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LEARN ABOUT IFT AND HOME TELEHEALTHCARE
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Radi Ann Porter, RN, DON, I was involved in the conversion to use of a digital camera in wound care on the SNF unit of a small hospital where I worked prior to returning to home health. The cost was minimal - about 250 dollars for the camera - an Olympus 310c I think which came with software. The camera had a macro function which allowed photos with good clarity up to about 8 inches from the wound. Training with the use of the camera went very well and the quality of the photo was its own reinforcer. In fact, both the training time and costs were minimal. The camera was simple enough to operate so that we trained two nurses who then trained the others. The nurses could shoot several pictures without feeling that there was a high cost involved so they were motivated to get a good photo which was good documentation of wound status. The camera had an LED screen which also helped the nurse see when she had a good photo. The cameras also had the ability to shut off the flash function which often bleached out the photo. We found that lighting with a procedure lamp worked best rather than using the flash. We placed a photo identifier near the wound with patient name, date, location, and a cm ruled measure device for clarity and positive ID of the wound. (When you are taking 15 photos, one heel can look like another!) One other expense was a photo printer which would give a good print of the photo. We chose an Epson 740 color photo printer and printed on a quality matte presentation paper which we found provided better results than standard letter type stock. Photos were downloaded to a pc directly to a wound photo documentation sheet that was a form developed in MS Publisher. The document was then printed and backed up to a CD-RW. I don't have a copy of that file but I am planning to get it for my own program at my home health agency. Wound rounds for the purpose of documentation were done once weekly. I did the downloads of the photos initially but then handed that duty to the SNF director without any problem. The staff was very happy with the quality of the photos and would often show off the photo to oncoming staff so they could see the wound which often was dressed by other shifts so they did not know what was under the douderm. The agencies which audited care in our facility were also very impressed with the results and commented favorably on the quality improvement during exit interviews. I am in the process of developing policy and procedure to introduce this type of wound documentation in the HH agency in which I am currently working. They are not using any type of photo documentation and all the nurses seem enthusiastic about the plan. Because we have three separate sites our initial expense will be greater as we will need three cameras, but on the up side, the cost of a camera with macro function seems to be dropping as much higher pixel resolution cameras hit the market.
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