Shedding Light on Native American Health Disparities Utilizing Long Wave Infrared Thermography

Introduction: Native Americans have a significantly higher rate of health disparities than other populations in America. Indian Health Services (IHS) studies show higher rates of diabetes, traumas, chronic kidney disease, and cancer.  Native American skin is very difficult to assess due to the dark tones of skin. In fact, the two top skin scales, Fitzpatrick and Monk, are criticized for “Eurocentric bias “due to insufficient representation of native skin tones. Our 198 bed, Level III trauma center in Farmington, NM has a patient population of over 45% Native Americans.Methods:Long wave infrared thermography (LWIT) was implemented as an adjunct to the admission skin assessment.  The bedside admission nurse is responsible for imaging standard protocol locations, skin discolorations, and wounds.  The nurse analyzes the images to look for thermal changes in areas of concern/risk.  Which in turn, helps guide the nurse on what interventions are needed to keep the skin safe and protected.  The Wound Care Team performs a quick daily audit of images to triage/prioritize consults.Results:The ability to capture vascular skin issues and pressure injuries in darker colored skin tones upon admission has been a game changer for the facility. In addition, LWIT aids the wound care team to determine if the area is a pressure injury or if the discoloration is more superficial/different etiology.  The interdisciplinary team critically thinks to provide the best interventions and guide the plan of care to help save limbs and prevent further skin damage. The care provided, in conjunction with LWIT, helps address health disparities and enables patients to get the care needed to get control of the illnesses they face.Discussion: Implementing LWIT resulted in a significant decrease in pressure injury prevalence, the ability to capture and treat vascular wounds and ischemic limbs with quick interventions, and providing excellent care, especially for our high population of Native Americans.  To date the facility has captured over 41,000 images on 14,000 patients. References: