Professional Wound Care & Nursing Services in Patna: Hospital Coordination & Advanced Bedsore Treatment

Step 1: Hospital Engagement (During Admission)

• Provider notification: Patient/family contacts home nursing provider immediately upon hospital admission for stage 3-4 bedsore requiring specialist care
• Provider response: Home nursing staff engages with hospital discharge planning team to understand clinical status, wound characteristics, and anticipated discharge date
• Clinical briefing: Receive detailed wound assessment documenting tissue type, drainage characteristics, infection status, and physician-prescribed care protocols

Step 2: Pre-Discharge Preparation (24-48 Hours Before Discharge)

• Equipment coordination: Air mattress rental, specialized dressings, cleaning supplies delivered and installed before discharge date
• Nursing visit scheduling: Initial home visit scheduled within 24 hours of discharge for comprehensive wound assessment and baseline documentation
• Medication reconciliation: Confirm all prescribed antibiotics, pain medications, and wound care products available at home
• Supply verification: Ensure 2-3 weeks of dressing supplies on hand preventing delays if follow-up supply orders needed

Step 3: Discharge Day Coordination

• Discharge summary receipt: Obtain complete discharge papers with wound assessment, prescribed dressing protocols, antibiotic regimens, and follow-up physician appointments
• Physician communication: Home nursing provider receives direct contact for urgent wound questions (infection signs, unexpected exudate changes, pain escalation)
• First visit timing: Home nurse conducts initial visit within 24 hours documenting wound baseline, initiating prescribed protocols, and assessing home environment for optimal care

Step 4: Ongoing Home Care Coordination

• Wound care schedule alignment: Nursing visits coordinated with physician follow-up appointments enabling wound assessment documentation shared with specialists
• Telemedicine integration: Between nursing visits, physician video consultations assess wound photos enabling medication adjustments without patient hospital visits
• Weekly reassessment: Physician-nurse communication every 5-7 days reviewing wound progression, adjusting care protocols based on healing trajectory
• Emergency protocols: Rapid hospital admission procedures established if wound deterioration (infection signs, tissue necrosis, drainage increase) requires urgent intervention

Comprehensive Wound Evaluation

• Moisture assessment: Evaluate exudate level (minimal, moderate, heavy) determining dressing frequency and type selection
• Color assessment: Document tissue color (red/healthy granulation, yellow/slough, black/necrotic) indicating wound bed status and healing progression
• Odor assessment: Detect unusual odors suggesting bacterial overgrowth or infection requiring intervention
• Exudate characteristics: Note drainage type (serous/clear, sanguinous/blood-tinged, purulent/pus) and volume indicating tissue viability and infection status
• Surrounding skin assessment: Evaluate periwound skin for maceration, erythema, or breakdown indicating pressure, moisture, or infection complications

Gentle Wound Cleaning Technique

• Irrigation solution: Use physiological saline (normal saline 0.9%) for gentle cleansing without tissue toxicity
• Cleaning method: Apply gentle patting technique using sterile gauze preventing mechanical trauma to healing wound bed
• Avoid scrubbing: Never scrub wounds; gentle irrigation and patting maintains granulation tissue integrity
• Sterile technique: Maintain aseptic conditions during cleaning preventing bacterial inoculation
• Frequency: Clean at each dressing change or minimum once daily depending on exudate level and physician protocols

Culture-Directed Antibiotic Protocol

• Culture collection: Nurses collect sterile wound cultures when infection suspected using proper technique for organism identification
• Sensitivity testing: Cultures include antibiotic sensitivity identifying effective treatment agents
• Targeted therapy: Antibiotics prescribed based on culture results rather than empiric broad-spectrum treatment
• Physician notification: Immediate notification if systemic infection signs develop (fever, spreading erythema, systemic malaise)
• No routine antibiotics: Avoid prophylactic antibiotics; prescribe only with clear infection evidence preventing resistance development

Mechanism and Application

How it works: Collagen-based scaffolding recruits fibroblasts and promotes collagen deposition; matrix degradation provides healing signals stimulating tissue regeneration.

