Understanding Wound Care Decision Making

New Study Looks at Interprofessional Knowledge and Practice

Barrie, ON – The management and prevention of wounds is a significant, underappreciated global health issue that costs the public billions of dollars each year.

Despite a strong understanding among medical providers of how wounds are treated, there is a surprising lack of information around decision making processes that encompass wound care assessment and management.

Traumatic wounds, such as animal bites, and chronic wounds, such as diabetic ulcers, all require in-depth, personalized attention from an interprofessional team, and, since wounds can vary greatly in their underlying appearance and cause, communication and decision making among team members can have a significant impact on wound healing time, patient quality of life, and patient and provider financial costs.

Recognizing that wound care decision making plays an important role in patient outcomes, members the Royal Victoria Regional Health Centre’s Interprofessoinal Practice Department conducted a research study to better understand the basic social processes used by interprofessional teams when making decisions around wound care.

Through a series of focus groups involving participants from a variety of different interprofessional backgrounds, study authors Corey Heerschap, Wound/Ostomy Clinical Nurse Specialist, Andrew Nicholas, Occupational Therapy Professional Practice Leader, and Meredith Whitehead, Director of Interprofessional Practice and Infection Prevention and Control, were able to have in-depth discussions and identify new and re-occurring themes surrounding the processes of wound care decision making.

Using an approach called multi-grounded theory, the authors were able to incorporate the outcomes of other similar studies to inform their own findings and broaden the socio-geographical impact of their results. After examining the data, ten unique, interrelated elements that critically impact wound care decision making processes were discovered: 1) patient factors; 2) interprofessional team; 3) assessments; 4) equipment and supplies; 5) documentation and communication; 6) care plans; 7) wound care consultations; 8) scope of practice; 9) clinician factors; and 10) knowledge and education.

The authors proposed that through a better understanding of the relationships between these ten elements, clinicians and administrators can better allocate resources to support evidence-base, patient-centered care.

“The study findings will assist decision makers, key opinion leaders, and healthcare providers in advocating for appropriate use of wound care resources to allow for efficient and effective best practice, patient centered care” says lead author, Corey Heerschap.

The study has been published in the International Wound Journal titled “Wound management: Investigating the interprofessional decision-making process”.

Heerschap, C., Nicholas, A., and Whitehead, M. (2018). Wound Management: Investigating the Interprofessional Decision Making Process. International Wound Journal. 1-10. https://www.ncbi.nlm.nih.gov/pubmed/30393966

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