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Improving patients' quality of life

2007.03.14 by Jan Fredrik Frantzen
Severe pain and oozing wounds. Patients with chronic wounds have enough to cope with in their everyday lives. Now they can get specialist help over the Internet.
With good photographs from the home-care service, specialists can evaluate the best way to treat the wound.
As many as three to five per cent of the population aged over 65 battles with wounds that will not heal.

Sometimes the wounds reappear several times, and often the home-care service does not have the capacity or knowledge to treat the wounds effectively enough.

"Many people suffer with persistent wound problems. This often hampers them in their daily lives, because the wounds may have an unpleasant odour and be painful," says registrar Nathalie Dufour of the Department of Dermatology at the University Hospital of North Norway (UNN).

Improved quality of life for the patient

In a new collaborative project between UNN and the Norwegian Centre for Telemedicine, these patients can now receive help over the Internet.

The home-care service takes digital photographs of the wounds and sends them to the Department of Dermatology at the hospital using a secure Internet solution. There, registrar Nathalie Dufour and nurse Ada Steen can assess the pictures and provide guidance in how the home-care service can treat the wounds to promote healing.

"It can be very difficult to treat wounds. It takes a great deal of experience, and no two wounds are exactly the same," explain Steen and Dufour. Patients who are to participate in the project must first visit the Department of Dermatology for a check-up.

The nurses in the home-care service also receive in-depth training in wound care at the department. After this, the home-care service submits photographs of the wounds once a week, so that the specialists at the hospital can provide guidelines for further treatment. And better treatment improves the patient's quality of life.

"In this way, we can also be involved in improving skills in wound care in the municipal health service, and pass on what we know here," says Steen. "In fact we see that some of the nurses become very interested in the subject, and want to learn even more."
From left: Registrar Nathalie Dufour and nurse Ada Steen are very happy to be able to offer counselling about the care of chronic wounds over the Internet.

Society pays a high price for wounds

Dufour and Steen say that patients with these chronic wounds represent one of the forgotten groups in the public health service.

This issue was not taken seriously in Sweden and Denmark either, before studies were conducted to find out how much chronic wounds actually cost society.

"In Sweden, they estimated that they were spending as much as NOK 1 billion [about 120 million euro] – just for dressings. On top of this come salaries and travel expenses for the health staff," says Dufour.

Although no equivalent studies have been conducted in Norway, they say that the estimated cost of dressings for such wounds here could total up to half a billion Norwegian kroner [about 60 million euro].

Better treatment through Internet counselling could reduce these costs, if patients get better faster and thus need less treatment. By far the most important factor, however, is that it can ease patients' problems and improve their quality of life.

"It's a good day at work when we get a picture of a wound which has improved a great deal in a week because we were able to give advice to the home-care service before the wound progressed too far," they add.

The project in brief

The objective of the project is to investigate the outcomes of the partnership between the Department of Dermatology at the hospital and the home-care staff, who treat wounds at the patient's home. The objective of the project is to achieve better and faster treatment of such wounds.

Much of the work is funded by the telemedicine research programme in the Northern Norway Regional Health Authority, while the Department of Dermatology at UNN covers the salaries of the nurses and the doctor involved in the project. The work began in January 2006, and will continue up to and including July 2008.

Contact person at the NST

Beate Nyheim, specialist consultant, telephone +47 975 43 010

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