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etermining the proper mix of wound care products to provide for the specific needs of any healthcare institution can be a challenge for providers and administrators, and nursing homes are no exception. Residents have multiple medical comorbidities that are more complex today than ever before. Wound type and severity often varies greatly from resident to resident, challenging providers to choose the right product mix. In some cases, the reaction to the problem has been to choose the lowest-priced products or continue using the same products without consideration as to whether a different mix of products might better suit the need. Defaulting to decisions based solely on acquisition cost or the past is not necessarily the best approach for an institution to take.
       In my experience, I have found that the decision-making process requires a multifactorial approach. The strategy I have found most effective in choosing the right wound dressings is to consider the total cost-benefit scenario, which involves product effectiveness, wear time, total healing time, and acquisition cost as well as reliability and simplicity of use. Considering these key areas should enable you to evaluate your own wound care regimen and, hopefully, improve your institution’s current practices.

Analyzing Dressings

       For several years, my facility engaged with a wound care product provider, and we renewed its contracts without putting rigor into evaluating its products’ effectiveness. Eventually, we decided to run test scenarios with various products on residents whose wounds had not healed in more than a year. We were surprised at the results of some products versus others, which included rapid healing of those slow-to-heal wounds. Subsequently, we chose to evaluate our wound care dressing choices by conducting a total cost-benefit analysis.

Conducting a Cost-Benefit Scenario

       Of our key considerations in evaluating products, we determined product effectiveness to be most important. In a long-term care facility, wear time and durability—2 components of a product’s effectiveness—are crucial. Specifically, we looked at the ability of dressings to adhere to residents’ skin in various scenarios while remaining gentle enough to avoid skin damage.
       The second key consideration was simplicity of use and compatibility with other dressings. In addition to caring for residents’ wounds, clinicians are also concerned with residents’ other medical conditions, which may be more severe. Our staff needed to be confident that the wound care products worked well together without having to resort to trial and error.
       Time spent was our third consideration in the scenario. We all know nurses are strapped for time, and the nurses in our facility are no different. Unscheduled dressing changes and difficult-to-apply products slow nurses down, ultimately costing our facility money and increasing our clinicians’ frustration levels. Therefore, it is important for the products to offer decreased application time and increased wear time to maximize effectiveness and staff time.
       In the equation of effective wound care, total healing time is critical both for the resident’s well being and the facility as a whole. A wound that heals quickly can bolster a resident’s state of mind, despite his or her other medical problems. This is the area in our analysis of wound dressings in which I found the greatest differences in wound care product brands. It was also the area of significant importance for us because it is one of the most critical aspects in our facility.

Personalizing the Cost-Benefit Ratio

       Determining the cost-benefit ratio for each individual institution requires ranking the importance of the key considerations according to your facility’s needs. For example, it is necessary to rank acquisition cost as an area of importance; however, we found that it is best not to evaluate this aspect in isolation. This is especially true since many of the other key considerations can affect a wound care product’s total cost. Additionally, determining the desired end result that will make the greatest impact on your organization is of utmost importance. Once you have determined the most crucial results, you can then focus on the measures necessary to achieve this success.

Additional Factors to Consider

       In addition to the key factors described above, there are several additional factors you may want to consider to help you make the smartest choices. Depending on the progressive nature of your facility, focusing on new technologies in wound care can be a crucial element to help meet your needs. Advanced technologies can improve the efficiency of the wound healing process. It is important to consider the reputation of the manufacturer of the technology, which should be a trusted brand producing reliable products.
       I have found that a good place to start looking for information on these advancements is by reading trade journals, such as ECPN, and monitoring new product sections or signing up for their e-mail newsletters. Another good resource for learning about new technologies is by monitoring a hospital’s purchasing decisions. Hospitals often try new technology before long-term care facilities do, and examining their actions can help you know when to make updates to your existing regimen. Industry conferences can also be a good source of information about the latest technology because many companies launch new products at these types of events.

Facilitating Change

       Changing wound care providers can be a large and daunting task for staff. Performing a total cost-benefit analysis will help you be confident that the decisions you make are in the best interest of residents and clinicians, but you may also want to consider the level of education and service that the wound care dressing provider will supply your staff. Look for a provider that will help bring staff up to speed on the latest protocols in wound care and provide simple dressing application instructions.
       After deciding which considerations were most important for our facility and completing the total cost-benefit analysis, we chose 3M Skin Health as a partner in wound care. We were confident that its products were the most effective for our specific needs. Its educational programs made learning simple for our clinicians, and we trusted that its products and services would always be dependable.
       It may take some time for staff members to transition to new products and services, and it is important to encourage them to embrace change for the good of the resident. It is also critical to encourage them to share feedback so that good choices can continue to be made moving forward. Staff should be encouraged to have patience at the onset of the new program because benefits may not be reaped immediately. If the cost-benefit analysis is conducted thoroughly from the beginning, the areas designated as most important should see valuable results.
       If you share relevant information with your staff during the decision-making period, you can help secure their support of the change. Your staff members will feel that they have input into the final decision and their approval will help the transition happen more smoothly, ultimately providing improvements for the residents as well as the institution.
       Remember that finding the best products and meeting both resident and staff needs is a continual process. Periodically re-evaluating your cost-benefit scenario and product choices will provide for a continuum of success as the needs of your facility change and new products are introduced to the market. By working with your wound care dressing providers and providing them with feedback from clinicians, you can find the appropriate mix of products to fit your institution’s specific needs.