Wound Vac Requisition

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Specializes in Birth center, LDRP, L&D, PP, nursing education.

I'm working on a use-case scenario for a wound vac and looking for input from wound care nurses:

1) Where do KCI pumps come from at your facility? What type of facility do you work at and do they typically own or rent?

2) Where do the pumps come from for discharged patients? Home care, hospital, or DME?

3) What are typical issues that you typically encounter with wound acs along the way? for example: Difficulting sealing to periwound?

Regular cannister changing?

Improper dressing change?

Difficulty obtaining/with practitioner orders?

Issues with home care or insurance for proper equipment upon discharge?

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Specializes in Med-Surg, Geriatrics, Wound Care.

I work at a hospital. Inpatient, the wound vacs (rented) are stored in our clean medical supplies area and delivered to patient rooms and OR as needed. Use the KCI web app to keep track of them. Dirty vacs are picked up by KCI rep in soiled utility rooms (I've heard this is not the norm). The hospital is debating purchasing vacs, but there are issues with sorting who will clean/maintain them.

Patients discharged, and those in the wound center have portable vacs delivered via KCI rep. Return of those is usually the patient responsibility (mail back the suitcase in the prepaid envelope).

At our hospital, I don't think the staff are good at troubleshooting. At all. They often don't even realize the vac is beeping, and don't know what the error messages are. Vacs have been accidentally unplugged and then automatically turned off. Vacs leak, and no troubleshooting done, and they turn the vacs off. Nurses don't know where canisters are (their clean utility rooms). A few times, the vacs are mishandled (put into biohazard bags) and sent to where biohazards are sent...

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Specializes in Army Nurse, CEN.

It is the same at our facility. Except for some of our outpatient wound clinic patients, we have a stock of ActiVacs that we will apply in the outpatient appt or before the patient is discharged home (if the VAC is being continued for a person going home home. Those going to a facility will be transferred to the nursing home VACs.

The floor nurses are pretty much afraid of the VACs. The best they can do is turn them on/off, plug in and change the canister. Our VACs are changed by the inpt wound/ostomy nurse, wound care provider, or in the OR by the surgeons.

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Specializes in Birth center, LDRP, L&D, PP, nursing education.

If floor nurses struggle so much with the dressing changes, who is teaching them on the floor? Is it the KCI rep? The wound care nurse? Or just part of orientation? Do you guys have to do ongoing competencies in wound care or dressing change? Thanks!

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Specializes in Army Nurse, CEN.

Our inpatient wound/ostomy nurse usually does the VAC dressing changes. She also does a presentation on wound care during the nurse residency/orientation program for new nurses. If the floor nurses have trouble they call her or down to us at the wound center. If it's at night, they will do their best to patch it or remove it and wait until morning. The floor nurses are good at the more simple dressing changes. I'm not sure what they have for competencies.

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Specializes in Wound Care / Foot Care / Case Management.

Hi!

I work out an outpatient I wound care clinic, located inside a hospital. KCI vacs are used on the inpatient side, I think they are rented.

The inpatient nurse normally orders a KCI vacs for home use. However, if the patient will be seeing us after discharge, I typically use another DME company.

Two common problems : 1) getting a good seal on a vac located near the orifice. This can often be solved by creating a smaller "windowpane" or by using a hydrocolloid (Duoderm) on the edges.

2) untrained personnel applying the VAC improperly.

Change the cannister when almost full. Most patients can do this part themselves. Medicare only pays for 15 per month if I'm not mistaken.

Insurance vary from state to state. However, most VAC suppliers will release an indigent VAC; don't utilize KCI often but know they are generous with this, at least with our hospital.

Hope this helps!

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Specializes in Birth center, LDRP, L&D, PP, nursing education.

Thank you!

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Hi, please somebody tell me how to document on a wound vac. thanks

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Thourogh info here:

Negative Pressure Wound Therapy (NPWT) Documentation ..

Home care nurses should include patient instructions re troubleshooting pump, pump battery charging, changing of canister, how to patch dressing leak; need to remove dressing + apply NSS soaked dressing if dressing unable to be patched/pump off over 2 hrs; re-inforce vac company toll free #.

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Specializes in Public health program evaluation.
On 11/25/2018 at 5:46 PM, Eagle2110 said:

Hi!

I work out an outpatient I wound care clinic, located inside a hospital. KCI vacs are used on the inpatient side, I think they are rented.

The inpatient nurse normally orders a KCI vacs for home use. However, if the patient will be seeing us after discharge, I typically use another DME company.

Two common problems : 1) getting a good seal on a vac located near the orifice. This can often be solved by creating a smaller "windowpane" or by using a hydrocolloid (Duoderm) on the edges.

2) untrained personnel applying the VAC improperly.

Change the cannister when almost full. Most patients can do this part themselves. Medicare only pays for 15 per month if I'm not mistaken.

Insurance vary from state to state. However, most VAC suppliers will release an indigent VAC; don't utilize KCI often but know they are generous with this, at least with our hospital.

Hope this helps!

In my clinic, we have a gentleman who has a vac between his great and third toe (second toe amputated), plus other wounds sites on the same foot. Great fun. We built up a 'dam' out of ostomy paste between the toes and wrapped the heck out that foot. Of course, this patient like to turn the vac off once he was home, so his foot stewed in the dressing, and we constantly struggled with maceration. Finally, we gave up on vac for this person. When vacs are shut off, they can cause a world of damage.

Have used hydrocolloid a number of times, both to save inflamed skin from vac dressings, and to help with the seal. It's a good trick.

I haven't had a coccyx vac yet- something to look forward to.

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