Wound care

[Gina Godwin]

I’m interested in pursuing a change from L&D to hospice. I did work PCU about 8 yrs ago and did some wound care when needed I’m just wondering what kind of wound therapy I should be brushing up on if I did make the transition to hospice?

[vampiregirl, BSN, RN]

Wound care in hospice typically has different goals than other environments such as PCU. The focus on hospice wound care is typically on management of drainage and odor as well as patient comfort/ quality of life.

However it is also helpful to have a basic working knowledge of the general principals of wound care. Knowing how to accurately measure wounds and wound care documentation is standard in most settings. Knowing the appropriate terminology is very helpful and being able to identify specific characteristics of wounds is essential for not only documentation but also in describing them to providers so that you can obtain the appropriate orders for patients.

Understanding pressure ulcer development and prevention is important - pressure ulcers can be very painful. Not all of them are preventable in hospice patients but minimizing risk by being proactive and treating appropriately makes a difference for the patient. Venous ulcers, skin tears, fungating cancer wounds and moisture associated skin conditions are also areas of wound care it is very helpful to be familiar with.

Most hospice agencies have a basic formulary/ protocol for skin care that includes recommended dressings. If you are caring for hospice patient's in SNF, wound care typically involves collaboration with the facility wound care nurse - even though hospice has the responsibility for the POC, this collaboration is very important.

I use several references frequency, probably my favorite is "Quick Reference to Wound Care" by Pamela Brown - I think I have the 4th edition. I like this resource because I think it does a good job addressing palliative wound care considerations.