Wound management in home care: an assessment

The purpose of this study was to determine the status of wound care management among home health agencies (HHAs) in the U.S. The survey was mailed to 562 randomly selected HHAs within all 10 HCFA regions. Two hundred and ninety-six agencies (53%) responded to the survey. The majority (56%) of the respondents did not have written policies and procedures specific to wound management. The investigators were able to analyze the documents of those who had indicated that they had written policies and sent copies of them (n = 87, 67%). The majority (76%) of these had separate wound assessment protocols, but only 14% had separate preventive skin assessment protocols. Sixty-four percent had treatment protocols for more than one type of wound, while the remaining 46% used no specific treatment protocol or used treatments based on physicians' orders only. Most of the HHAs with written wound management policies required documentation of wound status; however, only half had patient/caregiver teaching as part of the policy. Although there is a need for clinically useful, well-tested, standardized approaches to wound care, the results of this study indicated that there is inconsistency regarding wound care management among HHAs within the U.S.