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即时伤口护理:以卡尔加里为中心,围绕无家可归者的伤口护理模式。

Drop-In Wound Care: Calgary's Wound Care Model Centred Around People Experiencing Homelessness.

作者信息

Shin Wisoo, Dahchi Mustafa, Laird Jennifer, Lamano Rinna, Sair Kelly D, Emmott Eileen, Parsons Laurie

机构信息

Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Wound Clinic, Sheldon M. Chumir Health Centre, Calgary, Alberta, Canada.

出版信息

Int Wound J. 2025 Apr;22(4):e70179. doi: 10.1111/iwj.70179.

Abstract

People experiencing housing insecurities or homelessness face significant barriers to equitable healthcare. A drop-in wound care service was established to mitigate social barriers and improve accessibility. This model facilitates direct access to a multidisciplinary team of trauma-informed medical staff on a walk-in basis. A retrospective chart review was performed on patients seen at the drop-in clinic from January 2021 to December 2021. A total of 119 patients were serviced over 798 visits, with 254 unique wounds managed. 82.8% of patients were living unsheltered, in emergency shelters or in provisional accommodation at the time of assessment. Trauma wounds, lower leg ulcers and frostbites represented the top three complaints. 69.7% of all patients returned to service for at least a second visit, with a median of 4 visits per patient over 42.5 days. Unsheltered patients were most likely to return to service (87.5%) but were most likely to be lost prior to wound closure (68.8%). Timely access to care with consistent follow-up is essential for quality wound care. Our drop-in service presents a working model for providing equitable wound care to socially disadvantaged patient populations. The effectiveness of this model is highlighted by the continual expansion serving 909 and 1029 visits in subsequent years.

摘要

经历住房不安全或无家可归的人在获得公平的医疗保健方面面临重大障碍。为了减轻社会障碍并提高可及性,设立了一家即看即诊的伤口护理服务机构。该模式便于患者直接接触由具备创伤知情理念的医务人员组成的多学科团队,无需预约,随时就诊。对2021年1月至2021年12月在即看即诊诊所就诊的患者进行了回顾性病历审查。在798次就诊中,总共为119名患者提供了服务,处理了254处不同的伤口。在评估时,82.8%的患者居住在无遮蔽场所、紧急避难所或临时住所。创伤伤口、小腿溃疡和冻伤是最常见的三种病症。69.7%的患者至少复诊一次,每位患者在42.5天内平均就诊4次。无遮蔽场所的患者最有可能复诊(87.5%),但在伤口愈合前最有可能失访(68.8%)。及时获得护理并持续随访对于优质伤口护理至关重要。我们的即看即诊服务为向社会弱势群体提供公平的伤口护理提供了一个可行模式。该模式的有效性体现在后续几年服务量持续增长,分别达到909次和1029次就诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bab0/11955252/bf84a0c5553f/IWJ-22-e70179-g002.jpg

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Community-Based Wound Care Programs for Unhoused Individuals.社区为无家可归者提供的伤口护理计划。
J Epidemiol Glob Health. 2023 Dec;13(4):604-614. doi: 10.1007/s44197-023-00157-6. Epub 2023 Oct 17.
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Chronic wounds: Treatment consensus.慢性伤口:治疗共识。
Wound Repair Regen. 2022 Mar;30(2):156-171. doi: 10.1111/wrr.12994. Epub 2022 Feb 7.
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Health care for homeless people.为无家可归者提供的医疗保健服务。
Nat Rev Dis Primers. 2021 Jan 14;7(1):5. doi: 10.1038/s41572-020-00241-2.
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Trauma in adults experiencing homelessness.成年人无家可归者所经历的创伤。
Injury. 2020 Apr;51(4):897-905. doi: 10.1016/j.injury.2020.02.086. Epub 2020 Feb 20.

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