Best for: Stage 3-4 ulcers with slough requiring tissue regeneration; wounds with impaired healing capacity; complex wounds not responding to standard dressings.

Application protocol: Applied to clean wound bed; covered with secondary dressing maintaining moist environment; changed per exudate level (typically 2-3 times weekly).

Cost: ₹1,000-2,500 per application depending on wound size and specific product.

Availability: Coordinate through AtHomeCare Patna for procurement and professional application ensuring optimal technique.

Types and Applications

Silver-impregnated dressings: Broad-spectrum antimicrobial activity; particularly useful for infected wounds or high infection risk. Cost: ₹200-400 per dressing.

Iodine-based dressings: Alternative antimicrobial option; effective against resistant bacteria. Cost: ₹150-300 per dressing.

PHMB (Polyhexamethylene biguanide) dressings: Lower cytotoxicity than chlorhexidine; maintains moist wound environment. Cost: ₹300-500 per dressing.

When to use: Infected wounds with culture-confirmed bacteria; high infection risk in monsoon flood-exposed patients; wounds with visible purulent drainage or spreading erythema.

Duration: Continue until infection controlled (typically 7-14 days) then transition to standard dressings.

Advanced Therapy for Complex Wounds

How it works: Controlled suction removes excess exudate, promotes blood flow, and accelerates healing; can reduce wound size 25-50% over 4-6 weeks.

Best for: Stage 4 ulcers; large stage 3 wounds; wounds with heavy exudate; non-healing wounds despite standard care.

Patna availability: Coordinated through AIIMS Patna or PMCH for initial therapy setup; home nursing may continue maintenance if appropriate equipment available.

Cost: ₹15,000-30,000 per week rental including equipment and nursing coordination; insurance coverage varies.

Limitations: Requires reliable electricity; may not be feasible during monsoon flooding; best used short-term (4-8 weeks) until wound improved sufficiently for standard dressings.

Between-Visit Remote Consultation

• Photography protocol: Family members or visiting nurses photograph wounds using smartphone; images transmitted securely to physician
• Documentation: Photos include wound dimensions, tissue color, drainage characteristics, and surrounding skin status enabling remote assessment
• Physician consultation: Doctor reviews images and patient history; provides clinical assessment and care plan adjustments without requiring patient hospital visits
• Prescription management: Medications prescribed through telemedicine reducing trips to hospital or clinic during flooding periods

During-Monsoon Access Barriers

• Road closure compensation: When flooding prevents nursing visits (24-48+ hours), telemedicine enables daily physician assessment via photographed wound status
• Family guidance: Physician provides remote instructions for wound cleaning, dressing changes, or pain management during access barriers
• Emergency escalation: Telemedicine enables rapid identification of wound deterioration requiring emergency hospital admission despite road flooding
• Continuity assurance: Prevents care gaps when nursing visits postponed by flooding; physician maintains clinical oversight during disruptions

Monthly Nursing Visit Costs

Dressing and Supply Costs

Basic wound care supplies: ₹100-200 per visit (saline, gauze, tape)

Standard dressings: ₹150-400 per change depending on type and quantity

Specialized dressings: ₹500-2,500 per application (collagen, antimicrobial, alginate)

NPWT equipment rental: ₹15,000-30,000 per week

Typical monthly dressing costs: ₹2,000-8,000 depending on wound stage and dressing type

Insurance and Payment Options

• Insurance coverage: Many policies cover professional nursing visits for stage 3-4 wounds; specialty dressings may require prior authorization
• Hospital discharge benefits: Insurance often covers immediate post-discharge home nursing visits for recent hospitalizations
• Payment options: Flexible payment plans; monthly billing; some providers offer package discounts for extended care
• Contact AtHomeCare Patna: Verify insurance coverage and payment options at 9229662730 before initiating professional wound care