HN Summary
• Chronic wounds are a widespread and costly challenge in long-term care, with most residents experiencing at least one wound during their stay—often pressure injuries that heal slowly and carry higher risk of complications in older adults.
• Wide variation in wound care practices highlights the need for standardized, evidence-based approaches, including staff-wide education, daily wound assessment, access to best-practice databases, proactive prevention, and consistent performance tracking.
• Establishing a “Wound Care Culture” elevates care quality and outcomes, supporting faster healing, better resident satisfaction, stronger staff engagement, and more efficient use of resources across long-term care facilities.
Wounds are a major challenge in long-term care. Studies analyzing resident senior populations demonstrate that a significant majority will experience one or more chronic wounds during the course of their stay. Approximately half of the wounds experienced will be pressure wounds and the balance are mostly soft tissue tears, various ulcers and surgical wounds. Wounds in elderly patients take significantly longer to heal and are more prone to complications, compared to those in younger people. Preventing wounds or reducing the wounds’ healing times would be of significant value to both patients and facilities.
In reviews of wound treatment standards at long-term care facilities, there is a wide disparity in applied standards of treatment. Some facilities implement a higher or lower standard of care than others. Developing and implementing industry standards of quality in wound care in long term care will lead to faster healing, greater patient satisfaction and improved profitability for the facilities.
Developing a quality level of wound care, or “standards,” would greatly improve overall patient care and facility management. Here are seven elements to include as part of wound care standards for long-term care facilities. They are:
1) Placing a priority on wound care education for the entire patient care staff.
It’s not just the doctors and nurses who should be tasked with wound care. In today’s long-term care facilities, patients’ wound treatments are visible to every staff person who is involved in patient care, even if it’s simply observing dressings on a patient while assisting them to the rest room. Therefore, care staff, in addition to doctors and nurses, should all be educated regarding potential issues so they can all be aware and respond appropriately, when necessary, for the patient’s benefit. Expanded staff education and observation can also serve as evidence to insulate the institution from legal challenges relative to their providing a higher quality level of care.
2) Providing access to a comprehensive wound care database to identify and specify best practices.
Wound care treatment involves more than simply putting a dressing on a wound. Issues such as wound identification, severity, treatment specifications, treatment timeline, setting expectations and more have already been established as best practices. Instead of “reinventing the wheel” in wound treatment, having access to a comprehensive wound care database can provide valuable treatment information and demonstrably improve the quality of care.
3) Making wound care a daily activity.
Daily dressing observation also ensures that the wound is frequently assessed for signs or symptoms of abnormal healing, the formation of necrotic tissues, and the presence of wound colonization or infection. Wound infections are not rare – up to 50% of acute wounds become infected. Daily observation of wounds, by an educated team, will help to ensure that the signs or symptoms of wound infection will not be missed and can more quickly be attuned. Adopting a policy of more frequent observation and dressing changes will speed healing and ultimately reduce the need for more care.
4) Devoting more resources toward wound proactivity.
Preventing wounds and/or reducing the severity of a wound can provide significant benefits. Train staff to anticipate or observe wound festering situations. Developing a policy that evolves wound care from tactical to proactive can dramatically reduce the long-term need for greater resources.
5) Creating a management protocol devoted to achieving and exceeding wound care goals.
The best way to improve wound care quality is to keep records of every wound, the treatment utilized and the results. Setting goals and tracking results year over year can provide management with the tools for improving performance.
6) Participating in the global future of wound care.
In addition to internal record-keeping and management, sharing records of wounds and treatments by adding them to a global wound care database can evolve best practices and help improve the future of wound care.
7) Create a Wound Care CultureTM
We define Wound Care CultureTM as an integrated environment of shared beliefs, knowledge and practices that prioritize wounds and elevate their care and treatment. Creating a Wound Care CultureTM in your organization advances wound care from merely treating wounds to achieving evolutionary improvements in quality and overall patient care. As an added benefit relating to staff loyalty, cultivating a Wound Care CultureTM creates an environment where team members will be proud of their accomplishments and to being part of a team that successfully helps patients and improves their quality of life.
The evolution of wound care should transcend the tactical by embracing industry standards that promote a higher level of quality care designed to prevent wounds, improve treatment and provide for more efficient use of resources. Embracing quality standards is key to delivering optimal care and to maintaining a competitive edge dedicated to improving the lives of more people.
David Navazio is President and CEO of Gentell, the largest vertically integrated wound care company in the world.