In providing consultation services to nurses at long-term care facilities, physicians John Croghan and Philip Sheridan Jr. saw a need — wound assessment, documentation and reporting of information to other caregivers could be made easier for nurses.
That led to development of a hand-held device, the WoundRounds Web-based solution used at bedside in nursing homes and other long-term care facilities where pressure ulcers and other wounds are a prime concern. Croghan and Sheridan founded WoundRounds LLC in 2005, and the Hoffman Estates, Ill., provider of technology-enabled solutions for care of the elderly later changed its name to Telemedicine Solutions LLC. The device includes prompts for wound assessment and treatment as well as a camera for a visual record of wounds.
“I tested it at another of our facilities,” said Phyllis Bergquist, RN, director of nursing at Durand (Mich.) Senior Care & Rehab Center. She was impressed, and today has her staff using WoundRounds, a hand-held, smartphone-sized device.
“It makes the charting so much easier,” Bergquist said. “All the records are kept automatically instead of having to transfer to paper. The direction were going in nursing is electronic charting and the elimination of paper. This gives us everything we need to accurately track wound care.”
Cory Fosco, Telemedicines vice president for long-term care solutions, demonstrated the device, which enables nurses to upload charts, records, assessments and even time-stamped photographs onto a secure site for physicians and other caregivers to review. The primary users are skilled nursing facilities, rehab hospitals and long-term acute care hospitals.
“For nurses, its about putting the right tool in the hands of the wound nurse or the treatment nurse as the primary user,” he said.
The device can guide the nurse through the Braden scale at the point of care. With a click, the nurse can call up the previous patient assessments, then point and click for any changes.
“It brings forward the last Braden that was done,” Fosco said. “Its all point and click. It registers changes to the assessment automatically in six subcategories, then it calculates the Braden score very quickly instead of the nurse having to calculate on paper.”
Once thats done, the nurse is given a menu of possible interventions to complete and/or check off on the device screen. The data then is stored so caregivers can see trends.
Beyond the Braden scale, the nurse can bring up an 11-point assessment based on guidelines from the Wound, Ostomy and Continence Nurses Society and the National Pressure Ulcer Advisory Panel.
Fosco said part of the devices utility is in facilitating a consistent process for wound assessment.
“What do I see? What am I treating? What are the characteristics? With our solution, they can see the active wounds,” he said. “They also can add new wounds if need be. Its a consistent assessment every time the nurses do it. I can bring up the previous assessment, which looks at things like characteristics, classification, drainage amount, what the wound edge looks like. Then I can make specific changes reflecting what Im seeing and what Im treating.”
For facilities that have the camera enabled, a picture of the wound is automatically date- and time-stamped, a medical record number added and automatically attached to the assessment.
As the assessment is completed, WoundRounds calculates the pressure ulcer scale for healing developed by the National Pressure Ulcer Advisory Panel score and enables the nurse to document treatments and supply use. After use, the device is wiped down to prevent infection spread. Back at a computer, WoundRounds can upload the information just documented through an ethernet port.
At Provena McAuley Manor, a long-term care facility in Aurora, Ill., Wound Care Coordinator Maribel Falzone, LPN, said she uses WoundRounds every day.
“After the WoundRounds have been done, I can pull out reports of every type,” she said. “I send reports to my director of nursing, letting her know for this week how many pressure ulcers we have, how many were acquired, how many were admitted. For our quality assurance meetings, Im able to pull data from three months and let them know how things are going. How are we progressing? Where are our weaknesses? It even pinponts it to locations. If were having issues, I can locate where in the building were having issues.”
Bergquist said the device has proved itself useful and practical. Would she recommend WoundRounds to other facilities? “Definitely,” she said.
John Grochowski is a copy editor.