Using Telehealth Technology to Implement Evidence-Based Wound Care in Underserved Practice Settings
Review TypeNone: Sigma Grant Recipient Report
Repository Posting Date2019-02-21T22:01:47Z
Author DetailsVallire Hooper PhD, RN, CPAN, FAAN Nurse Scientist Scholar Mission Health Asheville, NC email@example.com
Lead Author Sigma AffliationEta Psi
Lead Author AffliationMission Health
Level of EvidenceDescriptive/Correlational
Research ApproachTranslational Research/Evidence-based Practice
CINAHL HeadingsTelemedicine; Telenursing; Professional Practice, Evidence-Based; Medically Underserved
Background: Chronic wound care remains a major US healthcare problem, impacting approximately 1 million older adults and 3 million total adults annually. The issue is particularly grave in the LTC setting where 13.2% of newly admitted ulcer-free patients will develop a new PU within the first year of admission. Evidence supports the use of WOC nurses to assure the highest level of quality, cost-effective care delivery in the management of PU and other chronic wounds. Unfortunately, a global shortage of WOC nurses limits this positive effect on wound care outcomes. Purpose: The purpose of this evidence-based practice (EBP) project was to test the fidelity and feasibility of using telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings. Methods: The project was conducted in two phases. Phase I incorporated an inter-rater reliability design with a specific focus on treatment integrity. Phase II incorporated an iterative, descriptive, exploratory design with a focus on treatment impact on patient outcome. A return-on-investment (ROI) analysis was also conducted. Findings: Telefidelity testing yielded an intra-rater reliability of 98% and an interrater reliability of 100%. Despite a lack of improvement in wound outcomes, other unexpected positive findings were noted. The telehealth technology device was well received by patients and families, nursing staff, and physicians. Return-on-investment analysis showed that the cost of the tele-technology purchase, inclusive of staff training, was recouped in less than 4.5 months of telewound consults. Recommendations: Results support further evaluation of telehealth technology as a tool to enhance the delivery of wound care services in remote underserved settings. Implementation and evaluation of this technology on clinical and financial outcomes in multiple wound care delivery environments should be determined moving forward. Successful implementation should serve as a template to expand evidence-based WOC nursing care across the globe.
DescriptionThe poster was presented at 3 different conferences in 2018: National Pressure Ulcer Advisory Panel, Las Vegas, Nevada, USA Wound, Ostomy, and Continence Nurses Annual Conference, Philadelphia, Pennsylvania, USA, and International Rural Nursing Conference, Nashville, Tennessee, USA
Vallire Hooper was the 2015-2016 Sigma Grant Recipient of the STTI/American Nurses Credentialing Center Evidence-Based Practice Implementation Grant Program
NotesThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
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