Wound prevalence, types, and treatments in home care

Abstract

Objective: To ascertain the number of home care patients with wounds, determine the types of wounds being treated in the community, and identify wound care treatments used at home.

Design: Descriptive, multisite, collaborative project.

Setting: 13 home care agencies located throughout lower Michigan that had voluntarily formed a research consortium. The location of patients visited was 43% urban, 39% suburban, 16% rural, and 2% unaccounted.

Patients: Systematic sampling was used to select nurses in each agency to collect data. Nurses (n = 281) recorded information about adult patients visited during the 1 week of the study. Data were recorded about 2847 patients, M age = 72.5 years. They included 1793 women and 1040 men (gender was not recorded for 14 patients); most patients in the sample (72%) were white. MAIN PLANNED OUTCOMES: A significant number of home visits would include wound care and that wound care would be primarily done with tap water and gauze.

Results: Wounds were present in 36.3% of patients. Of the patients with wounds, 58.3% had 1 wound and 41.7% had multiple wounds. Wound types included surgical (62.4%), pressure ulcers (24.9%), and vascular leg ulcers (22.2%). Tap water and gauze were the most-used wound care treatments. Patients with wounds had significantly longer home care visits than patients without wounds.

Conclusions: Patients with wounds are commonly found in home care. There is a low utilization of specialty dressings and commercial irrigation solutions across all wound types. Nurses who follow patients with wounds may need additional time to provide the care.