Date of Graduation

Spring 5-14-2020

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Family Nurse Practitioner

First Advisor

Karen A. Van Leuven, PhD, FNP-C

Second Advisor

Jodie P. Sandhu DNP, FNP-C

Abstract

Problem. Due to the aging population and the high prevalence of chronic diseases such as diabetes and cardiovascular disease, in the US, millions of people suffer from chronic wounds secondary to these chronic conditions. Wound care treatment is very expensive, costing the US health care system approximately $10 billion annually. San Mateo Medical Center treats many patients with wounds. However, the treatment is suboptimal as most primary care providers (PCPs) are not trained to perform wound care according to best practice. This creates several problems such as a large number of referrals to the Vascular Clinic, visits to the emergency room for dressing changes, and admissions to the hospital due to preventable wound infections.

Intervention. Wound care education targeted at PCPs was identified as an intervention to improve health outcomes through the delivery of evidence-based, cost-effective wound care. This project consisted of a class on assessment and management of vascular wounds, diabetic wounds, pressure injuries, and surgical wounds in the primary care setting. The class was implemented at San Mateo Medical Center on May 1st, 2019.

Measures. A pre- and post-class assessment was used to measure change of practice and practice improvement in the delivery of wound care in the outpatient clinics.

Results. Data analysis indicated that after the class, the PCPs felt knowledgeable regarding assessment and treatment of vascular wounds, diabetic wounds, surgical wounds and pressure injuries. The PCPs’ practice also improved as a result of the wound care class indicated by a mean value of 3.5 in the Likert Scale. Referrals to the Vascular Clinic decreased by 77.8%.

Conclusion. The provision of real-time, evidence-based, cost-effective wound care ensures the safety of patients by improving their health outcomes and increasing their satisfaction. Improving wound care knowledge by PCPs has long term implication that will benefit all parties in our organization.

Keywords: wound care treatment, chronic wounds, evidence-based, outpatient wound care, and best practice.

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