Development of an application for remote wound consultation by wound, ostomy and continence nurses

Onsite consultation with Wound, Ostomy and Continence Nurses (WOCN) for individuals with pressure injuries at their own home is not easy because most WOCNs work at hospitals. In addition, demand for remote consultation is increasing in terms of preventing COVID-19 infection. We co-developed an iPad application for WOCN remote consultation. The app features a video call function to connect a WOCN and a visiting nurse at a patient's home, and a data form to share patient information before first video call. In this presentation, we reported a case in which wound healing progressed through consultation using the application. The case was a woman in her 90s. She had an ulcer, which was 5.5 x 4.5 cm in size, on the back of her lower leg. A WOCN was consulted due to excessive exudate and no healing progress. At the first video call, the wound showed edematous granulation tissue and undermining. Venous insufficiency was suspected from the appearance of pigmentation. Because the patient spent more than 10 hours per day in a wheelchair, elastic stockings and lower limb elevation were proposed. In the second weekly video call, undermining disappeared, and edema decreased. At the 6th week, the wound size was reduced to 2.3 x 0.5 cm and the pain disappeared. The consultation was approximately 20 minutes including wound cleaning. Using the app, the shared information required for wound assessment and high-quality video calls enable smooth assessment from the first time, even remotely.