Interprofessional management of a complex continuing care patient admitted with 18 pressure ulcers: a case report

Interprofessional practice (IP)--ie, collaborative practice--involves interaction and knowledge-sharing between professionals from different disciplines in order to meet the needs of the patient. This approach to care is well suited to patients with pressure ulcers, whose complex and varying presentations require the monitoring and consultation of an IP team. A 44-year-old man with anoxic brain injury was admitted to a complex continuing care facility with 18 wounds, 17 of which were pressure ulcers. The patient was at high risk for further skin breakdown as a result of immobility, incontinence, impaired cognition, impaired sensation, low body weight, and positioning challenges secondary to contractures and spasticity. Wounds were located primarily around the patient's sacrum, trochanters, feet, and ankles. The care team included a physician, unit manager, clinical nurse educator, nurses, physiotherapist, occupational therapist, registered dietician, and pharmacist, all with varying roles related to wound care. The patient's wife was concerned about his overall health status and wanted to move him out of his room in a wheelchair to spend time with him. Using current best practices, the IP team implemented management strategies that facilitated wheelchair time during family visits; plus, all 18 wounds healed within 15 months of admission. The patient did not develop any new areas of skin breakdown. IP collaboration facilitated the problem-solving needed to meet the complex needs of this patient.