A recent study by researchers at the University of Chicago found that the reporting of wounds, especially pressure wounds, by long term care facilities is significantly underreported. Although the Centers for Disease Control states that approximately 11 percent of residents have pressure wounds, the Chicago study estimates that that number could be quite a bit higher.

In fact, pressure wounds are only one of the types of wounds from which residents of long term care facilities suffer. Another study shows that about 60 percent of wounds come from other causes including arterial and venous ulcers, diabetic ulcers, punctures, and skin tears. Although it may be challenging to gauge the precise number of patients with wounds in long term care facilities, the point is that a large number of residents suffer from them.

If we agree that the number of wounds is underreported, underreported wounds may be untreated or undertreated as well. From a legal perspective, this may be possible. For example, judging by the details behind cases filed against long term care facilities in the courts, a large number of cases list insufficient care of wounds as a cause for instigating the action. Therefore, in addition to the patient distress caused by untreated or undertreated wounds, this perceived institutional weakness from lack of attention to wounds opens long-term care facilities to greater risk from sanctions and litigation. This perception can have a significant negative impact on the organization, its brand and on the long-term industry as a whole.

We believe that there is an answer; one that will promote quality patient long term care while reducing organizational expense and risk. The solution requires adopting a new perspective on wound care within the organization and within the industry, one that removes wound care as a source of stigma and elevates it in priority and protocol, with the potential to benefit all parties—patient, facility and industry.

We call this new perspective creating a wound care culture within your organization. A culture is an environment of shared values and beliefs. By changing the wound care paradigm from the tactical cause and effect of wound care to making it a core institutional focus of improving patient care, you have transformed wound care into a dynamic component of organizational character and brand.

Here are 6 steps towards creating a wound care culture within your organization:

1) Disrupt your perspective: embrace wound care as a reality of long term care living, and not necessarily as a judgment on quality.
Today, wound care may carry a stigma within the field of long term care. Although it may be true that occasionally wounds can result from lower standards of care, in most cases wounds occur even in the highest quality facilities. As an industry we need to accept the reality that wounds happen and work to reduce the negative image behind wound care. By doing so, we will be able to more successfully address the issue, develop standards, and make improvements.

2) Wound care culture starts at the top.
Defining and prioritizing a wound care culture must emanate from the top. Only when a wound care culture is embraced, supported, and promoted by both management and nursing leadership will it lead to more successful outcomes.

3) Commit to wound care training and continuing education at all levels.
Develop a learning and development program that teaches wound care to all nursing and care givers, especially regarding identifying wounds early and best practices for treating them. Provide continuing education every 6-12 months, with recognition and certificates of accomplishment for those who complete the training.

4) Make wound care a daily endeavor.
Within a short period of 24 hours, a lot can happen with wounds. Develop a protocol that makes the inspection, treatment, and dressing changing an everyday activity. As management, provide for the time and materials that staff needs to make this standard of care happen.

5) Track and document each patient's case as well the organizational results.
Install a computerized program that facilitates documentation and tracking of individual wound treatment and outcomes. Review periodic reporting of overall results to help fine-tune your program and measure your progress toward reaching goals.

6) Review performance and reward successful outcomes, as well as the team members who made good things happen.
Make wound care a positive initiative. Develop a program to reward team members for achieving better wound care results in identifying wounds earlier and in improving results. Make your team proud of their accomplishments in helping patients and in improving outcomes.

David NavazioBy adopting a wound care culture, organizations create a win-win-win environment for patients, staff, and facility. When wound care becomes part of your organizational culture, it will serve as a valuable, positive measure of brand quality for long term care facilities, for our industry, and for our patients.

David Navazio is president and CEO of Gentell.​