The construction and application of continuous nursing platform for the care of patients with wound or stoma

Author: Yongyi Chen (RN, PhD), Hunan Cancer Hospital / the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University

With the advent of an aging society, chronic wounds have become a global health problem. According to the statistics, there were an estimated 463 million adults living with diabetes all around worldwide(Sen, 2021).Globally, diabetic burden was highest in China (89.5 million) with India (67.8 million), United States (30.7 million), Indonesia (21.0 million), and Mexico (13.1 million) following behind(Sen, 2021).In the United States, 3% of the population older than 65 years have open wounds, and chronic wounds as a whole cost the medical system over US$25 billion per year(Han and Ceilley, 2017).In China, there were nearly 100 million diabetic patients, which is the country with the largest number of patients in the world(Wei and Yiying et al., 2018).and the lifetime incidence rate was 25% (Tchanque-Fossuo and Wishy et al., 2018).The incidence of malignant wounds of malignant tumor is 5%-10% in cancer patients (Xiaolong and Qixia, 2014). Once chronic wounds occur, the symptoms of massive exudation, smelly, easy bleeding, pain, and other symptoms seriously affect their quality of life of patients. At the same time, there were one million patients with stoma, with nearly 100 thousand patients increase every year (Yanming, 2017).Patients not only suffered from the inconvenience caused by the change of the normal excretion route of feces, but also, they suffered by the complications caused by improper stoma care, which seriously affected the quality of life of patients(Zelga and Kluska et al., 2021).However, the allocation of wound nursing staff in China is insufficient, and the distribution of medical and nursing resources in urban and rural areas is uneven, which cannot meet the needs of patients. Therefore, it is urgent to establish a continuous nursing platform for the care of patients with wound or stoma.

After literature search, qualitative interviews, group discussions, and expert consultation, we determined the content of the continuous nursing platform for the care of patients with wound or stoma, and in conjunction with information technology personnel, an Internet-based continuous nursing platform for the care of patients with wound or stoma has been developed. It contains two platforms, Healthcare portal and Patient portal respectively. Patients login in the system by entering their ID number/phone number and password. Healthcare workers login in the system by work account and password. The Internet-based continuous nursing platform connects the external network, internal network and client, breaking down information barriers. The platform includes four modules of Basic Information, Wound/Stoma Information, Healthcare-patient Interaction, and Health Education. The Basic Information’s content includes name, age, height, weight, diagnosis, place of residence, education, etc. The Wound Information Module includes date of wound formation, cause, size, base color, exudation, treatment, dressing selection, etc. The Stoma Information Module includes date of stoma operation, type of stoma, surrounding conditions of stoma, stoma complications, stoma home caregivers, use of stoma chassis and accessories, etc.

With respect to the application of the continuous nursing platform for the care of patients with wound or stoma, when a patient with wound or stoma seeks special advice in our clinic of wound and stoma for the first time, an archive will be established. Log in to the platform and add a new patient case with stoma or wound, then enter patient’s ID number, synchronize HIS system to get the patient’s information. Then complete new cases and establish detailed case archives of patient with stoma or wound and collect and input the patient’s information. The opportunity to establishing follow-up archives is as follows: regularly review of the patients’ wounds weekly. If the condition of wound changes within one week, the patient’s wound should also be reviewed, until the patient’s wound heal or die. The other is stoma patients need to establish archives every time when they come to the hospital for a follow-up visit. A total of 1,166 cases of wound stoma had been documented by the end of 2021.770 cases of wound and 396 cases of stoma have been established. Lots of patients have online consultation by healthcare workers, which have effectively promote comprehensive rehabilitation of patients.

The Internet-based continuous nursing platform for the care of patients with wound or stoma can manage patient’s data conveniently, and a lot of patients have online consultation by healthcare workers, which have effectively promote comprehensive rehabilitation of patients.

This study was presented at ICCN2022 virtual conference. Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

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