Aim
The purpose of this project was to avert the development of pressure injuries for aged care clients through the integration of telehealth‑enabled nursing interventions. The model achieved timely value‑based care while optimising nursing workflow efficiency.
Methods
A descriptive case study design was used to evaluate the telehealth‑enabled nursing interventions.
- Prophylactic care: Patients were repositioned every four hours per protocol.
- Teleconsultation: Metropolitan wound care nurses activated ward‑based interventions.
- Risk identification: The Braden Scale was used to quickly identify high‑risk patients.
- Real‑time documentation: Telehealth enabled immediate documentation, evidence‑based decision‑making, and adherence to protocols.
- Data analysis: Retrospective review using de‑identified data from routine daily care audits assessed care and preceding clinical effectiveness.
Results
Participants
12
Aged ≥ 80 years
Stage 1 injuries resolved
9/9
Resolved within 7 days
Documentation compliance
62% → 95%
Post‑implementation improvement
Nurse confidence
3.1 → 4.6
5‑point self‑report scale
Dressing protocol errors
Reduced 70%
With virtual visibility & multidisciplinary team (MDT) approach
| Metric | Pre‑Implementation | Post‑Implementation | Notes |
|---|---|---|---|
| Documentation compliance | 62% | 95% | Improved through real‑time telehealth documentation |
| Nurse confidence (5‑pt scale) | 3.1 | 4.6 | Self‑reported |
| Dressing protocol errors | Baseline | Reduced 70% | Reduced via virtual oversight & MDT best‑practice protocols |
| Stage 1 pressure injuries | — | Resolved in ≤ 7 days | Nine patients affected, all resolved by Day 7 |
Conclusion
This quality improvement project demonstrates how telehealth can be used to prevent the deterioration of pressure injuries, improve patient outcomes, and elevate the standard of nursing practice. The model is efficient, scalable, and ethically defensible. No identifiable data were collected; therefore, formal ethical feedback or National Medical Research Register (NMRR) registration was not required.
Clinical Practice Recommendations
- Increase telehealth access: Implement the project at multiple aged care homes, including rural or other resource‑poor dwellings, to determine whether it is feasible in these settings.
- Telehealth guidelines: Create evidence‑based telehealth guidelines for pressure injury prevention, including risk assessment (Braden Scale), frequency of repositioning, and wound evaluation.
- Continued nurse education: Community telehealth training can build nurses' digital literacy and confidence, thereby limiting protocol incidents.
- Multidisciplinary teams: Include physiotherapists, dieticians, and geriatricians in the telehealth consultations to address other risk factors.
- AI and Power Analytics: Examine the use of AI‑derived risk prediction models that can calculate risk offline, drawing on (1) patient mobility, (2) skin‑condition images, and (3) patient records.
Policy/Systems Level Recommendations
- Integration into telehealth policy: Advocate for inclusion of telehealth‑based wound prevention protocols in aged care national guidelines.
- Resources: Funding for stable internet, telehealth devices, and electronic health record (EHR) connectivity to support sustainability and scalability.
- Evaluation for monitoring & auditing: Develop a digital monitoring dashboard that evaluates compliance with the repositioning schedule, wound care status, and documentation.
References
- Blytt, K. M., et al. (2024). The implementation of telemedicine in wound care: A qualitative study of nurses’ and patients’ experiences. BMC Health Services Research, 24, 11620. https://doi.org/10.1186/s12913-024-11620-w
- Chen, G., et al. (2022). Telemedicine for preventing and treating pressure injury: A systematic review. International Journal of Environmental Research and Public Health, 19(19), 12219. https://doi.org/10.3390/ijerph191912219
- Kandula, U. R., et al. (2025). Impact of multifaceted interventions on pressure injury: A systematic review. BMC Nursing, 24, 2558. https://doi.org/10.1186/s12912-024-02558-9
- Kapp, S., et al. (2023). The clinical and cost effectiveness of remote expert wound nurse consultation intervention: Pilot/feasibility cluster RCT. Pilot and Feasibility Studies, 9, 120. https://doi.org/10.1186/s40814-023-01387-5
- Chen, L., et al. (2025). A digitally enabled home-based wound care program (DE-HBWC): A new model for chronic wound care. Frontiers in Public Health, 13, 1591187. https://doi.org/10.3389/fpubh.2025.1591187