Patients with wound and skin lesions represent a high volume and high cost patient population. In the current provider system, home health care agencies need to balance effective care with prudent resource use. Despite evidence based practice recommendations that the appropriate approach to wound care is through moist healing practices, anecdotal information suggests that wet-to-dry dressings continue to be used. The purpose of the study was to determine the prevalence of wet-to-dry dressings among a home health care patient population and evaluate the patient outcomes between wet-to-dry and moist wound healing approaches. Data were obtained from 5 home health care agencies in northeastern Ohio that provided clinical information on patient status, wound healing approaches, and numbers of visits. Patients (N=515) were on average 67.3 years old, 57.1% female and 20.5% minority ethnicity. Of those requiring dressings (57%), patients with surgical wounds (N=185) were the most common, followed by 63 subjects with pressure ulcers and 29 subjects with stasis ulcers. Use of wet-to-dry dressings occurred in 28%, 18% and 43% of patients, respectively. There were no significant differences in healing status when comparing the three groups on wet-to-dry versus moist wound healing approaches. There were significant differences in the numbers of home visits required for patients with stasis ulcers wherein the patients receiving wet-to-dry dressings required substantially more visits (43.4 versus 18.1, t=2.37, p=.03). Despite years of evidence to the contrary, wet-to-dry dressings continue to be used. Although there were no differences in healing status, the measure of healing was gross and more refined measures are needed. A second finding of note was the number of home health care patients with identified wounds who did not require any kind of dressing suggesting that gross measures may over-estimate the numbers of patients with wounds.
Session #1204 - Home Care
The 29th Annual MNRS Research Conference (April 1-4, 2005)