Non-Healing Wound Outcome-Based Pathway
Transcription
Non-Healing Wound Outcome-Based Pathway
Non-Healing Wound Outcome-Based Pathway Pathway Identification Pathway Name Presenting Issue or Condition Defined Exclusion Criteria Overall Pathway Outcome Reason for Stoppage Non-Healing Wound A wound in which the patient does not have the physical capacity to heal 1. o o o o o o o New referrals (except in long-stay populations) Malignant wounds Maintenance wounds Prevention of wound deterioration Wound closed Supervening event: o Transfer to other CCAC o Admission to hospital >14 days o Admission to a LTCH o Death o Vacation away from home > 30 days o Patient refuses care Other: 1 Norton, L., Coutts, P. & Sibbald, G.R. (2011). Choosing between a healable, non-healable and maintenance wound. Wound Care: www.rehabmaganzine.ca, Fall 2011. 1v5 - 20130913 © Community Care Access Centre/Centre d’accès aux soins communautaires and Ontario Association of Community Care Access Centres/Association des Centres d’accès aux soins communautaires de l’Ontario, 2013. All rights reserved. Unauthorized distribution and duplication strictly prohibited. Page 1 of 5 Non-Healing Wound Outcome-Based Pathway Pathway Evaluation Date Created Date Reviewed (Subject Matter Experts) Subject Matter Experts Date of Endorsement by Provincial Patient Services Frequency of Review Next Review Date What triggers a special condition review of pathway April 24, 2012 N/A Based on Ontario Home Care Association & Ontario Community Support Association (OHCA-OCSA), Nursing Practice Council (NPC) feedback June 29, 2012 TBD based on RNAO and CAWC guidelines May 2014 Criteria for special condition review will be determined based upon results obtained from the OBP/OBR pilot. 1v5 - 20130913 © Community Care Access Centre/Centre d’accès aux soins communautaires and Ontario Association of Community Care Access Centres/Association des Centres d’accès aux soins communautaires de l’Ontario, 2013. All rights reserved. Unauthorized distribution and duplication strictly prohibited. Page 2 of 5 Non-Healing Wound Outcome-Based Pathway Best Practice Guideline Interval Outcome o 0 to 7 Days (from start of Non-Healing Wound pathway) o CAWC Best Practice Recommendation s for Preparing the Wound Bed o Holistic patient and wound assessment completed Outcome Evaluation Reporting o Correct outcomebased pathway confirmed o Wound therapy initiated/reassessed o SPO SPO SPO o o o Outcome not met Outcome not met Outcome not met Barriers to Outcome Achievement o o o o o o o o o o o Stanford SelfManagement Program o Discharge planning initiated for patient independence o SPO o Outcome not met o o o o o Resource barriers o Patient o SPO o CCAC o System Patient declined Other: Inaccurate diagnosis on referral Incomplete SPO report Unknown etiology Other: Patient contraindication Resource barriers o Patient o SPO o CCAC o System Patient declined Other: Non-adherence to BPG o Patient o SPO o CCAC Patient declined Patient capacity Resource barriers for purchase of supplies o Patient o SPO o CCAC o System Other: Follow up Actions o o o o o o o o o o o o o o o CC system navigation to address resource barriers Contact patient / caregiver re: rationale Other: Follow-up with SPO for report completion Discontinue pathway Other: Inter-professional referrals to address contraindications CC system navigation to address resource barriers Contact patient / caregiver re: rationale Other: Consult with SPO / ET / Wound Care Specialist Inter-professional referrals as required CC system navigation as required Contact patient/caregiver re: rationale Other: 1v5 - 20130913 © Community Care Access Centre/Centre d’accès aux soins communautaires and Ontario Association of Community Care Access Centres/Association des Centres d’accès aux soins communautaires de l’Ontario, 2013. All rights reserved. Unauthorized distribution and duplication strictly prohibited. Page 3 of 5 Non-Healing Wound Outcome-Based Pathway Best Practice Guideline Interval Outcome o 0 to 7 Days Chronic disease self-management plan initiated Outcome Evaluation Reporting o SPO o Outcome not met Barriers to Outcome Achievement o o o o o 8 to 21 days o Q3 months o CAWC Best Practice Recommendation s for Preparing the Wound Bed Assessment and Identification of resource/system barriers – intervention initiated No change in wound o CCAC o Outcome not met o o o o o SPO o Outcome not met o o o o o Non-adherence to BPG o Patient o SPO o CCAC Patient / caregiver appropriateness for selfmanagement Already linked with resource Patient declined Other: Resource barriers o Patient o SPO o CCAC o System Patient declined Patient capacity Other: Non-adherence to BPG o Patient o SPO o CCAC Resource barriers o Patient o SPO o CCAC o System Causative factors o Internal o External Patient declined Other Follow up Actions o o o o o o o o o o o o o o o o o o Validate use of BPG Consult with SPO Inter-professional referrals as required CC system navigation as required Contact patient / caregiver re: rationale Other: CC system navigation to address resource barriers Contact patient/caregiver re: rationale Inter-professional referral as required Escalation to manager Other: Validate use of BPG Inter-professional referrals as required CC system navigation to address resource barriers Consult with SPO ET / Wound Care Consultant Contact patient/caregiver re: rationale Case conference Other 1v5 - 20130913 © Community Care Access Centre/Centre d’accès aux soins communautaires and Ontario Association of Community Care Access Centres/Association des Centres d’accès aux soins communautaires de l’Ontario, 2013. All rights reserved. Unauthorized distribution and duplication strictly prohibited. Page 4 of 5 Non-Healing Wound Outcome-Based Pathway Interval Q3 months Best Practice Guideline Outcome o Resource/system barriers addressed Outcome Evaluation Reporting o CCAC o Outcome not met Barriers to Outcome Achievement o o o o Resource barriers o Patient o SPO o CCAC o System Patient declined Patient capacity Other Follow up Actions o o o o o CC system navigation to address resource barriers Contact patient/caregiver re: rationale Inter-professional referral as required Escalation to Manager Other 1v5 - 20130913 © Community Care Access Centre/Centre d’accès aux soins communautaires and Ontario Association of Community Care Access Centres/Association des Centres d’accès aux soins communautaires de l’Ontario, 2013. All rights reserved. Unauthorized distribution and duplication strictly prohibited. Page 5 of 5