Prevalence of chronic wounds in Quebec home care: an exploratory study

Because the prevalence of chronic wounds in Quebec is unknown, researchers conducted a chronic wound prevalence feasibility study in severely ill, elderly, or bedridden home care patients. Questionnaires seeking information about the number of wounds, patient comorbidities, and characteristics of the most severe wound (etiology, location, duration, progress, and treatments) were mailed to the head nurse and home care nurses of 149 local community health centers. Information regarding nurse and general health center needs related to chronic wound prevention and care also was solicited from nurses in 52 health centers. Data were obtained from 488 patients (average age 68.5 years); an overall prevalence rate of 1.4% was determined. Most patients (81%) had one or two wounds and pressure ulcer was the most common etiology (37% of wounds). Wounds had existed for a mean of 26.8 months (range 0 to 180, median 12 months). Most (94%) patients had a family physician but only one third of family physicians were responsible for the wound care provided/prescribed. Lack of time was the most frequently cited reason for not completing the survey. Wound chronicity, severity (44% of pressure ulcers were Stage III), lack of improvement (60% cited no improvement or worsening of ulcer), the absence of protocols and training in some local community service centers, and inappropriate use of therapeutic modalities are important reasons for concern and provide opportunities for improvement. Sample size and the absence of verifiable data limit the external validity of the findings but results indicate that chronic wounds are a common and important concern among home healthcare patients in Quebec. Improvements in data collection and patient protocols of care are needed to facilitate the acquisition of much-needed wound prevalence and outcomes data to help agencies provide optimal patient care.