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Reliability Testing of Augmented Reality Glasses Technology

Establishing the Evidence Base for Telewound Care

Kaylor, Jennifer; Hooper, Vallire; Wilson, Angela; Burkert, Randy; Lyda, Marlena; Fletcher, Kirstie; Bowers, Emily

Journal of Wound, Ostomy and Continence Nursing: November/December 2019 - Volume 46 - Issue 6 - p 485–490
doi: 10.1097/WON.0000000000000585
Wound Care

PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings.

DESIGN: Intrarater reliability design focusing on treatment integrity.

SAMPLE AND SETTING: Adult patients in a tertiary care hospital and a rural long-term care setting who were scheduled for routine wound care consults.

METHODS: Intra- and interrater reliability were assessed using a documentation-based wound assessment tool comprising 6 discrete assessment points. The wound teleassessment was first conducted by the telehealth “hub” WOC nurse remotely in collaboration with a bedside nurse wearing the ARG. The same hub WOC nurse then conducted an assessment at the bedside. Initial assessment points and treatment plans were compared to establish assessment and treatment intrarater reliability. A different WOC nurse, blinded to the first assessment, also conducted a bedside assessment and provided treatment recommendations, which were then compared to the hub WOC nurse's initial remotely ARG-generated treatment plan to establish treatment interrater reliability.

RESULTS: Sixteen patients with 21 wounds were assessed. Six wound assessment components were included, yielding a total of 126 total observation points. Intrarater assessment reliability was 98%. Treatment plan interrater reliability was 100%.

CONCLUSIONS: Results support further evaluation of ARG technology as a tool to enhance the delivery of wound care services in remote underserved settings. Implementation and evaluation of this technology on clinical and financial outcomes in multiple wound care delivery environments should be determined moving forward. Successful implementation should serve as a template to expand evidence-based WOC nursing care across the globe.

Jennifer Kaylor, BSN, RN, CWON, Mission Health System, Asheville, North Carolina.

Vallire Hooper, PhD, RN, CPAN, FAAN, Mission Health System, Asheville, North Carolina.

Angela Wilson, BSN, RN, CWON, Mission Health System (Formerly), Asheville, North Carolina.

Randy Burkert, BS, Mission Health System, Asheville, North Carolina.

Marlena Lyda, BSN, RN, Mission Health System, Asheville, North Carolina.

Kirstie Fletcher, BSN, RN, Mission Health System (Formerly), Asheville, North Carolina.

Emily Bowers, MSN, RN, Mission Health System, Asheville, North Carolina.

Correspondence: Vallire Hooper, PhD, RN, CPAN, FAAN, Mission Health System, 509 Biltmore Ave, Asheville, NC 28801 (

The authors declare no conflicts of interest.

The funding source had no further role in study design, the collection, analysis, or interpretation of the data, writing of the report, or in the decision to submit the paper for publication. The views expressed in this publication represent those of the authors and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

© 2019 by the Wound, Ostomy and Continence Nurses Society.