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Population/Community Health Promotion

Brooke D. Smith

Delaware Technical Community College

NUR330-201 Population & Community Health

Dawnyel Furlong, MSN, APRN, FNP-C

November 27, 2022

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I chose to complete my practicum at the TidalHealth Wound & Hyperbaric Center in

Salisbury, MD. The center provides specialized treatment for chronic or non-healing wounds

through diagnostic examination and personalized treatment programs. I have been under the

direction of my preceptor, Brooke Gannon, MSN, RN for the last six weeks. During my

practicum, and with her assistance, we identified three needs/problems of the

population/community: coordination of care at home (i.e. available resources), consistent

transportation, and knowledge deficits regarding proper wound care, hygiene, disease process,

and dietary restrictions.

These patients frequently function with true autonomy for proper wound care, in

contrast to those in acute and long-term care settings, including their adherence (or non-

adherence) to treatment and care plan regimens. We know that patients are more likely to

follow their care and treatment plan if they are actively involved in goal setting and care about

the outcomes. Cooperative goal setting is essential since what patients are willing (and able)

to do to reach a goal is essential to its success (Thornberry, 2019). In order to improve the

coordination of care at home, knowledge deficits, and transportation, or lack thereof,

collaboration must start with the initial assessment and care planning with outside resources

such as home health.

Proper wound management can prevent serious, potentially fatal complications. People

and family caregivers can receive professional treatment and training from a home health

agency. Nursing care that is given to assist, treat, and maintain the health of acute or chronic

wounds is known as wound care. The majority of wounds that require home health care

treatment are chronic wounds. Most chronic wounds have insufficient blood flow to certain

parts of the skin. Surgical wounds, pressure ulcers, injuries to the feet or legs that have poor
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circulation, diabetic ulcers, and wounds that can reopen are a few examples of chronic

wounds (PHCS, 2022).

An agency that is available that can serve as a referral, and my personal preference, to

assist with the problems identified within the community, as identified above, is Peninsula

Home Care located at 1001 Mt. Hermon Road, Salisbury, MD 21804. The Maryland Branch

Director is Beverly White, and she can be reached at (410)-543-7550. Peninsula Home Care

provides education on wound care, disease treatment and prevention, and medication

management through skilled nurses. Peninsula Home Care also offers support through

Medical Social Workers who can assist with transportation difficulties, counseling, case

management, and referrals. Medicare was one of the predominant health insurances observed

within the community, and Peninsula Home Care is a Medicare Certified Preferred Provider.

In order to qualify, a patient must require medical care at home, a provider must make that

determination and create a plan for patient care. A patient must receive the ongoing competent

nursing care, physical therapy, or speech-language pathology treatments that they require. A

patient must be confined to home. This indicates that a patient cannot typically leave their

home. If a patient does leave their house, it is only after much difficulty. Absences from home

must be brief, rare, or necessary for medical care. Even if a patient occasionally attends

church, a barber or beauty salon, and, of course, medical appointments, they may still be

considered homebound. (Peninsula Home Care, n.d.).

The home health care nurse visits the patient's house to conduct a comprehensive

assessment as the first step in the process. Your provider receives the assessment, and a

skilled nursing plan is created. The home health organization and provider weigh a variety of

considerations while determining the best course of action for treating the wound. In each
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situation, this necessitates that the nurse visits the patient's house on a frequent basis to

inspect, clean, treat, and dress the wound. To track the healing process, a record is preserved

and given to your healthcare physician. The provider will give the home health agency a

formal order to modify the wound if they believe the wound care plan needs to be altered.

(PHCS, 2022).

Knowledge deficit of the treatment process is frequently the cause of patient non-

compliance with wound care techniques. Patients may neglect clinical visits, medications, and

appropriate wound care techniques if their fears and misconceptions regarding the course of

treatment and prognosis are not adequately addressed. It is impossible to overstate the

importance of healthy nutrition for wound healing. The rate at which wounds heal will be

optimized by a sufficient dietary supply of nutrients. A referral to dietary/nutrition counseling

can be made by the home health nurse for patients who should promote the use of foods high

in polyphenols, bioflavonoids, and antioxidants. Berry, tomato, walnut, pomegranate, oat,

carrot, spinach, and dark chocolate are a few examples of appropriate foods. The best wound

healing may be hindered by common chronic medical disorders such diabetes, hypertension,

and peripheral artery disease. Patients who have a history of these disorders and present with

acute or chronic wounds will receive specialized counseling and education on the potential

effects these conditions may have on how well their wounds heal by their home health nurse.

Patients need to be made aware of the connection between comorbidity management (medical

or surgical care) and a better overall wound healing outcome (The Wound Pros, 2022). In

rural communities, transportation is a significant socioeconomic factor of health. A person's

capacity to get adequate and well-coordinated healthcare, buy nourishing food, and otherwise

take care of themselves is impacted by the accessibility of reliable transportation. By reducing

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unnecessary EMS use, increasing healthcare service consumption, lowering no-show rates,

and enhancing access to health-supporting services, adequate mobility may help healthcare

providers. The home health Medical Social Worker can provide the patient with resources and

assistance to locate local transportation (Rural Health Information Hub, 2022).

The health of communities can be improved by effective programs. These initiatives

may be coordinated to effect good change and pave the way for new regulations that will have

an even greater impact on public health. A community where everyone is safe, environments

support health, steps are taken to prevent and control acute and chronic disease, and

individuals and families can thrive, is what health programs aim to achieve (Savage, 2020, p.

125).
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Resources

Peninsula Home Care. (n.d.). https://www.peninsulahomecare.com/about-us/

Professional Home Care Services. (2022). Wound care in home health care.

https://www.phcsonline.com/blog1/wound-care-in-home-health-care/

Rural Health Information Hub. (2022). Transportation to support rural healthcare.

https://www.ruralhealthinfo.org/topics/transportation

Savage, C. L. (2020). Public/community health and nursing practice: caring for populations. F.A.

Davis.

The Wound Pros. (2019). The role of patient education in wound healing.

https://www.thewoundpros.com/post/the-role-of-patient-education-in-wound-healing

Thornberry. (2019). Collaborative, patient-centered goals are key for home health and hospice.

https://ndocsoftware.com/2019/04/collaborative-patient-centered-goals-key-home-health-

hospice/