Implementation of a Wound Care Algorithm at Local Syringe Services Program

Abstract

Skin and soft tissue infections disproportionately affect people who inject drugs (PWID). Wounds and infections that occur secondary to injection drug use have physical, emotional, and social effects. PWID place a significant burden on the healthcare system and increase healthcare costs due to emergency department utilization and prolonged hospitalizations resulting from use. Syringe services programs (SSP) offer an opportunity to provide early access to healthcare services, such as wound care, to improve the health of clients, decrease emergency department visits and hospitalizations, and thus, reduce overall health care costs. There are currently no guidelines for providing wound care services at these sites. The purpose of this project was to implement an algorithm to guide the distribution of educational tools, first aid supplies, and provide skin assessments and referrals by non-medical staff. The project’s measurables included data collection related to the number of clients who visited the site, how many had wounds, the number of first aid kits distributed, the number of skin assessments completed, and the total number of referrals made. The Plan-Do-Study-Act (PDSA) framework was used to evaluate algorithm compliance by staff. Analysis of the data, process, and staff feedback were the key drivers of the PDSA cycle reviews. During the 12 weeks of implementation there was 100% algorithm compliance in nine of the 12 weeks, with an overall usage of 96%. Barriers included staff availability, client participation, referral options, and a lack of medical personnel. It is imperative that healthcare services at SSPs be supported as they have the ability to positively impact patient health outcomes and decrease overall healthcare costs. Keywords: syringe services program, syringe exchange program, skin and soft tissue infections, wound care, and algorithm