Date of Award

5-28-2020

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Lisa VanGetson APRN, DNP, FNP-C

Second Advisor

Susan Cutshall APRN, DNP, CNS

Third Advisor

Joyce P. Miller DNP, RN

Abstract

Chronic diseases have increased the incidence of vascular ulcer development. These ulcers require long-term wound management and other interventions from different health care specialists to achieve healing and decrease further complications. Following acute hospital and clinic vascular ulcer care interventions, patients are discharged home or to other facilities in the communities with vascular ulcer care instructions. Often, these patients come back to the vascular clinic or get readmitted into the hospital with deterioration of their wounds. This project used questionnaires to determine what barriers vascular ulcer patients and their caregivers have in the management of these wounds in the community. Dorothy Orem`s self-care theory was used to describe the self-care deficit of patients with vascular ulcers, and the nursing systems designed by the vascular clinic nurses to educate patients and their caregivers on appropriate wound care and vascular ulcer interventions. Adherence to treatment was monitored through return demonstrations at the vascular clinic during appointments, as well as a review of video-recordings of ulcer management at home by patients and their caregivers. The identified barriers to treatment adherence include knowledge deficit, lack of motivation, inability to apply compression socks, and difficulty obtaining wound care supplies due to lack of cost coverage by their health insurance. The results indicate the need to individualize care plan, and for appropriate coordination of care for vascular ulcer patients in the community to improve wound healing and prevent hospital readmissions.

Identifier

SC 11.DNP.2020.Ikeri.A

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