Wound Care

The Key to Wound Care Management in the Home? Collaboration

Caring for another person’s wound is, first and foremost, an act of compassion.

Florence Nightingale, one of the few women permitted to treat wounds during the Crimean War, was praised for providing comfort and reassurance to the patients she cared for.

Today, compassionate wound care is often delivered in the homes of patients. Home care nurses and personal support workers help people with chronic wounds deal with the physical and emotional pain their conditions can cause.

These frontline workers show an eagerness to improve their wound care management skills. They should be supported by the home care agencies that employ them so that they can achieve the highest possible quality of care. In most cases, facilitating communication with the right people (including specialists) is a crucial part of this support.

This post will look at some of the benefits of a collaborative approach to wound care management.

Collaboration and advances in Wound Care Management

 50% of wound care services are delivered in private homes. If you’re a decision-maker at a home care agency, wound care management is likely one of your priorities.

You already know that generalist nurses should be aware of wound care best practices, as well as possible interactions between the care they provide and factors such as patient lifestyles. You understand how important it is for personal support workers (PSWs) to know when they are and are not authorized to help. But keeping up can be a serious challenge.

Wound care is evolving quickly. In 2007, just a few short years ago, ET nursing was recognized as its own distinct area of specialization by the Canadian Nurses Association. Since then, knowledge in the field has increased steadily, as has the number of products and technologies available to promote healing.

As difficult as it may be for those with a broad scope of home care responsibilities, understanding advances in wound care is important. A recent study found that implementing best practices for lower extremity ulcers could lead to a 66% reduction in medical costs for the Ontario government. More importantly, such practices can lead to better outcomes and reduced suffering for patients.

Collaboration is key. In many cases, a team-based approach that involves practitioners from various disciplines – which may include nursing, dermatology, podiatry, plastic surgery, and nutrition, among others – can lead to better outcomes. Evidence suggests that this type of collaboration can work just as well in home care settings as it does in hospitals and other health care facilities.

Whenever possible, home care agency leaders should try to coordinate team solutions and help generalist nurses communicate with and learn from relevant specialists. As comprehensive sources of information on wound care management, wound care specialists will usually provide the most crucial input.

Patient-centred wound care

More and more, people expect to be actively involved in their care. Patients are more informed than ever before, and a growing number of them want to collaborate on the development and monitoring of their health care plans.

Many patients feel more in control when they receive care at home than they would in a health care facility. But feelings of vulnerability and discomfort can still arise. Opening up your home to an outsider is difficult, all the more so when that outsider is going to come into close contact with a physical ailment that may be a source of shame, embarrassment, and frustration.

Chronic wounds are not what most people would call pleasant. In addition to causing physical pain, they can take a psychological and emotional toll. Wounds seep. They emit odours. Sometimes they seem to take forever to heal – if they heal at all. Nurses know that caring for a patient’s wound is an intimate act, an act that should be carried out with great sensitivity.

Sensitivity will mean different things in different situations. But for the most part, patients – especially those independent enough to receive care at home – need straightforward information about their conditions and treatment options. In other words, they want to know what’s going on.

To the best of their abilities, nurses and PSWs should keep patients and the people involved in their care (including relatives and other nurses and official caregivers) in the loop. In addition to informing important medical decisions, keeping patients informed can empower them to take ownership of their health. Certain factors controlled by patients – such as attitude and nutrition – can have significant positive impacts on healing wounds.

Those responsible for the administrative aspects of a home care agency can support caregivers in keeping patients informed. Ongoing assessments of how client information is recorded, maintained, and used is important. Are patient histories complete and available in a standardized format?

Improving Communication for Better Collaboration

Collaboration between home care providers and specialists in relevant fields results in superior wound care management planning.

Clear (and standardized) communication within home care agencies is also important, as it can ensure that nurses and PSWs are working with complete, up-to-date client medical histories. This process also increases accountability across home care agencies and helps those involved in management and coordination understand client trends.

Lastly, collaboration between clients – as well as relatives who take an active role in their care – and home care workers can have a very positive impact on wound healing.

These types of collaboration can result in significant cost savings for home care agencies, increased confidence for home care workers, and (most importantly) happier and more physically comfortable patients.

When it comes to the communication that occurs between home care nurses and specialists, education is crucial. Wound care nurses know that sharing their knowledge can help ease the pain of those with chronic wounds. Generalist nurses are, for the most part, ready and willing to learn.

A recent set of workshops in northern Nova Scotia revealed the value health care practitioners place on specialized education. In their efforts to pass on wound care wisdom, nursing leaders drew physicians, fellow nurses and nurse practitioners, occupational therapists, and other care providers from a wide range of environments – including home care.

But in many cases, nothing can replace direct consultation with a wound care specialist. Because these experts are in such high demand, arranging in-person assessments can be difficult. Luckily, thanks to digital communication tools, remote consultations are possible.

A recent Nova Scotia study (referenced in this Canadian Home Care Association report) revealed the benefits of connecting home care providers with specialists through handheld electronic devices. A similar initiative by the Capital Health Region of Alberta used a web-based software program to help two enterostomal therapy nurses reach more home care patients.

Recently, an Ottawa branch of a major Canadian health care company used technology from Aetonix to connect home care nurses to those who specialize in wound care, yet another illustration of the power of increased communication between practitioners.

Technology that revolves around communication has the potential to improve collaboration not only between nurses and specialists, but within a patient’s entire circle of care.

When developed with better patient outcomes in mind, electronic communication tools can improve wound care management in many ways. Specialists can assess wounds through high-quality video. Home care workers can empower patients as they heal by checking in on them and providing care reminders remotely. Home care agencies can enjoy better internal communication through features that generate reports and log calls.

Knowledge is Power

Wound care is an often-misunderstood area of specialization. Experts can change that. Health professionals with overlapping areas of expertise and an interest in contributing to wound care solutions can help.

Unfortunately, some home care nurses and PSWs report feeling disconnected from the larger medical community. Steps should be taken to guard against this. Decision makers at home care agencies should make collaboration as easy as possible. Relevant tools should be considered and communication infrastructure should be assessed. Ultimately, the result of finding a system of collaboration that works will be happier caregivers and happier patients.

Feature Image: Valerie Everett

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