Results
The incidence of new facility-acquired (FA) PrUs decreased
substantially from 24 during the baseline month to an average of
four per month over the next six months. A comparison of total
number of wound events to non-events per month was found
significant; Chi Square for Trend=63.736; p=.000. By April, the odds
of a new facility-acquired pressure ulcer occurring were
33 times less likely than in October.
Dec
PRESENT ON ADMISSION
FACILITY AQUIRED
40
20
Conclusion
During the seven month study, the skilled nursing facility was
able to significantly decrease the incidence of facility-acquired
pressure ulcers, which may be attributable to improved
documentation & communication among care team using the
electronic wound documentation system.*
0
OCT
NOV
DEC
JAN
FEB
MAR
APR
References:
1.Jankowski IM, Nadzam DM. Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs. Jt Comm J Qual Patient Saf 2011;37:253-64.
2.Horn SD, Buerhaus P, Bergstrom N, Smout RJ. RN staffing time and outcomes of long-stay nursing home residents: pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care.
Am J Nurs 2005;105:58-70; quiz 1.
3. House S, Giles T, Whitcomb J. Benchmarking to the international pressure ulcer prevalence survey. J Wound Ostomy Continence Nurs 2011;38:254-9.
4.VanGilder C, Amlung S, Harrison P, Meyer S. Results of the 2008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis. Ostomy Wound Manage 2009;55:39-45.
5.Takahashi PY, Kiemele LJ, Chandra A, Cha SS, Targonski PV. A retrospective cohort study of factors that affect healing in long-term care residents with chronic wounds. Ostomy Wound Manage 2009;55:32-7.
6.Young J, Ernsting M, Kehoe A, Holmes K. Results of a clinician-led evidence-based task force initiative relating to pressure ulcer risk assessment and prevention. J Wound Ostomy Continence Nurs 2010;37:495-503.
7.Soban LM, Hempel S, Munjas BA, Miles J, Rubenstein LV. Preventing pressure ulcers in hospitals: A systematic review of nurse-focused quality improvement interventions. Jt Comm J Qual Patient Saf 2011;37:245-52
Poster Presentation at Symposium on Advanced Wound Care (SAWC), September 2012
*WoundRounds®
Hoffman Estates, IL
www.woundrounds.com
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*WoundRounds®
Hoffman Estates, IL
www.woundrounds.com