The impact of nurse practitioner-led wound clinic for under-resourced populations: a retrospective study

Abstract

Background: Chronic wounds represent a significant health care burden, particularly among under-resourced people, due to limited access to care, social determinants, and untreated comorbidities. These factors contribute to delayed healing, complications, reduced quality of life, and increased costs. Purpose: This study examined the types of chronic wounds, barriers to care, and clinical outcomes among underresourced individuals treated at a nurse practitioner–led (NP-led) wound care clinic, to inform targeted interventions for improving access and continuity. Methodology: This retrospective cohort study analyzed medical records of 493 patients treated at a NP-led clinic on the west coast between 2020 and 2024, focusing on wound types, care barriers, and clinical outcomes. Results: The most common diagnoses were nonpressure chronic ulcers (17.6%) and pressure injuries (16.6%), with lower extremities as the main location (20.49%). A strong correlation was found between number of appointments and follow-up (r = 1.0). No significantrelationship was seen between referral source and clinic visit status (x2 = 2.67, p = .26). Overall, 91.9% of wounds healed, whereas 16.8% of patients experienced persistent wound issues, reflecting barriers such as inaccessibility (17%) and refusal of care (5.7%). Conclusions: NP-led wound clinics are essential for under-resourced populations but face systemic challenges in patient follow-up and engagement. Findings highlight the need for interventions, improved continuity, and strategies addressing health care and social determinants. Implications: Enhancing continuity, fostering patient trust, and addressing social determinants through remote monitoring, community outreach, and tailored approaches are vital to optimize outcomes for under-resourced individuals with chronic wounds.