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Case Study
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The integration of technology into the community Theresa Hurd, Judy Zabrikas, Trish Fowler, Barb Baker Problem: Wound care has never been more advanced or complex. There have been several medical breakthroughs in the past few years, including biological skin replacements, negative pressure therapy, hyperbaric oxygen, collagen replacements and several other advanced techniques. While clinicians welcome these technologies, they are often overwhelmed with the rapid introduction of new clinical options. Wound care remains a major challenge: One community care organization in Ontario discovered that more than half of all nursing visits involved wound care. This load is growing as patients with chronic wounds are discharged from hospital in larger numbers. It is imperative that new technologies are made available in an appropriate and fiscally responsible manner. Negative pressure therapy is a case in point. In the last decade this technology has offered a method of accelerating the closure of complex and problematic wounds. However, it has proven difficult for clinicians to identify which patients may benefit, and precisely when this therapy should be implemented and discontinued. This technology is often perceived as expensive when compared to the more widely used gauze dressings Solution: A program led by the APN included the development and implementation of patient-specific criteria to manage the application of negative pressure therapy, based on current guidelines as well as specific protocols. Outcomes were carefully measured and tracked using criteria developed by an expert panel to assess effectiveness Discovery: Through this program a community care center was able to ensure that negative pressure therapy was made available to all patients in a consistent manner with positive clinical outcomes. Healing times were reduced significantly. Wound care costs were also reduced Conclusion: Using carefully designed protocols, combined with systematic monitoring, it is possible to introduce a new wound care technology such as negative pressure therapy in a manner that is consistent, fiscally responsible, and clinically effective. |
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