PT Doing wound care?!

[Gampopa]

I just got off the phone with my sister who was DXed 9/27 c a perianal abscess. She's been on antibx and had surgery to drain the abscess and the pocket was packed. She goes daily to have the packing removed and repacked. This is done by PT. Am I wrong in thinking this needs to be done by nursing staff and in particular a wound care specialist? She's still running a temp. and having extreem pain c BMs and packing changes. When she asks the PT what she can do to reduce the pain and keep herself clean they don't give her many options. She is on oxycodon. She lives in KY and is going to a small community hospital. Is it unusual to have PT doing wound care?

[TracyB,RN, RN]

When I worked on the rehab unit at my hospital, it was not all that unusual for PT to do SOME of the simple dressing changes, but I wouldn't let them do it on my pts... heck, if I have to chart on the wound, I need to see it.

Some of the nurses would let the aides do their dressing changes.... UUUGGGGHHGH

[Ahhphoey]

I work in a small hospital in an urban area, about 250 beds, and I've seen PT do wound care in many instances. If a patient were ordered whirlpool treatments, PT will perform this treatment as well as redressing the wound after the treatment is completed. I spoke with a friend who is pursuing a career in PT and she was taught this as a part of her in school training. I trust the PT staff at my hospital to do this and have not seen any negative reactions as a result of this...as of yet anyway.

[P_RN, ADN, RN]

As far back as I remember PTs are fully qualified to debride and do other wound care. Dressings should be covered there. PTs have master's degrees, I think.

[jaimealmostRN]

Is she taking antibiotics at all? If it were me, I would insist (to either my dr. or the manager of the PT dept) that I wanted to see a wound care specialist. I know that PT's are very well educated, but if the wound is near the anal area, there may be some other concerns (infection, contamination of dressing site) that a PT isn't trained to address.

[RN4NICU, LPN, LVN]

As far back as I remember PTs are fully qualified to debride and do other wound care. Dressings should be covered there. PTs have master's degrees, I think.

You are correct - PT's have master's degree at entry-level. They are fully qualified to do wound care.

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Not EVERY d*mn thing has to be a nursing function. We can loosen the reigns a little bit and let the other services take care of our patients too. If it is an issue of not being able to see the wound - it is acceptable to chart "unable to assess" and list the dressing as the reason, describing the dressing (dry, intact, or exudate present, etc.) Whoever changes the dressing will be charting the condition of the wound. Some of those dressings are supposed to be left in place and not messed with - to the point that even the next shift (and possibly a couple of shifts after that) should leave it in place - not even moving it to peek! Sometimes our need to see everything is detrimental to the therapies we are providing.

[zenman]

I worked at one hospital where we had a PT wound care team.

[nursemary9, BSN, RN]

Hi

In Illinois. PT's do wound care--at my home care employer, the wound care manager was a PT. They are allowed to surgically debried wounds, where nurses are not. When I first started at Home Care, that woman taught me everything I now know about wounds.

At my hospital now, a large trauma center, PT's manage the Wond Vac program.

They are excellent!! I would trust the PT completely as I have seen that they are usually quite progressive & keep up with the latest products.

Of course, this is only my experience.

Mary Ann

[memphispanda, RN]

PT does the majority of wound care at the hospital in which I work. Nursing only does the most simple of dressings, while PT does whirlpool, debridement, packing, etc.

[mittels]

I have several pt's on home health that I CM. PT and I share the drsg changes. I go out 3 X week, she goes to the Dr. once a week, and then to PT out pt for wound care on alternating days.

[eak16]

here PT's do water-pic. They are very good, and are usually less rushed than nurses.

Amen to not needing everything to be a nursing responsibility! Isn't that the point of interdisciplinary teamwork?

[TELEpathicRN]

Besides just doing gait training, ROM, etc, PT'S are wound specialists! They are more than qualified to handle these wounds (even the area that it is in). Maybe she needs to see another MD. Also, sedation for dsg changes would make her more comfortable and maybe have no recollection (if they used Versed). I wish your sister good luck.