LTC Wound Care Program

[txdon]

I need help developing an effective wound care program at my LTC 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.

[Txnursekristi]

I need help developing an effective wound care program at my LTC 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.

It seems to me that your nurse is crying out for help - rightfully. She told you that she is unable to effectivley do her job, and that she doesn't feel safe. Your next 2 sentences support her argument. I understand the budget concern, but how much are you spending on wound supplies? How much on lawsuits r/t wounds? I think in the long run, you will see that a full time wound nurse will save you money.

I should give a disclaimer here and let you know that I am a full time wound nurse in a 150 bed SNF. I am a Wound Care Certified LPN. All I do is skin. I currently have ZERO FAPU's. I spend probably 50% of my time doing hands on wound care (from rashes to skin tears to stage IV's), 25% on research and paperwork (monitoring, tracking, recommending changes), and 25% on preventative care. I don't know how big your facility is, but I know that in order to be successful at PREVENTING wounds, you need someone full time. And when your ulcer rate drops to zero, KEEP THEM FULL TIME!!! It WILL save you money!!!