Wound Care

Specialties LTC Directors

Published

DON's I need your help. I need help developing an effective wound care program at my facility. I currently have a wound care nurse who does all the wound measurements for pressure and non-pressure wounds weekly. She puts them on a special tracking form that includes that family, dr has been notified, careplan updated, etc. The floor nurses are responsible for the daily wound treatments. Once a week the wound nurse comes to the weekly care conference and reports findings. An IDT note is written on the progress of the wound. The progress note usually consist of current measurements and continuing with current treatment.

The nurse I have doing measurements wants to do wounds full-time. She works on the skilled nursing side and thinks she is more than just passing meds. I clearly explained to her that I didn't have a budget of a full time wound nurse. As a result, she is unhappy, complaining she isn't able to effectively do her job. Basically, she feels as though she is being asked to do 2 full time jobs and she says she doesn't feel safe doing the wounds because she isn't able to put the time needed. I will say I have questioned if she is actually even looking at some of the residents on the list, or if she is just putting the same information back on the report on a few of them. Also, I had a resident with a rather extensive wound - it started on her abdomen, and tunneled down to her perineum. This particular wound had three sections. She only documented the abdomen. Also, she is constantly complaining that our wound care program is a mess. She recently mentioned that supplies are left in all the resident rooms, weekly progress notes are not being done, etc.

I have to admit wounds are not my strength. My facility currently has 6 resident's with FAPU's. I am needing some help and resources.

Specializes in Gerontology, Med surg, Home Health.

It sounds like a great opportunity for you. You can learn as you go and nevermind what the others think. Ask for their help if you need it. I was the wound nurse in many buildings because I loved wounds and had the knack for picking the right treatment. Just make sure your job description is clear.

Specializes in Geriatrics.

I am in the role of ADON in my facility and one of my routine tasks is our Wounds. Every Monday I assess all of our Pressure Areas, including documenting, updating POCS, updating Dr/family if necessary, changing treatment if need be. Tuesdays I measure Surgical, Vascular Wounds and do the same for them. Anytime a new wound is found the floor nurses know they must call me to get started on it right away. I complete a weekly grid in Excel and review that with our IDT weekly. I give the MDS nurses copies so they can ensure they are reflecting accurately in their MDS. My facility consults with a Wound CNP, she visits weekly and I round with her. She sees patients biweekly and more often if needed. I call her as needed to get treatment orders for new wounds. I started this program in December, our in house acquired was 11.48% and was 0% until this week. We had three discovered this week :(I need at least three days a week to fully devote to Wounds to get it done thoroughly. I also have several other responsibilities but this is one of the main ones. I am not sure if you guys would be able to give her part of her hours doing wounds and the other two days on the floor?

Specializes in Geriatrics.

Our floor nurses do bi weekly skin checks on Monday's and Thursday's, they have graphs with body diagrams to complete head to toe. Then our nursing assistants complete body diagrams three times a week with their showers. skilled residents are getting a head to toe daily at least, not for wound purposes though.

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