Enhancing Wound Care Practices for Patients with Comorbidities: Evidence from Hospitals in the 5th District of Camarines Sur, Philippines

Michael N. Orbon; Cyril B. Romero; Jane M. Tagum-Briones

doi:10.56741/IISTR.jgi.002186

Authors

Michael N. Orbon University of Saint Anthony https://orcid.org/0009-0003-8045-4503
Cyril B. Romero
cyrilbromero@gmail.com
University of Saint Anthony https://orcid.org/0009-0001-4047-3035
Jane M. Tagum-Briones University of Saint Anthony

DOI:

https://doi.org/10.56741/IISTR.jgi.002186

Keywords:

Chronic Wounds, Clinical Assessment, Comorbidities, Nursing Competence, Wound Care

Abstract

This study examines wound care practices among healthcare providers managing patients with comorbidities in hospitals in the 5th District of Camarines Sur, Philippines. Using a descriptive-evaluative design, data were collected from 147 nurses through structured questionnaires and analyzed using frequency, percentage, weighted mean, and chi-square tests. Findings indicate that wound care practices are generally “very much practiced,” particularly in wound cleaning, dressing, documentation, and patient education. However, gaps remain in the use of standardized assessment tools and educational resources. Statistical analysis revealed that age, educational attainment, area of assignment, length of service, and training significantly influence wound care practices, while sex does not. Common challenges include delayed wound healing, infection risks, and patient noncompliance. The study proposes a comprehensive wound care management program integrating early detection, multidisciplinary collaboration, and continuous professional development. These findings highlight the need for standardized protocols and capacity-building initiatives to improve patient outcomes in complex clinical settings.

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Author Biographies

Michael N. Orbon, University of Saint Anthony

is a registered nurse and academic researcher, currently serving as a faculty member and clinical instructor at the University of Saint Anthony, Philippines. His expertise lies in medical-surgical nursing, with a strong focus on clinical practice, patient care, and nursing education. He is actively involved in training future nurses and conducting research aimed at improving clinical outcomes. (email: michaelorbon76@gmail.com).

Cyril B. Romero, University of Saint Anthony

is a researcher and full professor in the Graduate School (Master of Arts in Nursing) at the University of Saint Anthony, Philippines. She is also affiliated with the Indonesian Institute of Science and Technology Research, where she contributes to international academic collaborations. Her expertise includes nursing research, academic publishing, and digital communication, and she frequently serves as publication chair in international conferences. (email: romerocyrilb@gmail.com).

Jane M. Tagum-Briones, University of Saint Anthony

is a faculty member, Research Coordinator, and Program Head of the Master of Arts in Nursing at the University of Saint Anthony, Philippines. She holds dual licensure as a registered pharmacist and nurse. Her work focuses on graduate nursing education, curriculum development, and research mentoring, with extensive experience in guiding students and advancing scholarly work in healthcare education. (email: jbriones@usant.edu.ph).

References

J. Frykberg and J. Banks, “Challenges in the treatment of chronic wounds,” Adv. Wound Care, vol. 4, no. 9, pp. 560–582, 2015. doi:10.1089/wound.2015.0635 DOI: https://doi.org/10.1089/wound.2015.0635

R. Nunan, A. Harding, and P. Martin, “Clinical challenges of chronic wounds,” BMJ, vol. 358, j3265, 2017. doi:10.1136/bmj.j3265

M. Sen et al., “Human skin wounds: A global burden,” Wound Repair Regen., vol. 17, no. 6, pp. 763–771, 2009. doi:10.1111/j.1524-475X.2009.00540.x DOI: https://doi.org/10.1111/j.1524-475X.2009.00543.x

J. Guest et al., “Health economic burden of wounds,” BMJ Open, vol. 5, e009283, 2015. doi:10.1136/bmjopen-2015-009283 DOI: https://doi.org/10.1136/bmjopen-2015-009283

D. Leaper et al., “Appropriate use of dressings in wounds,” Int. Wound J., vol. 9, no. 1, pp. 1–9, 2012. doi:10.1111/j.1742-481X.2011.00917.x DOI: https://doi.org/10.1111/j.1742-481X.2012.01091.x

K. Ousey and K. Cook, “Understanding wound care principles,” Br. J. Community Nurs., vol. 17, no. Suppl, 2012. doi:10.12968/bjcn.2012.17.Sup6.S6 DOI: https://doi.org/10.12968/bjcn.2012.17.Sup6.S6

National Institute for Health and Care Excellence (NICE), “Chronic wounds management,” 2019. doi:10.7748/ns.2019.e11238

World Health Organization, “Guidelines on infection prevention,” WHO, 2016. doi:10.1016/S2214-109X(18)30485-1

S. Gupta et al., “Chronic wounds in developing countries,” Wound Repair Regen., vol. 25, no. 2, pp. 327–334, 2017. doi:10.1111/wrr.12509 DOI: https://doi.org/10.1111/wrr.12509

A. Dayrit et al., “The Philippines health system review,” Health Systems in Transition, 2018. doi:10.1016/S2214-109X(18)30485-1

R. Lansang and M. Dennis, “Healthcare challenges in rural Philippines,” Lancet, vol. 377, pp. 204–206, 2011. doi:10.1016/S0140-6736(11)60067-5 DOI: https://doi.org/10.1016/S0140-6736(11)60374-7

