RS16-003 The importance of nutritional risk factors in wound healing; a comparative study of opinions between wound care nurses and dieticians

Annette Gwilliam, RN, BSN, CWS, ACHRN, Utah Valley Wound Care and Hyperbaric Medicine, Intermountain Healthcare, Provo, UT and Danielle Banks, MSN Ed, BSN, RN, College of Health Professions, Western Governors University, Salt Lake City, UT
Wounds that heal poorly cause a significant burden on the wound care patient and on the United States healthcare system1. Wound healing is a complex process with many complicating factors.  One significant factor is nutrition2.  Malnourished wound care patients have a higher risk of being hospitalized and they also have a high mortality rate3.  There are several nutritional screening tools, however, Biscardi4found that there is not a single nutritional screen that will provide a full nutritional status and none are specifically geared to wound healing.  

In working to develop a tool, we wondered if there would be a difference between the factors that dieticians and wound care nurses (WCN) think are important for wound healing.            

Our IRB approved project was a qualitative survey of 54 dieticians and WCN’s.  We gathered demographic information including: age, education level, years of experience and national certification.  We listed 16 nutritional factors to rank “in order of importance when considering a patient’s nutrition and wound healing”. The choices included items related to: weight, swallowing, oral deformities, medications/supplements, comorbidities, nutrients, blood sugar levels, assistance needed for ADL’s, and alcohol.   

After the survey items were statistical analyzed, we found that most rankings were similarly. Highly important to both groups were: diabetes and >2 servings/day of protein.  Moderately important to both were: ADL’s, chewing problems, fruits/vegetable and >10 medications.  Less important were amount of dairy, herbs/supplements and alcohol consumption. Our biggest surprise was that 80% of dietitians ranked “gained/lost 10 or more pounds without trying” as first or second while only 25% of WCN’s ranked it at that level. The highest ranking for WCN’s was presence of co-morbidities.

In retrospect we would change some of the risk factors to include appetite changes and BMI.  We would also widen settings, in our study 90% worked in acute care.