Clinical Update Innovations in pressure ulcers


Development of wound care software for smartphones and tablets


T


he biggest challenges affecting the control and treatment of pressure ulcers are non-compliance to protocol and inconsistency of documentation. Electronic


information systems may contribute to better documentation access, accuracy and wound assessments. The software application, detailed below is prototyped on


an Android smartphone and tablet, and offers advantages over paper-based charting, namely —data sharing and remote consultation between multiple healthcare providers; wound histories in graphic and text format, including wound images; alarms for programmable conditions; ongoing learning via help screens and tutorials. The work can improve documentation of pressure ulcers,


improve patient and caregiver experience, and advance e-health in nursing practice. This report describes an interactive software application that runs on a smartphone or tablet device to allow healthcare workers to electronically document pressure ulcers and other chronic wounds. The work advances healthcare applications for handheld devices within the broader scope of e-health. The prevalence of pressure ulcers is 25% in patients in


acute care, 30% in non-acute care, 22% in mixed health-care settings, and 15% in community care[1]


. Pressure ulcers are


one of the leading iatrogenic causes of death reported in developed countries, with patients in long-term care and the elderly being particularly vulnerable. Although preventable and treatable if found early, bedsores can become chronic, can lead to secondary infections, and may even become fatal — even under the auspices of medical care. The development of pressure ulcers also directly impacts quality of life, as patients face additional stress due to loss of independence and social isolation[2][3]


. The problem extends to other chronic wounds,


such as venous and arterial leg ulcers, and diabetic foot ulcers. Risk assessment and regular standardised documentation


are identified as critical steps in the prevention and treatment of pressure ulcers, and one of the biggest challenges to controlling and treating pressure ulcers are non-compliance to protocol and inconsistency of documentation[4][5]


. These


challenges are exacerbated by lengthy forms and time pressures on healthcare workers. As a result, electronic information systems are being explored as a means to contribute to better documentation access and accuracy, information sharing and, ultimately, better wound assessments and treatment[6]


. A broad review demonstrates numerous e-health


technologies being developed for the healthcare community, although they are not well-catalogued. Relative to wound care, MediSense[7]


offers wound care software on a web- based interface that can be viewed on a computer monitor. Figure 1. Screen shot of MediSense software. Well Care Strategies[8] offers healthcare facilities the option to


build modular wound care software from a menu of options and features. The product most similar to the authors' work is WoundRounds, developed in the US[9]


, which is a software


application running on a smartphone or handheld device. The authors' work offers the benefit of tailoring the application to the facility-specific wound care forms and other facility-specific preferences and IT infrastructure.


Wound care software on handheld devices We have developed a prototype e-health solution to promote higher consistency and compliance in wound care documentation in comparison with paper-based systems. It is an interactive software application used to electronically document chronic wounds and wound care, with applicability across hospital, care home, and homecare settings. The wound care software has been developed on the Android platform for 3G/4G smartphones and tablet devices with back-end database services. The software application replicates the data entry on paper forms [Fig 1] currently used within the local Regional Health Authority, including the National Pressure Ulcer Advisory Panel's (NPUAP)’s PUSH tool, the Braden Scale, and other wound care management forms used by the specific regional health authority.


Benefits The software application offers four distinct advantages over paper-based charting.


Telehealth The wound care software facilitates data sharing and remote consultation between multiple healthcare providers over a 3G/4G cellular or WiFi network. This allows for wound management consultants, physicians, and other specialists to provide team-based care to a patient without physically moving the patient between multiple facilities. The ability to consult remotely is a significant benefit to a patient with pressure ulcers, who will often also experience limited mobility.


www.woundsinternational.com 13


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