On the Mend
By KJ Fields
Group Health's Wound Care Program, available in all clinics, helps patients with chronic, non-healing wounds.
Proper cleaning and a bandage often help a wound, scrape, or minor injury heal on its own. But some wounds require special medical attention. For example, Group Health member Carolyn Erhardt, who has diabetes, had an ankle wound that refused to close for two years. When she developed a second fast-growing wound that became infected, her doctor sent her to a Group Health Wound Team nurse. "It was really scary. I found out that I could've lost my leg or even my life," recalls Erhardt.
Chronic wounds like Erhardt's are at risk for infection, re-injury and, in extreme cases, may even require the removal of a limb. There are many types of wounds — arterial wounds, pressure ulcers, crush injuries, diabetic ulcers, surgical incisions, and abscesses — each requiring individual management. Because proper treatment is a complex issue, Group Health established a Wound Care Program in 2009 staffed with registered nurses who are credentialed to provide high quality, evidence-based care for patients with chronic wounds.
"Evidence shows that consistent wound care provided by a team of trained, dedicated staff helps wounds heal faster," says Paul Thottingal, MD, certified wound specialist physician (CWSP), medical director of the Wound Care Program, and an infectious disease specialist. "We create a team around the patient that includes their primary care provider, a wound care nurse, and other clinicians such as the pharmacist, nutritionist, specialists, or educators as needed. Group Health also provides expertise through nationally certified nurse practitioners who support the wound teams, primary care physicians, and specialists as they manage these wounds.
Located in every Group Health clinic, the overall program now manages between 250 and 300 patients at any given time.
Involving Patients as Partners in Care
Conditions such as diabetes, high blood pressure, kidney disease, peripheral neuropathy (loss of sensation in hands and feet), certain medications, or poor nutrition can interfere with healing. "Every situation is different so we look at the whole patient to find out what is preventing recovery," explains wound care nurse Jeanne Butler, RN. "Patients need to be actively involved in their treatment and follow the advice they get from the team."
Erhardt did just that. She was put on antibiotics, insulin, and a strict diet and she visited her wound care team three times a week. "The nurse or pharmacist called me almost every day to make sure I was staying on track," Erhardt says. "I'm amazed at how much they did for me." Within five weeks, Erhardt's wounds were healing.
In all Group Health clinics, the patient's team tracks each wound's progress against benchmarks, and if things don't proceed as expected, they draw upon the combined expertise of Group Health's entire Wound Care Program to review the case on a regular basis.
"This is a sophisticated, very patient-oriented program that's getting unbelievable results," says Butler. "Some of our patients have had wounds for years that are finally being closed in just a few months."