Evaluation of the assessment and documentation of chronic wounds in residential social care in the Czech Republic.
OBJECTIVE
Accurate evaluation of non-healing, chronic wounds followed by the selection of an appropriate therapeutic strategy is a must for the foundation of health-care management. Assessment of non-healing chronic wounds in clinical practice in the Czech Republic is not standardised in acute care settings or in residential social care facilities. The aim of the study was to analyse the methods being used to assess non-healing, chronic wounds in residential social services in the Czech Republic, where more patients with chronic wounds are present because of the increasing incidence of wounds in old age.


METHODS
The research was carried out at 66 residential social care institutions across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The same methodology was used in previous work which has been done in acute care settings in 2013.


RESULTS
The results of this research have corroborated the inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to the evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of the wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were improved when a consultant for wound healing was present.


CONCLUSIONS
An effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of 'non-healing, chronic wound assessment' algorithm.
Associate Professor (docent) Masaryk University, Faculty of Medicine, Department of Nursing. Brno, Czech Republic.
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Saibertová
Associate Professor (docent) Masaryk University, Faculty of Medicine, Department of Nursing. Brno, Czech Republic.
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Pokorná
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D018153:Czech Republic; D004282:Documentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D012112:Residential Facilities / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy*
Czech Republic; documentation; long-term care; nursing homes; wound assessment; wound healing