title: Home care nurses' ratings of appropriateness of wound treatments and wound healing.
abstract: OBJECTIVE
  The purpose of this study was to examine nurses' ratings of appropriateness of wound treatments and wound healing for patients in home care in relation to patient demographic and visit variables.
  
  
  METHODS
  A cross-sectional design was used.
  
  
  METHODS
  Data were collected about patients with wounds by 281 nurses from 13 home care agencies located throughout lower Michigan. Patients with wounds (n = 881) ranged in age from 21 to 100 years. They included 492 women and 383 men who were white (72.4%) or African-American (26%).
  
  
  METHODS
  The Community Wound Assessment Tool was developed for the study and was used to obtain demographic and wound data. The demographic section contained information about the patient's age, sex, reason for the visit, length of visit, and time the case was opened. The wound section included the wound type, treatments, presence of incontinence, nutritional supplementation, and adverse home environmental factors. Nurses rated wounds as healing or not healing. Wound treatments were rated as all appropriate, some appropriate/inappropriate, and all inappropriate.
  
  
  METHODS
  Nurses were systematically selected from each agency and collected data about each patient visited on one occasion. MAIN OUTCOME MEASUREMENTS The main outcome measurements were the relationship of patient demographic variables and visit variables to the appropriateness of wound treatments and wound healing.
  
  
  RESULTS
  The nurses' rating of wound treatments as appropriate was significantly related to younger patient age and a shorter time for the case to be open. Wound healing was initially associated with younger patient age, continence of urine or stool, shorter home visits, shorter time for the case to be open, and fewer reasons for the visit. When wound healing was controlled for the type of wound in path analysis, the patient's age was no longer significant and incontinence appeared to impair healing of nonsurgical wounds. The appropriateness of the wound treatments was significantly related to wound healing.
  
  
  CONCLUSIONS
  Nurses' ratings of appropriateness of wound treatments and healing are significantly related to factors that affect length of service and complexity of care for the home care patient with a wound. Decisions nurses make about wound treatments and healing are important for the patient as well as for the agency.
authors.affiliation: Wayne State University, College of Nursing, Detroit, Michigan 48202, USA. bapieper@home.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Pieper
authors.forename: Thomas
authors.initials: T
authors.lastname: Templin
authors.forename: May
authors.initials: M
authors.lastname: Dobal
authors.forename: Ada
authors.initials: A
authors.lastname: Jacox
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009732:Nursing Care / Q000379:methods / Q000592:standards*; D017060:Patient Satisfaction; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000451:nursing* / Q000628:therapy*