An Automated Pressure Ulcer Monitoring System to Improve Pressure Ulcer Healing Outcomes for Veterans with SCI
Abstract
Rationale: Pressure ulcers (PrUs) are a high-risk, high-volume, high-cost problem for Veterans with spinal cord injury (SCI) and for the Veterans Health Administration (VHA). PrUs cause one-third of all VHA SCI admissions and over half of all hospital bed days of care for Veterans with SCI. Effective evaluation of PrU treatments depends on reliable and valid measurements of healing. The SCI Pressure Ulcer Monitoring Tool (SCI-PUMT) is the only validated instrument for evaluating PrU healing for Veterans with SCI. The SCI-PUMT consists of geometric and substance factors. Despite being the only validated tool, clinical use of the SCI-PUMT has been slow because it requires measurement of the PrU by hand, computation of the score, transcription into the electronic medical record, it varies by user, and requires extensive training to ensure correct use. Therefore, it has yet to make an impact on clinical practice, patient outcomes, or the research literature. Computer and image-based wound monitoring techniques are more reliable and faster than manual methods. A variety of commercially available wound measurement and documentation systems exist; however, none provide a validated PrU assessment (e.g., SCI-PUMT score), and they have one or more additional drawbacks: (a) require specialized equipment, (b) lack automated wound measurement requiring the user to manually outline the wound for measurement, or (c) take two-dimensional rather than three-dimensional measurements, thus not accurately measuring wound volume. Objective: The goal of the proposed 3-year study is to automate PrU measurement to track PrU healing progress for Veterans with SCI through development and evaluation of a computer aided PrU Monitoring System (PrUMS). PrUMS will provide a fast, easy, objective, and low-cost measure of the SCI-PUMT and wound volume. Given the high prevalence and cost of PrUs in SCI, a valid and reliable measurement of PrU healing is needed for improving the consistency, quality, and effectiveness of clinical care. Impact: How will this help persons with SCI? Effective evaluation of PrU treatments depends on valid and reliable measurement of healing. Intervening early to prevent PrUs from worsening is critical for improving patient outcomes. Effective intervention, therefore, depends on reliable and valid measurement of PrU healing, PrUMS, which will be created by this research. Clinical use of PrUMS will lead to improved PrU treatments, improved clinical decision-making, improved documentation and evaluation of PrUs, and ultimately, improved patient outcomes. Who will this help? This research has the potential to help all persons with SCI who develop a PrU. If one does develop a PrU, this monitoring system will help track the healing process to make sure the best treatment plan is used and is working effectively. How quickly could this help someone? Once the monitoring system is developed and tested in a clinical facility, if successful, it will be readily available for use by other SCI clinics around the country. How will this advance patient quality of life? Improving PrU outcomes for persons with SCI will lead to an improved quality of life. PrUs are a severe, costly, and lifelong complication that negatively affects functioning, quality of life, and community reintegration (e.g., education, vocation). Therefore, by improving PrU treatments by tracking PrU healing, patient quality of life will be improved. What are the potential clinical applications, benefits, and risks? This research poses no additional risks for persons with SCI; the only risks are those related to standard care for treatment of PrUs. The benefits of this research are that it will allow clinicians to track PrU healing over time and will facilitate uploading PrU scores and images into the electronic health record to improve patient outcomes. Future benefits will include putting evidence-based decision support for PrU treatm
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610393
Entities
People
- Matthew Peterson
Organizations
- James A. Haley Veterans' Hospital
- United States Army