VHA Home HealthCare, Toronto, Canada.
Humber River Health, Toronto, Canada.
J Wound Care. 2023 Nov 2;32(11):748-757. doi: 10.12968/jowc.2023.32.11.748.
To improve wound-related quality of life (QoL) in clients with hard-to-heal wounds in their lower limbs and to increase referrals to multidisciplinary teams in the management of care for these clients.
This was a quality improvement project with a two-group pretest-posttest interventional evaluation design. We implemented a package of interventions including the WounDS app, education related to wound care, and client engagement through a QoL self-assessment. Wound-related QoL was measured using the Cardiff Wound Impact Schedule and referrals to the multidisciplinary team were tracked through chart audits. We explored nurses' experiences with the interventions through semi-structured interviews.
Clients' average ratings for 'wellbeing', 'physical symptoms and daily living', and 'overall QoL' improved by 27%, 38% and 54%, respectively. The number of referrals increased by 78% post intervention. Nurses described the interventions as effective strategies that motivated them to implement a holistic approach to care.
The project was successful in creating a culture shift to practice holistic wound care. This package of interventions (WounDS app, education and client self-assessment of QoL) led to improvements in the QoL of clients with hard-to-heal wounds. Further studies are needed to generalise the findings. Strategies for sustainability include forming a champion group and providing the education and decision supports based on nurses' educational needs assessment.
提高下肢慢性难愈合伤口患者的伤口相关生活质量（QoL），并增加向多学科团队转介以管理这些患者的护理。
这是一个质量改进项目，采用两组成组预测试后干预评估设计。我们实施了一整套干预措施，包括 WounDS 应用程序、与伤口护理相关的教育以及通过 QoL 自我评估来让患者参与。使用卡迪夫伤口影响量表（Cardiff Wound Impact Schedule）来衡量伤口相关 QoL，通过图表审查来跟踪向多学科团队的转介情况。我们通过半结构化访谈探索了护士对干预措施的体验。
患者在“幸福感”、“身体症状和日常生活”以及“整体 QoL”方面的平均评分分别提高了 27%、38%和 54%。干预后转介数量增加了 78%。护士将这些干预措施描述为有效的策略，激励他们采用整体护理方法。
该项目成功地改变了实践整体伤口护理的文化。这组干预措施（WounDS 应用程序、教育和患者 QoL 自我评估）导致慢性难愈合伤口患者的 QoL 得到改善。需要进一步的研究来推广这些发现。可持续性策略包括组建一个拥护者小组，并根据护士的教育需求评估提供教育和决策支持。
