Poster 189: Use of telemedicine in the management of spinal cord injury patients with pressure ulcers.

Abstract

Objectives: To determine the utilization of telemedicine in the management of pressure ulcers in patients with spinal cord injury (SCI) and to evaluate patient and staff satisfaction with telemedicine on an outpatient basis for pressure ulcer management. Design: Retrospective chart review and satisfaction survey using Likert-type scales. Setting: Tertiary care hospital. Participants: 21 patients with SCI. Intervention: The records for 21 patients with SCI (comprising 24 admissions) were reviewed. Patients and staff completed satisfaction surveys using Likert-type scales. Main Outcome Measures: Descriptive statistics and satisfaction data. Results: All 21 patients were community-dwelling men; mean patient age was 69 years; 90% were white; 57% had paraplegia; and 43% had tetraplegia. The majority (76%) had American Spinal Injury Association class A SCI. 76% were living with a significant other or other primary caregiver; 24% lived alone; 82% had at least once-daily nursing care. The average distance from the patients’ homes to the regional SCI unit was 37.3 miles. Reasons for admission to the telemedicine program included recurrent pressure ulcers, frequent outpatient clinic utilization, or post-flap surgery. At admission, pressure ulcers were stages II (20%), III (20%), or IV (60%). Pressure ulcer locations were sacral (29%), ischial (40%), trochanteric (14%), lower limb (11%), or heel/foot (6%). Mean admission duration was 15.2 weeks. Survey data revealed that patients agreed (17%) or strongly agreed (78%) that the program alleviated the ordeal of traveling to the SCI center. Patients agreed (31%) or strongly agreed (58%) that the telemedicine equipment worked well and was easy to use. Staff either agreed (12%) or strongly agreed (88%) that the telemedicine program resulted in the identification of problems or recommendations for future care that may have otherwise been delayed. Conclusions: Data suggest that an outpatient SCI telemedicine program can have a positive impact on pressure ulcer management and patient satisfaction.