Wound Cart

[MargieGirasol, LVN]

Hello everyone, I recently started a new job that I love at an assisted living facility. I’ve always been an organized person, however my new job isn’t the most organized. Upon trying to find things for wound care I found our wound care cart a mess! I don’t know where to start organizing it. Any suggestions on the best way to organize it? I have 5 drawers, 2 shallow and 3 deeper. I would appreciate any assistance!

[SarHat17, ASN, RN]

We have a similar cart on my unit; let me see if I can remember what is in each drawer. We keep some items on our par in the supply room, but there are more varied options kept stocked in the cart and the Wound Care RNs take the cart with them when they round. (They leave it outside the patient room.)

Top/1st drawer is measuring tape, different tapes, scalpel, scissors, that type of stuff.

2nd drawer has all the mepilex dressings, mepitel, island dressings, etc.

3rd drawer has wound vac supplies.

Bottom/4th drawer is ostomy supplies.

I'm sure there are other bits and pieces in there, but that's the gist!

[amoLucia]

Op, for your cart in an AL facility, your cart is prob quite small so space should be limited.

Firstly, check out any and all supplies for EXPIRATION DATES. Toss out the old stuff (use your discretion for those 'just past the date' items. I'm saying this because I'm guessing most of your pts are private pay and each would have personal own supplies paid out of pocket.

Secondly, make sure your treatments are current. If the wound/tx has healed, there shouldn't be any need for leftovers, unless there is a possibility of reoccurrence. Again, remember supplies cost $$$. Find out if your facility has some P&P re storing old supplies or returning them to families (for repeat use). They're costly and I'm sure families will pitch a fit re waste or over-use!

Thirdly, and this is just my preference, I'd keep all Mary Smith's supplies together, separated from John Jones' stuff. Use a big baggie or some type of box container to collect & isolate individual supplies. And that would include their own 4x4s, kerlix, extra ACEs, tegaderms, op-sites, ostomy equip, etc.

Fourthly, you prob have some 'community'  supplies, like maybe saline or some loose bandages and oints/creams. And you prob need a few guazes, rolls of various size tapes, klings, op-sites, band-aids, etc  just for emergency 'spares' for pts. I really doubt the facility will provide supplies for any long term for them. But you'll need a few items to continue old txs or start new ones. Some ostomy items might be here also; MAYBE. Also a few suture sets & staple removal sets and scissors. Tape measures for wound documentation.

I also strongly advise making sure ALL opened bottles are DATED, and tubes have caps on them (even if you makeshift a tape cap for them). This will be a State survey thing.

As I've known ALF level pts, they're just like home-care pts, only in a congregate community setting. I'm not sure how their residential living expense is financed, but as I know it, I'm not sure if Medicare/Medicaid covers ALF. That means out-of-pocket private pay. Big costs! So being frugal should be your rule, but remembering that the cost for txs are just like the cost of their meds. Some things might be covered by insurance; again MAYBE. The families or your Social Worker can prob direct you. You'll just need to keep 2 steps ahead of everything to make sure you have adequate supplies avail.

I was NOC super in LTC. I made it a point to make periodic 'tx cart checks'. The waste was astounding; much of it due to nurses' poor techniques. And for that there was no excuse. Sometimes what I would find I would box up to show the DON and the staff. Very hard for me to make any real changes. But once you straighten things out, it'll be better.

Also, on a very different topic, I suggest you change your screen name. Anonymity is preferred on social media.

Good luck to you.