Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Jennifer A. Browne


Problem. Patients with chronic wounds often present with additional physical and emotional problems because healing of chronic wounds may require months to resolve. Practitioners develop treatment plans based on their own training and clinical expertise, but unfortunately, there are no universal guidelines to inform the management of chronic wounds. Expanding multi-factorial assessments and interventions could improve patient outcomes. The purpose of this project was to implement a wound care protocol for outpatient wound care clients based on a nutritional and psychological self-assessment. Methods. A patient-completed checklist, done on arrival to the clinic, triggered clinician-driven protocol interventions addressing mental health and nutritional needs. Data comparisons of the before-and-after intervention included the scores of the Wound-QoL-14 subscale ' Psyche', the scores of Mini Nutritional assessment (MNA), and wound sizes. For evaluating the outcomes of before-and-after intervention, the Wilcoxon signed-rank test was used to analyze the scores of subscale "Psyche" and the scores of MNA. Wound sizes were analyzed using the paired-sample t-test. Results. Forty-one patients were involved in this project. Approximately 50.5% and 46.3% of patients were identified at high psychological and nutritional risk, respectively. After 4 weeks, comparisons of before and after intervention scores demonstrated statistically significant improvement in both the psychological and nutritional subscales. Additionally, there was a significant decrease in wound sizes. Conclusion. With an increasing volume of patients seen in this facility, clinician tools can help streamline the assessment of factors that caused poor wound healing. Assessment tools that trigger clinician-driven interventions support the standardized application of evidence-based care recommendations.