Healing Hands

Wound Care is a Key Part of Serious Injury Care Serious injury care often involves the treatment and prevention of wounds, particularly for people who have suffered tissue and spinal cord injuries in workplace and auto accidents. There are many types of wounds – including burn, surgical, infectious and pressure – and home care staff play a key role in their care. Clients may also have health conditions, such as diabetes, that increase their risk of wounds.

“Wound care is a huge part of what we do,” says Zunobia Shafiqe, Manager of Clinical Services for Bayshore Home Health’s Vancouver-Private Services Office. She sees clients for initial home care assessments and sets up services as required.

Pressure wounds are common among people who must spend long periods of time sitting or lying down, such as those with serious injuries, people with paraplegia and quadriplegia, and senior citizens with reduced mobility. Also called bedsores or pressure ulcers, pressure wounds are areas of damaged skin and tissue that develop when sustained pressure, usually caused by a bed or wheelchair, cuts off circulation to parts of the body, frequently the hips, buttocks and heels. The tissue dies, causing painful wounds that can progress rapidly. They are often difficult to heal and can become infected and even life-threatening.

When assessing a client’s risk for pressure wounds, several risk factors are considered. These include a person’s level of mobility, whether protective reflexes or the ability to feel sensations has been compromised, bladder and bowel control, eating and nutrition, age, friction and shearing forces, trauma, and the use of equipment such as casts, traction, bedding or chairs.

Even with precautions in place, wounds can still develop. Treatment can involve medication, wound cleaning, dressings, surgery, frequent turning of the body to avoid pressure on fragile tissue, or the use of equipment, such as special mattresses.

To assist front-line staff, Bayshore has an innovative, national enterostomal therapists’ consultation program. Enterstomal therapists (ETs) are nurses specially trained in wound and ostomy care. Bayshore has five ETs and plans to hire more.

“Part of the client intake process is a proactive consultation with the ET,” says Holly Quinn, Bayshore’s Director of Clinical Programs. “We make sure everything is in place to prevent problems.”

When a client is admitted with a wound or develops one, it is assessed, and a digital photo is sent to an ET, such as Diane Ruyter, who works for Bayshore’s Barrie, Ontario, office. The ET reviews the photo and medical information and arranges a teleconference with on-site staff, if needed, before making recommendations. The staff provide progress reports to the ET. If a wound does not improve, they try another approach.

Ruyter has seen first-hand how speedier wound healing combined with encouragement and education from health care staff can make a dramatic difference. Aside from experiencing pain, people who have long-standing wounds are often depressed. “When the wound heals, they get their life back. Their mobility and social life improve, they’re free and able to do what they used to do, and they’re thrilled.”

Staying informed about wound care is a priority for nurses and ETs. “There are always new treatments,” says Shafiqe.

New developments in wound treatment also challenge home-care companies to keep pace. “We take steps to ensure we provide evidence-based wound care to our clients,” says Quinn. “We take best practice guidelines, assess them for validity and make sure the research has been done, then revise our policies and procedures to help our nurses live up to those guidelines.”

Bayshore is rolling out a cross-country program that provides its nurses with new knowledge. “All of our staff have had basic wound care training – this program updates that with today’s evidence-based practice,” explains Quinn.

There is clearly more to wound care than most people think, and integrating new research is something Bayshore takes seriously. “Wound care is a great area of nursing,” Shafiqe says. “It is really amazing to see a stage four pressure ulcer and be part of the healing process and assist in closing the wound. I enjoy helping clients get back to their ‘normal’ lives.”

BAYSHORE HOME HEALTH — A LEADER IN
SERIOUS INJURY HOME CARE

Bayshore Home Health is a Canadian-owned company and has been a trusted provider of home and community care services since 1966. It operates more than 30 offices nationally and works with many organizations that deliver specialized home care services to clients with serious injuries, including workers compensation boards, auto insurers, rehabilitation service providers and government care agencies. To learn more about any of the services listed below, please call 1-866-265-1920 or visit http://www.bayshore.ca/ .

* Brain and spinal cord injury care
* Wound and burn care
* Fracture and amputation care
* Palliative care
* 24-hour nursing
* Personal care and home support
* Serious injury care planning
* Safety assessments
* Teaching
* Care coordination with third parties