Case Studies in Wound Care Mary Farren, RN, MSN, CWOCN Centers of Excellence
Dec 16, 2015
Case Studies in
Wound Care
Mary Farren, RN, MSN, CWOCN Centers of Excellence
Keys to Success
• Collaboration
• Technology
• Evidence-Based Protocols
Wound Management
• Goals of care: – Healing – Palliation
• Co-morbidities• Infection• Pain management • Laboratory data: Hgb, Hct, Albumin• Home care services: SN, PT, OT, SW,
HHA• Learning potential of the patient &
family
Pressure Ulcer:Nursing Care Components
• Address all risk factors
• Secure needed support surfaces
• Evaluate rehabilitation needs
• Provide family support and education
Home Management of a Pressure Ulcer
• Home Visit by MD • Wound debridement
in the home• Curasalt Hypertonic
Saline Dressing QD • Group 2 Support
surface• Interdisciplinary
collaboration
7/26
Home Management of a Pressure Ulcer
• Post debridement
• Treatment & dressings modified over time
• Family education was successful
8/16
Successful Achievement of Outcomes
• Appropriate support service
• Effective wound treatment
• Healing in 7 weeks
9/13
Technology in the Home:Surgical Wound
• Vacuum assisted closure
• Wound measurement: 12.5 x 5.5 x 4cm
• Mesh exposed, sutures visible
5/13
Successful Achievement of Outcomes
• Effective wound treatment
• Ostomy management
• Healing in 6 weeks.
6/23
Home Management of aSurgical Wound
• Clinical specialist consultation
• Exposed tendon
• Treatments modified over time
– silver impregnated hydrogel
4/28
Successful Achievement of Outcomes
• Diabetes adherence addressed
• Healing in 14 weeks
8/04
Criteria for VNSNY Clinical Specialist Consultation
• Stage three, four, or unstageable pressure ulcer
• Wound worsening under care
• Unconventional treatment
• Assistance needed with palliative care options
• RN/MD collaboration for evidenced based treatment
• Nurse requests support for complex care management issues
• Request for VAC therapy
Interdisciplinary Communication
and Collaboration• Collaboration
• Improved patient outcomes
• Avoidance of hospitalization
• Improved compliance with regulatory requirements