Pressure Wounds
Describe each stage.
We will read it off :)
side note: if a new wound is found, it needs to be reported to the CM and MD. Etiology of wound has to be documented in the narrative.
When would you use an Ag dressing? How often should it be changed? How long is it appropriate to use?
infection or inflammation (odor, increased drainage, erythema)
once weekly and PRN
after 2 weeks, wound should be re evaluated and another dressing considered.
NO
we can educate the family but we can not stay long term to perform ostomy care
who determines the pressure settings on the wound vac?
The MD. It can not be adjusted without MD order
What type of tube do you use for a wound culture?
How do you collect a culture?
anerobic or aerobic swab
after cleasing with sterile saline or sterile water
Who can stage a wound?
RN or MD/NP/PA
Give examples of a primary dressing.
Give examples of a secondary dressing.
Open for discussion.
Who provides ostomy supplies?
We provide supplies for Medicare patients while on service. All private payors should be set up through an outside supplier. Medicare should be set up at discharge.
What do we do if a wound vac comes off and can not be re applied immediately?
Wet to dry dressing
this should be taught to patient within first week and at SOC so that patient can perform after hours when nurse is not readily available
When should wound picture and measurement be obtained?
How do you measure a wound?
How do you label a wound picture?
measurements at soc, weekly and with a change, pictures at soc, monthly and with a change
demonstrate on the board
everyone label a ruler and upload to forcura (use wound picture provided)
What is the best intervention that can be performed by the patient or caregiver in healing and prevention of pressure injuries?
pressure relief- Q2 turning, floating
Foam dressings are not for pressure relief :)
Is hydrogel appropriate for a draining wound?
How long should hydrogel be used?
NO
up to 3 days for the gel and up to 5 days for the sheet
What is crusting?
forming a barrier between the skin and wafer by applying skin prep over powder.
Protect the stoma during this and do not apply prep directly to stoma
What type of foam do you use to pack tunnels?
white
They should be talking daily.
Do you need an order to apply zinc paste?
YES! You can not order cream or powders without an MD order.
What type of wound dressings would you use for autolytic debridement?
honey
side note: we do not perform sharps debridement in the home
How much space should be left between the wafer and the stoma?
1/8 in (3mm)
What do you put on exposed muscles, tendons, bones, nerves, etc
What resources to we have at Amedisys to assist us with wound care?
Nutritionist- Jessica Capps
Regional wound care- Paula Shrader
What makes the wound visit skillable?
The assessment of the wound.
Wound stable in the note is note appropriate. Details of the wound and the assessment is required.
Name different types of dressings:
review dressing types
What does a healthy stoma look like?
bright red and beefy, not pale
Put the cap on.
How do you write a proper wound care order???
list needed items.
everyone write a wound care order for the wound in front of you.