Todd Shaffett Southeastern Louisiana University

Chapter 1 Introduction

CHAPTER I
INTRODUCTION
Background and Significance of Problem
The skin is the largest organ of the human body and is the most susceptible to disease and affliction. According to the National Association for Home Care & Hospice (2012), more than 12 million people across America are receiving home health care services for various reasons, including the treatment of chronic wounds. In 2009, annual cost for home health exceeded $72 billion. This does not account for rehospitalizatons, surgeries, including amputations, or the loss of life. Chronic wounds comprise a large percentage of home health care visits each year, totaling more than 72 million patient encounters. Most of the wound care being received by those in the home setting involves both Registered Nurses (RN) and Licensed Practical Nurses (LPN) without advanced training or certification in wound care. There is a lack of certified wound care nurses that are employed by home health agencies across the United States (US). Chronic wounds are reported to cost our healthcare system in excess of $25 billion dollars a year and this number is steadily growing due to our aging population (Sen et al. 2009).
There are currently more than 11,000 home health care agencies throughout the US. In the State of Louisiana there are more than 200 agencies serving more than 74,000 patients per year according to a personal interview with Warren Hebert, Chief Executive Officer for the Home Care Association of Louisiana (September 15, 2015). There is little research that has been conducted on the effects of wound care being ordered, delivered and supervised by non-expert or trained individuals. Furthermore, there is a lack of evidence to understand the impact of having certified wound specialist directly involved in those patients receiving home care services. The current trend for home health care delivery is a physician, usually not wound care certified, will write an order for home health to evaluate and treat, relying on the home health care nurse to decide what wound care orders and interventions are best suited to meet the needs of the patient. An order is then generated from the home health nurse and sent to the attending physician for review, signature and implementation of said orders. Imagine this same scenario; however, this time the nurse that is making the home visit and developing the plan of care for the patient and the wound is an Advanced Practice Nurse Practitioner who has been trained and certified in wound care.
Aim of the Project
The purpose of the DNP Project titled “Wound Expertise in Home Health” will take a qualitative descriptive approach to verify if see if there is a statistical difference exist in outcomes when an Advanced Practice Registered Nurse, who is wound care certified, is directly involved in the assessment, intervention, and plan of care of those patients receiving home health services with a principle diagnosis that is wound related.
Concepts and Definitions
Relationship of Project to Advanced Nursing Practice—
(How can your DNP Project be linked to the DNP Essentials? You need to list those here and provide examples of how your project meets these essentials-your project may or may not meet all of the essentials)
Benefit of Project to Clinical Practice
Research Question
The PICOT question is: Can the use of Wound Care Certified Advanced Practice Registered Nurses improve wound care outcomes by yielding an increased healing rate within a 12 week period in comparison to patients receiving home health care services without Wound Care Certified Advanced Practice Registered Nurse supervision and involvement among subjects 65 years or older. Secondary outcomes will be defined as reduced hospitalizations, reduced number of infections, reduced unnecessary utilization of resources, and improved quality of life for the subjects. Benefits of conducting such research can lead to health care policy change, improved clinical algorithms, and development of more cost-effective models of healthcare delivery.
Question needs to be more concise and may sound something like:
“Effects of utilizing Wound Care Certified Advanced Practice Registered Nurses on improvement of wound care outcomes and healing rate in adult home health patients: A Quality Improvement Project”
In the paper you would describe that you would be comparing the two groups: those receiving care with the supervision and those without

APA/Writing Style-use the rubric/headings to guide your writing-you were missing information in the paper; also make sure your writing is concise and less wordy.

References
National Association for Home Care & Hospice. (2012). Basic statistics about home care:
Updated 2010. Retrieved from http://www.nahc.org/assets/1/7/10hc_stats.pdf
Sen, C. K., Gordillo, G. M., Roy, S., Kirsner, R., Lambert, L., Hunt, T. K., … Longaker, M. T.
(2009). Human Skin Wounds: A Major and Snowballing Threat to Public Health and the
Economy. Wound Repair and Regeneration : Official Publication of the Wound Healing
Society [and] the European Tissue Repair Society, 17(6), 763–771.
http://doi.org/10.1111/j.1524-475X.2009.00543.x
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