Abstract

The cost of treating pressure sores is on the rise, and recently the use of digital technology has been introduced into home care wound management strategies to increase the effectiveness of nursing visits and reduce overall costs of care. Through the digital images of a patient's wound, a primary nurse collaborates with a wound care specialist to determine best practise for wound care. The use of this technology has subsequently led to decreased home care visits, reduced costs and improving patient outcomes. Background: The prevalence of pressure ulcers in the United States is estimated at between 1.5 and 3 million people, and the annual cost of treatment of such sores is approximately $8.5 billion. Approximately 31% of home care referrals are for pressure sore care. In recent years, the use of digital photography has been introduced into various clinical settings such as cardiology, dermatology, pediatrics, trauma, and mental health. The focus of digital photography use is in early interventions, acute and chronic care, post-hospital management, and long-term care management. This study examines the introduction of digital photography into home care wound management, and its effects on the efficacy of the visits by wound care nurses and on the reduction in the cost of wound care.

Method: A pilot project was conducted in two counties in New Jersey where digital photography was used to improve wound care outcomes. Home care nurses were trained in the use of digital cameras, including accurate lighting techniques, camera type, as well as distance and settings necessary to ensure high quality photographs. On the initial home visit, the primary nurse assesses and documents the severity of the wound and then takes a digital photograph of the wound. After the visit, the nurse downloads the image onto a central computer. A wound specialist nurse assesses the image and evaluates the wound based on size, color, and condition of the skin surrounding the wound. In collaboration with the primary nurse and the individual, the wound specialist nurse develops a specific treatment plan for the patient.

Results: The use of digital photography for home care wound management resulted in more rapid and complete wound healing for wound care patients. Further goals for the program include decreasing the costs of wound care by reducing the number of home care visits and creating a more efficient use of wound supplies.

Conclusion: Using digital technology to evaluate and develop wound management techniques led to increased home care wound patient healing rates and decreased outcome related costs. Digital photography is very useful in the care of patients with complex wounds who require a higher level and frequency of care than what is offered through home care programs. Furthermore, this technology will help provide higher levels of care by incorporating wound care specialists in treatment management, without requiring home visits by such high cost specialists. Currently in Ontario, Saint Elizabeth Health Care has implemented the use of digital photography in their treatment of wound care patients. There are issues, however, with the implementation of such technology. The quality of photographic image will depend on lighting and environmental issues, which could alter the image. Nurses must be properly trained in the use of digital photograpy to deal with these issues and to ensure accurate analysis of the photograph.

Reference: Demarest L., Acoraci R. "Choosing and using a digital camera in home care". Home Healthcare Nurse. 2004; 22(1) 61-63