Here - EWMA 2013

ORAL PRESENTATIONS
53
Free Paper Session: E-health and Home Care
TELEMEDICINE FOR WOUND MANAGEMENT IN HOME CARE SETTINGS
Kian Zarchi 1 , Gregor B.E. Jemec 1
1 Department of Dermatology, Roskilde Hospital (Roskilde, Denmark).
Aim: To evaluate the feasibility and effectiveness of secondary telemedicine for home
care wound management.
Method: All home care nurses in the municipality Vordingborg, Denmark (pop. 46000),
were trained to use an integrated web-based software, to create, store and transfer
medical records, including clinical photographs. The software allows bilateral web-based
communication between the home care nurse and the Department of Dermatology. All
patients with chronic non-healing wounds (>6 weeks), who were being treated by home
care nurses and who gave consent to participate, were included. The home care nurses
obtained and stored relevant medical data. Data were communicated to and evaluated
at the Department of Dermatology, leading to further diagnostic investigations and
treatment plans executed by the responsible home care nurse.
Results: Between January 1, 2011 and May 1, 2012, 84 patients with 139 non-healing
chronic ulcers were included. Two thirds of the patients (67%) achieved wound healing
within the end of the study (November 2012). In 20%, complete wound healing could not
be achieved due to various reasons, such as the presence of very severe
atherosclerosis and multiple comorbidities, and 13% of patients died during the trial due
to non wound-related reasons. On average, it took 178 days to achieve wound healing.
Significant improvement was achieved in diagnosis of wound-type and treatment plans
in the course of the study.
Conclusion: Secondary telemedicine provides a feasible and effective option in wound
management through collaboration between a specialist centre and empowerment of
home care nurses.
FREE PAPER SESSION: E-HEALTH AND HOME CARE
54
THE BURDEN OF WOUND CARE ON HOME CARE NURSES
Free Paper Session: E-health and Home Care
Kian Zarchi 1 , Maja F Hansen 2 , Hanne Hansen 2 , Gregor B.E. Jemec 1
1 Department of Dermatology, Roskilde Hospital (Roskilde, Denmark);
2 Vordingborg Home Care Nursing (Vordingborg, Denmark).
Aim: To determine the prevalence of wounds in home care patients as an indicator of
the burden of care.
Method: An exploratory retrospective review of patient records was conducted in the
municipality of Vordingborg, Denmark (pop. 46000). Data of all patients who received
wound care from January 1, to December 31, 2011 were analyzed.
Results: A total of 631 patients (1.4% of inhabitants) received wound therapy by home
care nurses. Lower extremity wounds were the most common reason as 32% suffered
from foot ulcer, and 17% from leg ulcer (above the foot). In 7% of cases, pressure ulcer
was registered as the diagnosis. In 91% of cases, wound care was no longer being
provided at the time of the review (summer 2012), of which 69% was due to wound
healing, 11% due to death and in 20%, the reason was not specified. However, half of
the patients (53%) received wound care for more than 6 weeks. Furthermore, one fifth of
patients (20%) received wound care for more than 6 months, and 14% for more than 9
months.
Conclusion: A considerable number of patients receive wound care by home care
nurses, suggesting that wound care constitutes an important function. One fifth of the
patients treated receive therapy for more than 6 months, indicating that a targeted effort
at improving care in a subgroup of patients may alleviate the work-load considerably.
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