A quality monitoring system in the management of pressure injuries at home. Prospective observational cohort study within a Home Care Provider

Submitted: July 24, 2024
Accepted: November 26, 2024
Published: January 24, 2025
Abstract Views: 114
PDF: 100
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Providing care at home is important to avoid patients’ hospitalization. This aim can be achieved by monitoring the quality of care provided at home, which also largely depends on the wound care management. The main objective of the study is to create a quality monitoring system for home management of pressure injuries by a Home Care Provider (HCP). A single-center prospective observational cohort study was performed, including patients with pressure injuries taken care of by the HCP in Milan from 01/09/2021 to 15/04/2022, with 6-month follow up. Data were collected regarding patient’s clinical and social situation, status of the pressure injury and its care. Two primary and five secondary outcomes were calculated. 50 patients were enrolled, average age of 85.54 years, in 60% of cases totally dependent (Barthel scale). 94% of patients are assisted by at least one caregiver, with adequate skills in 50% of cases. Injuries are most widely distributed between GRADE II (50%), III (28%) and IV (8%) (EPUAP), while the anatomical location is mostly in the sacrum (48%), gluteus (22%) and heel (12%). The dressing change frequency was mainly 3 (44%) or 2 (12%) times per week, while in 26% of cases it was daily, with active involvement of the caregiver, where possible. Not-advanced dressings were used in 62% of cases. Primary outcomes: 44% healed injuries; average healing time 62.09 days. Secondary outcomes: 16% hard-to-heal wounds; 10% injuries developing complications; 0% worsening injuries at the end of follow-up; 44% requests for anti-decubitus devices by the nurse; 54% cases in which health education activity to the patient/caregiver was provided by the nurse. The developed monitoring quality system made it possible to identify some characteristic of the HCP wound care and it can be used to improve quality of care using ob- jective and periodically calculable outcomes. The lack of reference data in the literature suggests the development of future collaborations between different Home Care Providers to carry out studies regarding wound care at home.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

1. Definizione e aggiornamento dei livelli essenziali di assistenza, Decreto del presidente del consiglio dei ministri 12 gennaio 2017, G.U. Serie Generale , n. 65 del 18 marzo 2017.
2. Artico M, D’Angelo D, Piredda M, et al. Pressure injury progression and factors associated with different end-points in a home palliative care setting: a retrospective chart review study. J Pain Symptom Manag 2018;56:23-32. DOI: https://doi.org/10.1016/j.jpainsymman.2018.03.011
3. Eunhee Lee. Longitudinal Outcomes of Home Care in Korea to Manage Pressure Ulcers. Res Nurs Health 2017;40:255-62. DOI: https://doi.org/10.1002/nur.21793
4. Ferrell B A, Josephson K, Norvid P, Alcorn H. Pressure ulcers among patients admitted to home care. J Am Geriatr Soc 2000;48:1042-7. DOI: https://doi.org/10.1111/j.1532-5415.2000.tb04778.x
5. Bergquist S, Frantz R. Pressure ulcers in community-based older adults receiving home health care. Prevalence, incidence, and associated risk factors. Adv Wound Care 1999;12:339-51.
6. AIUC, Associazione Italiana Ulcere Cutanee. Progetto SLIP – Studio Italiano Lesioni da Pressione, dati finali. Disponibile al sito: http://www.aiuc.it/pagina/527/progetto+silp.
7. Rodrigues I, Mégie MF. Prevalence of Chronic Wounds in Quebec Home Care: An Exploratory Study. Ostomy Wound Manag 2006;52:46-57.
8. Jørgensen S F, Nygaard R, Posnett J. Meeting the challenges of wound care in Danish home care. J Wound Care 2013;22:540-2, 544-5. DOI: https://doi.org/10.12968/jowc.2013.22.10.540
9. Raeder K, Strube-Lahmann S, Müller-Werdan U, et al. Prevalence and influencing factors of chronic wounds among clients of home care services in Germany. Z Evid Fortbild Qual Gesundhwes 2019;140:14-21. DOI: https://doi.org/10.1016/j.zefq.2019.01.001
10. Zarchi K, Martinussen T, Jemec G. Wound healing and all-cause mortality in 958 wound patients treated in home care. Wound Repair Regen 2015;23:753-8. DOI: https://doi.org/10.1111/wrr.12335
11. NPUAP, EPUAP and PPPIA. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Australia; 2014.
12. National Pressure Ulcer Advisory Panel. Push Tool Version 3.0: 9/15/1998.
13. Murphy C, Atkin L, Swanson T, et al. International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene. J Wound Care 2020;29:S1–28. DOI: https://doi.org/10.12968/jowc.2020.29.Sup3b.S1

How to Cite

Borsani, V., Salomone, A., Landolfi, A., Romito, G., Romoli, L., Pellegatta, F., & Sironi, O. (2025). A quality monitoring system in the management of pressure injuries at home. Prospective observational cohort study within a Home Care Provider. Italian Journal of Wound Care, 8(3). https://doi.org/10.4081/ijwc.2024.115

Similar Articles

<< < 1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.