Development of Telenursing Guidelines to Improve the Quality of Services in Diabetic Wound Care in a Hospital in Thailand: Case Study.

Background: The majority of patients with diabetic wounds living in Mae Chan District, Chiang Rai Province face challenges such as a shortage of nurses, limited access to health care, and insufficient resources. Strategies such as specialist networks, patient monitoring, and online care platforms are crucial to improving diabetic wound management in the community. Objective: This study aims to develop telenursing guidelines for caring for patients with diabetic wounds and foot ulcers, and to investigate the effects of telenursing on wound healing among patients. Methods: Participatory action research was conducted in three cycles: (1) assessing the current situation and feasibility of telenursing; (2) evaluating telenursing guidelines for wound healing; and (3) examining the effects of telenursing on wound healing, amputation rates, and patient satisfaction. Results: The mean diabetic wound severity scores decreased after receiving telenursing care at weeks 2, 4, 6, and 8 (P<.001). No patients were found to have foot or leg amputations. The patients in the group who received telenursing care showed that their wounds healed in an average of 8.6 (SD 4.3) weeks. The satisfaction score for telenursing care was 4.7 out of 5 (SD 0.2). Conclusions: Telenursing guidelines were developed to enhance access to wound care, reduce amputation rates, and promote wound healing, resulting in a significant reduction in wound severity and the absence of amputations. The study further demonstrated that telenursing not only expedited healing times but also reduced health care costs and improved patient satisfaction.