The American College of Surgeons (ACS) Surgical Patient Education Program has developed a Home Skills Program for Wound Care. The program includes booklets and skills videos on the care of lacerations and abrasions, the management of surgical wounds, and the care of slow healing and chronic wounds, including pressure ulcers, diabetic foot ulcers, and venous leg ulcers, will complete the program.
Building on the success of the Ostomy, Feeding Tube, Central Line and Your Lung Operation Home Skills Kits, the new skills program will be used by surgeons and other wound management professionals (physicians, nurses, physician assistants, and aides) with the patient and family. The aim of the program is to improve the quality of patient care and promote safety through education that recognizes the role of patients as integral members of the surgical team.
The incidence of non-healing cutaneous wounds in the U.S. is 5 to 7 million episodes per year, costing the nation’s healthcare system an estimated $20 billion annually. Approximately 60 percent of wounds managed in the home are surgical, and within all of home care, 50 percent of cases involve complex wound management.1 Diabetic patients with non-healing wounds that result in amputation may have a mortality rate of up to 50 percent in five years—a rate similar to several types of cancer.2
The lack of post operative wound care education for patients is a reason for avoidable readmissions. Small studies have indicated that 63 percent of patients who did not receive wound care information needed to access a health care facility after discharge due to a wound-related issue they were not equipped to handle. With approximately 65 percent of operations being outpatient, there needs to be greater emphasis on helping the patient and his or her family to manage their wound care post discharge.
The average physician in training receives less than 10 hours of formal didactic education related to wound care, despite the complexity of non-healing wound care.3 And although families are the major providers of long-term care, no standardized patient education training program or outcome database is available to ascertain the efficiency of wound healing practices, measure the reduction in additional services, or focus attention on other endpoints, including health-related quality of life, functional status, and satisfaction. For outpatients, the most influential factors of patient satisfaction in surgery are informed consent and information about home care after discharge.4
The wound program was developed collaboratively with input from several specialty areas, including the ACS Advisory Councils for General, Plastic, Gynecology, Vascular and Orthopaedic Surgery; American College of Wound Healing and Tissue Repair; American Association for the Surgery of Trauma; Uniformed Services University of the Health Sciences; American Burn Association; Association for the Advancement of Wound Care; Wound Ostomy Continence Nurses; and patients.
The program includes wound-specific instructional booklets with step-by-step skill instructions and skills videos. Electronic delivery will be available with resources and documents placed on key websites for optimal access by patients, families, surgeons, and nurses; professional training offered through the ACS and at accredited skill centers; and the opportunity for use on hospital education channels.
Resources for surgical patients are available on the ACS website or at the Patient Education Booth located in ACS Central in the San Diego Convention Center, Exhibit Hall. You can obtain free copies of the program, which includes checklists and evaluations to solicit patient input on their wound experience and use of the program. The ACS would also appreciate surgeon feedback and will provide a short survey about your experience with the wound program.
Educational grants from Acelity, Smith & Nephew, and Ethicon have provided partial support for this program. For details regarding the ACS Wound Management Program, contact Nancy Strand at [email protected].
References
1 McNaughton V, Orsted H. Surgical site infections in community care clients. Wound Care Canada. 2005;3:10-13.
2 Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, et al. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719-1724.
3 American College of Wound Healing and Tissue Repair and the Angiogenesis Foundation. Patient-centered outcomes in wound care. 2013; V1. Available at: https://acwound.org/news/WoundCareWhitePaper.pdf. Accessed on October 9, 2017.
4 Pieper B, Sleggreen M, Freeland B., et al. Discharge informational needs of patients after surgery. J. Wound Ostomy Continence Nur. 2006; 33(3):281-291.