New tx nurse and i need help with a wound program

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    Hi Ive been a nurse for five years but only a wound care nurse for five months. I work in LTC, My DON has asked me to come up with a program for residents with wounds or at risk for wounds. Can anyone share ideas of what things are used in your facilites? Greatly appreciate any help.....

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  2. 7 Comments...

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    What kind of program do they want? Are you looking for sample standing orders, or are you looking for policies and things like that? I have tons of stuff, and I'm always willing to share, if you'll message me and let me know what you need!
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    I am also a new treatment nurse and would love to have info on like policies and procedures, pressure ulcer prevention, etc. Love doing the wound care but get so frustrated with finding things I know that could have been prevented .Would love the guidance from a fellow treatment nurse.
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    Basically u have to revamp the whole program as far as play music every two hours so people are turned. Have inservice for the programs and develop team to initiate.....for some reason I can message on here I tried.
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    Oct 19 by TxnursekristiWhat kind of program do they want? Are you looking for sample standing orders, or are you looking for policies and things like that? I have tons of stuff, and I'm always willing to share, if you'll message me and let me know what you need!


    Hi! I am new to wound care nursing too. I need all the help that i can get. How can i contact u?
  7. 0
    I was asked to do the same thing. Help initiate a wound care prevention and management program. Fortunately I have an absolutely wonderful Wound Care Specialist who does weekly rounds at my facility and is availible by phone at all times. I started with the orders, our were a hot mess! One person referred to a wound as an open area, one a stage 4, another an abrasion. I walked in to each room not knowing what it was I would find. So I clarified all the wound classifications, made sure the treatment order was appropriate, referred to the RD for dietary consult, referred to PT to see if they required a specialty cushion/brace/PRAFO boot/shoe/etc. Than set up interventions to prevent future skin breakdown such as lotion to applied daily, gerisleeves, long sleeve shirts, moisturizing body wash, bath oil, heelzup, positioning devices, specialty mattress, gerichair pads, strict turning/repositioning policy, every single aide on every shift is responsible for completing a skin sheet for each resident they were assigned. Gave inservices on proper transferring, body alignments, pericare, etc. I'm not done yet as I'm only 2 months in to developing the program and I know we could do more. I'd love to hear tips on what other facilities do to prevent skin breakdown. Any tips?
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    I am not a WOCN, but am chair of our skin team for our hospital. I work in a teaching hospital, so we may do things differently. We use the Braden scale every 12 hours on our patients. The lower the score, the more interventions we put into place. We use a lot of specialty beds and prevalon boots, escpically for our bed bound patients. We also use the mepilex saccrum border (basically a giant bandaid that goes over the saccrum and coccyx) for prevention. We have signs above the beds with clocks on it and all the even numbers. Next to the numbers are the words left and right so that way everyone is on the same page on which way to turn the patient. If patient is chronically on O2 and they are getting breakdown that way, we put duoderm on the skin behind the ears so it doesn't rub. If there is a facility acquired pressure ulcer, we also go back and do a case review about it, and take it back to the staff. We point out what could have been done better and what they did well. It was also important to explain the to staff what happends when we get FAPU, how we don't get reimbursed and get dinged for it and so on. We just rewrote our policies for the hospital and made up a new physcian order set if you still need help with this, and don't mind it being from a hospital not a LTC facility.
    pnkgirl25 likes this.
  9. 0
    Quote from saline2
    I am not a WOCN, but am chair of our skin team for our hospital. I work in a teaching hospital, so we may do things differently. We use the Braden scale every 12 hours on our patients. The lower the score, the more interventions we put into place. We use a lot of specialty beds and prevalon boots, escpically for our bed bound patients. We also use the mepilex saccrum border (basically a giant bandaid that goes over the saccrum and coccyx) for prevention. We have signs above the beds with clocks on it and all the even numbers. Next to the numbers are the words left and right so that way everyone is on the same page on which way to turn the patient. If patient is chronically on O2 and they are getting breakdown that way, we put duoderm on the skin behind the ears so it doesn't rub. If there is a facility acquired pressure ulcer, we also go back and do a case review about it, and take it back to the staff. We point out what could have been done better and what they did well. It was also important to explain the to staff what happends when we get FAPU, how we don't get reimbursed and get dinged for it and so on. We just rewrote our policies for the hospital and made up a new physcian order set if you still need help with this, and don't mind it being from a hospital not a LTC facility.
    I am a CWON on a nurse driven consult team at a teaching hospital. Our incidence rate is low but as everyone, we are striving for "0%" (that's a whole other discussion). We are in the planning stages of developing/implementing a hospital wide pressure ulcer prevention campaign. Your post caught my attention as you listed many interesting techniques to assist/educate staff. If you are still willing to share your info (policies/order sets, etc), I would love to learn more. I just joined allnurses.com so I don't know that I can receive inbox messages, but you can email me at afankhauser@kumc.edu. Thanks!!


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