Study backs home-based wound care

Quality wound care that’s provided at home is just as effective as similar care provided in a specialist clinic, new research indicates.

The study, published in the Australian College of Nursing journal Collegian, looked at the treatment of venous leg ulcers, which are currently treated in a variety of settings including including at home, by a GP, at a specialist clinic or in hospital.

“Structured, evidence-based care provided in the home by well-trained nurses can achieve venous leg ulcer healing … at rates comparable to specialist clinics,” the study concludes.

Rresearcher Dr Rajna Ogrin, a trained podiatrist and senior research fellow with Bolton Clarke, says chronic venous leg ulcers are the most common form of wound in the community and have a huge impact on quality of life as they can be painful, messy and slow to heal.

And they are becoming an increasingly common problem as the population ages.

Fragmented system

But she says the current treatment system is fragmented and a patient can receive care from up to 13 different providers within a year.

Dr Ogrin says treating wounds at home can have drawbacks – including the need to have enough space, the right equipment and sufficient light, not to mention OHS issues for clinicians.

However, having appropriate structures for wound treatment at home can also benefit person-centred care.

“There are people that just can’t get  out, and their preference is to get that care in their home,” Dr Ogrin told Community Care Review.

The study, done in collaboration with Queensland University of Technology (QUT), used data from 103 participants recruited from specialist clinics in Queensland, and 98 home care clients in metropolitan Melbourne.

All participants received evidence-based care despite the setting and all home care registered nurses had undergone wound management training, with a research nurse available to provide additional support.

The study found people being treated at home were at greater risk of their wounds healing more slowly, probably because they were likely to suffer from more complex conditions and co-morbidities.

Despite this, the rate of healing between the home care and clinic participants was the same, Dr Ogrin said.

Participants in the homecare setting also reported experiencing lower levels of pain than clinic patients.

“If the care is standardised, if they’re following what we know from the evidence, works, then really it doesn’t matter where that care is delivered because the care is what should be delivered,” Dr Ogrin said.

The findings supported previous Canadian research suggesting quality of care is more important than the location of care.

Home wound care must be supported

Dr Ogrin says government policy needs to support the training and structures needed to make home-based delivery of wound care possible.

“It requires real thought around the support mechanisms in place to enable the delivery of this evidence based care,” she said.

“Much more work needs to be done to support evidence-based practice delivery in the home, with structured process and clinicians that are trained and enabled to deliver that quality care.

“By putting these structures in place you can deliver care that is on an equal footing as that in most clinics.”

Up to 68 per cent of home nursing care involves the provision of wound care.

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