Monitoring wound healing in the home health arena.

To determine the type and quality of documentation in home health care agencies in the United States, a 15-question survey was sent to 500 agencies. The returned surveys revealed the following: (1) narrative notes were the most consistently used documentation tool; (2) 74% of agencies take photographs of the wound as part of their documentation; (3) 87% of agencies stage pressure ulcers according to the National Pressure Ulcer Advisory Panel (NPUAP) staging system; (4) 7% use reverse staging to document improvement in wounds; (5) 32% use standard protocols to treat different types of wounds; (6) 96% to 98% monitored healing by measuring length times width, as well as drainage and wound bed changes. The results indicate that most home health care agencies use the NPUAP staging system but do not track healing in a consistent way. They do not follow a consistent documentation standard, nor do their wound assessments bring together all the monitored factors indicative of healing progress.