Evidence-based health care in home care

How do you make decisions about which treatment to use when you have a patient with an eschar-covered pressure ulcer on the sacrum or a patient with diabetes who develops an ulceration on the metatarsal head? For years, health care professionals relied on past experience, the experience of colleagues, or new product sales literature. In today's cost-conscious, outcomes-driven health care environment, however, approaches such as clinical reasoning are often not enough and, in fact, are often unacceptable. But why is that?