1315_Jacobs.pdf

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1、OUT-PATIENT CARE OF LOWER EXTREMITY WOUNDSTHE PROBLEM OF COMPLIANCEPOTENTIAL CONFLICTSI HAVE NO CONFLICTS FOR THIS PRESENTATIONSTANDARD OF CARE FOR WOUND CAREINSTITUTIONAL BASED WOUND CARE WOUND CARE CENTERS EMPLOYED HEALTH CARE PROVIDERS ACADEMIC CENTERSPRIVATE PRACTICEINDUSTRY DRIVEN“THOUGHT LEADE

2、RS”PUBLIC INSURANCE,NO INSURANCE MEDICARE COMPLETE PLANSINDUSTRY CONTROL OF MEDICINE“FAR TOO LARGE A SECTION OF THE TREATMENT OF DISEASE IS TODAY CONTROLLED BY THE BIG MANUFACTURING PHARMACISTS,WHO HAVE ENSLAVED US IN A PLAUSABLE PSEUDO-SCIENCE”DOGMA,MYTH,FAITH,AND SCIENCE MEDICAL DOGMA A PRINCIPLE

3、OR SET OF PRINCIPLES LAID DOWN BY AN AUTHORITY AS BEING INCONTROVERTIBLY TRUE MEDICAL MYTH A TRADITIONAL STORY EXPLAINING A NATURAL PHENOMENANON-ADHERENCE IN OUT-PATIENT WOUND CARENON-ADHERENCE TO WOUND CARE PROTOCOLS IS A MAJOR DRIVING FORCE IN DELAYED HEALING/FAILURE TO HEAL ULCERATION AND INFECTI

4、ONS WITH RESULTANT INCREASED MORBIDITY AND MORTALITYNON-ADHERENCE TO WOUND CARE PROTOCOLSPATIENTDOCTORTHIRD PARTY PAYERSINSTITUTIONAL REGULATIONSFEDERAL REGULATIONSTHE COST OF NON-COMPLIANCE125,000 DEATHS IN THE US ANNUALLY$100-$300 BILLION DOLLARS ANNUALLYNON-HEALING WOUNDLOCAL AND/OR INFECTIONAMPU

5、TATION DEATHNON-ADHERENCEINTENTIONALUNINTENTIONALIN EITHER CASE,EDUCATION AND DOCUMENTATION ARE CRITICALDEFINITIONSCOMPLIANCE PATIENT FOLLOWS DIRECTIVES/ORDERS AND IS SUBMISSIVE FAILURE TO COMPLY IS DISOBEDIENCECONCORDANCE PATIENT IS A DECISION MAKER WITH HEALTH CARE PROVIDERADHERENCE PATIENT MAINTA

6、INS THE TREATMENT REGIMEN ACTIVE CHOICE BY PATIENTVermeire E,Hearnshaw H,Van Royen P,Denekens J.Patient adherence to treatment:three decades of research.A comprehensive review.J Clin Pharm Ther 2001;26:33142EFFICACY AND SAFETY IN WOUND CAREESTABLISHED PROTOCOLS WHICH AND BY WHOM?WOUND CARE GUIDELINE