It’s already been a busy day in the wound clinic when a nurse rushes in to hand the physician a stack of home care nursing orders to sign. The forms, some of them more than five pages long, have been generated by various home health agencies in response to the one-page wound care orders that had previously been sent to them. The original orders consisted of instructions on how to clean the wound, secure a specific dressing over it, and change the dressing at a given interval for a specific time frame. A day later, the wound center receives documents with exhaustively detailed care plans for the patient’s many different health complications. One document in particular lists 20 medications the patient is taking (none of which the wound clinic physician prescribed), orders for tube feeding, catheter-care instructions, and a host of other detailed orders. At the bottom of this form is a place for the wound care physician’s signature. What’s wrong with this picture? How could new orders that were not written by the wound care physician need his approval? How should this situation be addressed? This article will help answer these questions.
There is a continually growing need to shift traditional wound care practice into what is now considered “best practice” and “advanced wound care” with the availability of evidence-based information. With this growing body of evidence-based knowledge, there is also a need for specialty wound care at all levels. An increasing number of physician practices that specialize in wound care are developing, and growth in companies that devote resources to managing wound care patients in all settings is evident. As these trends continue, hiring more specially trained nurse practitioners (NPs) will expand both the reach and the knowledge of those who offer advanced wound care.
This article will examine the role of NPs and detail how wound care centers in particular are benefiting from their utilization when appropriate training and education are considered.
It’s become common knowledge that wound healing requires a holistic approach. Any healthcare provider caring for the wound patient must consider the wound itself and all existing comorbidities beyond the wound in order to evaluate the patient’s full healing potential as related to the location and etiology of a particular wound. From the business perspective, cost-effective wound care requires attention to patient medical history (eg, cardiovascular disease), to nursing history (eg, self-care ability/education), to the elements of the moist wound healing process (eg, appropriate dressing availability/use).
As qualified healthcare professionals who are specially trained to practice within the unique blend of nursing theory and the medical decision-making model, nurse practitioners (NPs) can provide a valuable perspective to the wound care team within hospital-based outpatient wound care departments (HOPDs). However, these professionals must be set up for success upon being recruited into wound care. This article discusses the requirements needed to effectively practice wound care as an NP, the benefits of the integrated NP role in HOPD wound care, and provides practical checklists that will help both the NP provider and facility ensure a beneficial transition.
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