Evaluating Pressure Ulcer Healing Rates Following Spinal Cord Injury: A Collaborative Practice Model

Patients with spinal cord injury (SCI) represent a unique population as they have decreased or absent sensation, limited motor skills, decreased circulation, and are often dependent on others to assess their skin and provide care. For these reasons, SCI patients present a serious challenge to the Certified Wound Ostomy Continence Nurse (CWOCN). Complicated medical management makes care of the SCI patient even more challenging. Careful and recurrent assessments are needed, and constant adjustments of therapeutic interventions are necessary for successful and positive outcomes in healing pressure ulcers in this patient population.

A collaborative practice model was developed to improve the healing rate of individuals with SCI who have developed pressure ulcers in the community setting. The healing rate of pressure ulcers by the CWOCN/NP-C in an Outpatient Clinic was investigated. Causal factors related to the healing rate of pressure ulcers in this population were identified.  This poster highlights the results of a retrospective study of outcome data as evidenced by healed pressure ulcers. Patients included in the study were those that were SCI, were  outpatients who lived locally, and presented with stage I, II, or III pressure ulcers. Patients who presented on their first visit with stage IV wounds were excluded from the study group and were referred for surgical intervention.

An interdisciplinary approach was found to be an effective model in healing pressure ulcers in this complex SCI population. The various disciplines involved represent experts if their fields of practice and enhance the healing rates of more recalcitrant pressure ulcers.  More research is needed to substantiate the success in enhancing the healing rates in the SCI population with the use of an interdisciplinary team in the outpatient setting.