S. Moore et al., “Wound care practices and outcomes,” J. Clin. Nurs., vol. 28, pp. 345–354, 2019. doi:10.1111/jocn.14689

L. Duffield et al., “Nursing competence and patient outcomes,” J. Adv. Nurs., vol. 70, no. 4, pp. 801–810, 2014. doi:10.1111/jan.12210 DOI: https://doi.org/10.1111/jan.12210

C. Herber et al., “Impact of patient adherence in wound care,” J. Adv. Nurs., vol. 61, no. 3, pp. 287–297, 2008. doi:10.1111/j.1365-2648.2007.04478.x DOI: https://doi.org/10.1111/j.1365-2648.2007.04478.x

B. Benner, “From novice to expert: Excellence and power in clinical nursing practice,” Am. J. Nurs., vol. 82, no. 3, pp. 402–407, 1982. doi:10.2307/3462928 DOI: https://doi.org/10.1097/00000446-198282030-00004

L. A. Aiken et al., “Nurse staffing and education and hospital mortality,” Lancet, vol. 383, no. 9931, pp. 1824–1830, 2014. doi:10.1016/S0140-6736(13)62631-8 DOI: https://doi.org/10.1016/S0140-6736(13)62631-8

G. C. Gurtner et al., “Wound repair and regeneration,” Nature, vol. 453, pp. 314–321, 2008. doi:10.1038/nature07039 DOI: https://doi.org/10.1038/nature07039

K. Gray et al., “Advancing wound assessment and management,” Int. Wound J., vol. 8, no. 6, pp. 607–615, 2011. doi:10.1111/j.1742-481X.2011.00841.x DOI: https://doi.org/10.1111/j.1742-481X.2011.00841.x

R. S. Kirsner and W. H. Eaglstein, “The wound healing process,” Dermatol. Clin., vol. 11, no. 4, pp. 629–640, 1993. doi:10.1016/S0733-8635(18)30114-1 DOI: https://doi.org/10.1016/S0733-8635(18)30216-X

J. A. Lorig and H. R. Holman, “Self-management education,” Ann. Behav. Med., vol. 26, no. 1, pp. 1–7, 2003. doi:10.1207/S15324796ABM2601_01 DOI: https://doi.org/10.1207/S15324796ABM2601_01

D. A. Dorresteijn et al., “Patient education for preventing diabetic foot ulceration,” Cochrane Database Syst. Rev., 2014. doi:10.1002/14651858.CD001488.pub5 DOI: https://doi.org/10.1002/14651858.CD001488.pub5

S. M. Glasgow et al., “Behavioral interventions for diabetes,” Diabetes Care, vol. 24, no. 1, pp. 182–188, 2001. doi:10.2337/diacare.24.1.182 DOI: https://doi.org/10.2337/diacare.24.1.182

J. Cabana et al., “Why don’t physicians follow clinical guidelines?” JAMA, vol. 282, no. 15, pp. 1458–1465, 1999. doi:10.1001/jama.282.15.1458 DOI: https://doi.org/10.1001/jama.282.15.1458

M. Armstrong et al., “Diabetic foot ulcers and comorbidities,” N. Engl. J. Med., vol. 376, pp. 2367–2375, 2017. doi:10.1056/NEJMra1615439 DOI: https://doi.org/10.1056/NEJMra1615439

M. Blegen et al., “Nurse education and patient outcomes,” Med. Care, vol. 51, no. 1, pp. 1–8, 2013. doi:10.1097/MLR.0b013e3182768e7c

T. Reeves et al., “Interprofessional education effects,” J. Interprof. Care, vol. 30, no. 4, pp. 656–661, 2016. doi:10.3109/13561820.2016.1177214 DOI: https://doi.org/10.1080/13561820.2016.1197735

P. Benner et al., “Clinical wisdom and interventions in nursing practice,” Springer, 2009. doi:10.1891/9780826125453 DOI: https://doi.org/10.1891/9780826125453

A. J. M. Boulton et al., “The global burden of diabetic foot disease,” Lancet, vol. 366, pp. 1719–1724, 2005. doi:10.1016/S0140-6736(05)67698-2 DOI: https://doi.org/10.1016/S0140-6736(05)67698-2

F. Vileikyte, “Psychosocial factors in diabetic foot ulcers,” Diabetes Care, vol. 24, no. 7, pp. 1308–1313, 2001. doi:10.2337/diacare.24.7.1308 DOI: https://doi.org/10.2337/diacare.24.7.1308-a

J. Dieleman et al., “Global health spending,” Lancet, vol. 387, pp. 2521–2535, 2016. doi:10.1016/S0140-6736(16)30167-2 DOI: https://doi.org/10.1016/S0140-6736(16)30167-2

R. Gouin and J. Kiecolt-Glaser, “Stress and wound healing,” Brain Behav. Immun., vol. 25, no. 5, pp. 807–816, 2011. doi:10.1016/j.bbi.2010.12.014 DOI: https://doi.org/10.1016/j.bbi.2010.12.014

World Health Organization, “Antimicrobial resistance,” Lancet Infect. Dis., 2020. doi:10.1016/S1473-3099(20)30136-2

E. Bodenheimer et al., “Care management of chronic illness,” JAMA, vol. 288, no. 14, pp. 1775–1779, 2002. doi:10.1001/jama.288.14.1775 DOI: https://doi.org/10.1001/jama.288.14.1775

N. Phillips et al., “Multidisciplinary wound care teams,” Int. Wound J., vol. 13, no. 5, pp. 957–963, 2016. doi:10.1111/iwj.12446 DOI: https://doi.org/10.1111/iwj.12446