The overall prevalence of POA-PIs on hospital admission in this study was higher than previous published reports. The majority arrived from community-dwelling locations. The severity of community-dwelling POA-PIs was higher than known benchmarked hospital-acquired PI severity. This real-world profile of community-dwelling patients with PI suggests that these individuals are considerably vulnerable and underserved by home care services. Opportunities exist for community PI screening, prevention, and intervention.

Patient preferences are statements made or actions taken by consumers that reflect their desirability of a range of health options. The concept occupies an increasingly prominent place at the center of healthcare reform, and is connected to all aspects of healthcare, including discovery, research, delivery, outcome, and payment. Patient preference research has focused on shared decisions, decisional aids, and clinical practice guideline development, with limited study in acute and chronic wound care populations. The wound care community has focused primarily on patient focused symptoms and quality of life measurement. With increasing recognition of wound care as a medical specialty and as a public health concern that consumes extensive resources, attention to the preferences of end-users with wounds is necessary. This article will provide an overview of related patient-centered concepts and begin to establish a framework for consideration of patient preference in wound care.From the seminal models of evidence-based practice, patient preference has occupied a prominent place in clinical decision making. More recently, consideration for patient preference emerges as a key component in the redesign of healthcare processes with significance for improving outcome and safety.2 But what are patient preferences? How are they elicited, regarded, and incorporated into recommended action? What interrelated patient-centered concepts have been studied in various patient populations? Lastly, what contribution has the wound care community made to the understanding of patient preference? This article aims to introduce the reader to the issues, begin a dialogue on patient preference in wound care, and suggest opportunities for future discovery.Patient preferences are ''statements by individuals regarding the relative desirability of a range of health experiences, treatment options and health states.'' 3(p259) Preferences reflect beliefs and attitudes of the patient and family, and are related to the process, probability, and severity of potential choices. 4 Patient preference is conceptualized and measured differently across disciplines, from health economics, patient education, psychology, ethics, and using qualitative and quantitative approaches. In the field of medicine, oncology has been the frontrunner in operationalizing methods to determine patient preference for various cancer treatment options, most notably in breast and prostate cancer treatments.

No abstract

As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty.