Improving Wound Care using the TIME Framework

Abstract

Abstract Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach to the non-wound care expert allowing more diverse utilizations across the primary care spectrum. The modified TIME framework was shared with 29 providers over three educational sessions. Participants included Nurse Practitioners and Physicians. The knowledge attained and the usability of the framework was evaluated using a case study approach and self-reported comfort level relating to the assessment and initiation of wound treatment. Conclusion:After the educational sessions, the comfort level of all providers increased dramatically from pre- to post-assessment.Comfort level was self-reported on a 5-point Likert scale (1 = poor, 3 = average, 5 = excellent). Responses indicated that 42% of participants reported below average or poor comfort at the pretest, while 96% of participants reported average or above average comfort at the posttest. Comfort level related to knowledge gained in developing a treatment plan also increased: At pretest, 77% of participants reported below average comfort, while 96% of participants reported average or above average comfort at the posttest. Results also indicated a significant increase in wound care knowledge and understanding of wound care concepts related to the modified TIME framework, including identifying specific wounds and initiating treatment

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