Here - EWMA 2013

FREE PAPER SESSION: E-HEALTH AND HOME CARE
Free Paper Session: E-health and Home Care
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Pressure ulcers as a risk factor of discharge to acute care unit
in older hospital-at-home patients in need of geriatric management
and rehabilitation after acute illness.
Miquel Àngel Mas Bergas 1 , Sebastià J Santaeugènia Gonzàlez 1 , Sara Gamez Vera 2 ,
Veronica Delgado Castel 2
1 Department of Geriatric Medicine and Palliative Care. Badalona Serveis Assistencials
(Badalona.Catalonia, Spain);
2 SAID. Badalona Serveis Assistencials (Badalona. Catalonia, Spain).
Aim: There is evidence of the usefulness of multidisciplinary hospital-at-home (HaH)
interventions for older patients with acute geriatric conditions. The aim of this study was
to assess the effect of pressure ulcers on clinical outcomes of these patients.
Methods: A longitudinal pilot study analyzed outcomes of older patients with medical/
surgical conditions consecutively admitted to a HaH unit for Comprehensive Geriatric
Assessment and rehabilitation, based on the presence and evolution of pressure ulcers.
Results: Of 121 patients assessed, 47% had pressure ulcers at admission and 19% at
the end of intervention. Baseline characteristics of the group were: age 82; 81% female;
Charlson Comorbidity Index 2; number of geriatric syndromes 5; length of stay 51 days.
The subgroup of patients with pressure ulcers at admission had higher prevalence of
malnutrition (37 vs 20%), more number of geriatric syndromes (4.2 vs 3.7) and higher
rate of discharge to acute care unit (14 vs 9%). Moreover, we found a higher rate of
discharge to acute care unit (33 vs 8%) in those patients with pressure ulcers at
admission without improvement of this condition at the end of intervention.
Conclusions: Pressure ulcers had negative impact on destination of patients at the end
of intervention in our HaH unit. The presence of pressure ulcers at admission or a bad
evolution of this condition was found associated with an increased rate of admissions to
acute care unit
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Free Paper Session: E-health and Home Care
COMMUNITY NURSING CARE – CHALLENEGES AND POTENTIALS IN
MULTIDISCIPLINARY APPROACH IN WOUND CARE
Mirna Žulec 1
1 Technical College Bjelovar (Bjelovar, Croatia)
Aim: Community nursing care is main key for wound care management and patient
education. Main goal was to examine needs in community care from nursing point of
view.
Method: Community and home care nurses (totally 63) were asked to fulfill
questionnaire with 10 questions about their impression of wound care knowledge,
cooperation with doctors (general practice doctors and specialist) and their needs in
organizing better wound care management.
Results: 70% claimed that they are up to date with wound care knowledge, more than
80% suggest wound care treatment to general practitioner, 35% patients are referred to
specialist. From that number 40% gets treatment different than suggested.
More than 90% claims that on line suggestions and specialized center for wound care
will be helpful ine their work.
Conclusions: It is obvious and expected that community and home care nurses have
the main role in wound care management in patient home. Also, it is evident that medical
professional are not informed about accurate guidelines in wound care. On line advisory
center or specialized outpatient clinic would be helpful for better wound management
outcomes.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
49