Gentiva Wound Care Protocols^®

Background:
Marie S., is a 62-year-old Illinois resident with a diagnosis of venous stasis with a painful, leg ulcer. For the past two years, the wound had been treated by her husband with daily gauze dressings and ACE wraps. She had been fitted for compression stockings in the past, but was not consistently wearing them.

Individual Needs:
Marie was referred to Gentiva by her physician for wound care and edema control measures. The bilateral lower leg edema made it difficult for her to walk and the painful, draining wound impeded her overall quality of life. The evaluating nurse wanted another opinion, so she took a digital photo of the wound and transmitted it via email to Gentiva's National Director of Wound Care Services, Ben Peirce, RN, ET, CWOCN. Within 24 hours, Peirce scheduled a teleconference with the nurse and suggested an occupational therapist join the treatment team.

The Treatment Process:
Using Gentiva's LifeSmart^® Care Protocols, Marie's treatment team-which consisted of a registered nurse, an occupational therapist and a home health aide-developed a plan of treatment that included three nursing visits a week, approved by the physician . The nurse applied and monitored an advanced foam dressing designed to manage the exudite without drying the wound. This resulted in less pain during dressing changes and less frequent dressing applications. The foam dressing's low profile also made applying compression easier. After the physician ruled out peripheral arterial disease, the occupational therapist taught Marie how to put on her fitted compression stockings to control the edema. And the home health aide assisted with an ADL carepath so Marie could be more mobile and independent in her home. This also increased the effectiveness of the compression stockings.

Recovery and Results:
After several visits, it became clear to the occupational therapist that Marie was still having difficulty managing the compression stockings. She did some additional research with a DME company on compression therapy and ordered innovative Velcro-secured compression garments¹ that Marie was able to manage more easily. As the wound pain subsided, she and her husband were able to change the foam dressings three times a week. With the consistent edema control measures in place, the wound healed quickly. Marie continues to consistently wear her compression garments and to walk regularly and the wound has not recurred during the six months since then.

"This case perfectly illustrates the essence of our LifeSmart^® Care Protocols," says Peirce. "They guide us along a path of evidence-based disease management with measurable goals and predictable outcomes. However, our focus is not simply on the wound. We are just as concerned with patient becoming independent in managing the underlying chronic condition. It's a much more pro-active approach than has been used in the past and it requires real teamwork. And we've found that it not only heals wounds but it also cuts down on recurrences."

1. CircAid, www.coloplast.com