(PI-016) Improved Healing Rates Through Standardized Antimicrobial, Offloading, and Compression Practices

Tina Zettel, RN – RN Case Manager, Outpatient Wound Care, Mercy Health

Introduction: Our clinic identified that there is often times an issue with consistency in wound care practices amongst wound clinics, and even providers within the wound clinic. Variability in clinical practice and inconsistent utilization of evidence based interventions can lead to delays in healing time. Our clinic wanted to standardize practices and follow evidenced based interventions to achieve shorter days to wound closure compared to other wound care clinics in our system.

Methods: The problem was addressed by standardizing wound care practices at our two clinics ensuring consistent use of evidence-based interventions. Wounds at our clinics were cleansed with 0.057% sodium hypochlorite to effectively reduce or eliminate bioburden, while offloading protocols were reinforced not only for diabetic foot ulcers but for any wound affected by pressure. Multilayer compression was emphasized to manage edema and optimize venous return. Quality metrics were used to track provider utilization and ordering of offloading and compression, ensuring these conversations and interventions occurred at every visit. This protocol-driven approach reduced practice variability and supported faster, more reliable healing outcomes.

Results:

This experience demonstrates that consistent, protocol-driven wound care can significantly accelerate healing across multiple wound types. Over a three-year period, our two clinics achieved markedly faster days-to-healed compared to the system’s 23-clinic average—improving diabetic wounds by 15.5 days, pressure injuries by 29.5 days, traumatic wounds by 8 days, and venous ulcers by 14.5 days. Although arterial wound data showed variability due to a small number of longstanding cases, one clinic still outperformed the system by 18 days. Overall, an average improvement of 11.7 days to healed across all wound types illustrates that standardizing antimicrobial cleansing with 0.057% sodium hypochlorite, reinforcing offloading, and ensuring consistent compression use can meaningfully reduce healing times. This highlights the value of reducing practice variability, tracking provider adherence to interventions, and maintaining evidence-based protocols to drive better outcomes.

Discussion: “This experience shows that standardizing evidence-based wound care practices—such as consistent antimicrobial cleansing, appropriate offloading, and multilayer compression—can meaningfully accelerate healing across multiple wound types. By reducing practice variability and tracking provider adherence to key interventions, our clinics achieved faster days-to-healed than the system average in almost every wound category. The overall improvement of 11.7 days demonstrates that reliable processes, rather than isolated individual practices, are critical for achieving consistent and superior patient outcomes.