ABSTRACT
When the Association for Advanced Wound Care Quality of Care Task Force members determined there was no unanimously accepted definition of quality as it relates to wound care, they: 1) identified relevant components of quality wound care, and 2) created a framework of quality wound care indicators to enable the creation or assessment of wound care delivery systems. The framework is an innovative conceptual model that serves as a basis for the Association strategies to facilitate high quality wound care for patients/clients across the continuum of care and recognizes the role of the supporting systems necessary to provide wound care services. It uses the Institute of Medicine's Crossing the Quality Chasm: A New Health System for the 21st Century to define quality systems for wound care and includes safety and effectiveness coupled with the delivery of timely, efficient, equitable, collaborative, patient-centered care. This framework can be utilized during clinical, managerial, or regulatory review of wound care service delivery.
Subject(s)
Quality of Health Care , Wounds and Injuries/therapy , Humans , Outcome Assessment, Health Care , Patient-Centered CareSubject(s)
Nursing Assessment/methods , Physical Examination/methods , Humans , Integumentary System/abnormalities , Integumentary System/injuries , Integumentary System/pathology , Integumentary System/physiology , Physical Examination/nursing , Skin Physiological Phenomena , Skin Pigmentation , Skin Temperature , SmellSubject(s)
Aging , Eczema/prevention & control , Ichthyosis/prevention & control , Skin Care/methods , Skin Physiological Phenomena , Skin/anatomy & histology , Aged/physiology , Aging/pathology , Aging/physiology , Baths/methods , Baths/nursing , Eczema/etiology , Emollients/therapeutic use , Geriatric Assessment , Geriatric Nursing , Humans , Ichthyosis/etiology , Keratolytic Agents/therapeutic use , Nursing Assessment , Skin Care/nursingABSTRACT
Assessment and management of stoma complications are often the responsibility of nurses across the continuum of care. These complications can occur at different times based on their etiology - immediately postoperatively or even several years after surgery - and often require modifications in a person's daily stoma management. This article presents a conceptual framework to help categorize types of stoma complications based on either etiology or location and offers management options to facilitate quality care. The five major categories of complications include Poor Siting, Stoma Proper, Peri-Intestinal Area, Mucocutaneous Junction, and Iatrogenic. Most of these suggested approaches to care are the recommendations of certified ostomy nurses based on their educational training, expert opinion, and successful experiences. Although these recommendations have often solved the specific problems and greatly improved the quality of life for the person with stomal complications, much research is still needed to confirm and/or improve these nursing approaches.
