By Kathleen Thimsen, DNP, MSN, ET/WOCN, FNS (Associate Professor, Director – Doctor of Nursing Practice Degree Program)
When we hear about wound management, images like band-aids or dressing changes likely come to mind. But for nurses, it is much more multifaceted. Proper wound management is a comprehensive approach that includes a focused and wholistic patient assessment of systems, medications, nutrition, and hydration along with attention to psycho-social aspects of a patient’s environment specifically planned for that individual.
These parameters, combined with a patient’s existing conditions, make wound management both a science and an art, a combination that is the essence of nursing practice.
In Fall 2021, I will be leading the Beyond Band-Aids certificate program as part of UNLV School of Nursing’s Continuing Education program. It is a three-part series that covers the basics to complex wound management competencies. This editorial does not replace the lessons learned from this program; it compliments the principles on accurate and efficient wound care and associated assessments and patient management, aimed to achieve timely and optimal results.
Evolving from Care to Management
Wound management extends beyond mere wound care by virtue of the specialist having advanced competencies (knowledge, skills, and practices) that increase the potential for efficacious and efficient strategies implemented to address the barriers and obstacles to healing. These competencies have been described in the literature and have been practiced as standards of care since the introduction of Moist Wound Healing (MWH) theory that was introduced by Dr. George Winter in the 1960’s. The MWH theory underwent extensive study from the 60’s and 70’s with the establishment of the theory in the 1980’s, when “wet to dry dressings” were replaced by advanced dressing technologies. Studies and data since that point have repeatedly validated the role and impact that MWH technologies have played in reducing the time to healing and closure, decreased pain at the wound site and a reduction in scarring and scar tensile strength.
The program begins with understanding basic assessments and skills in identifying wounds etiology, comprehensive assessments, treatment strategies, product classification s and technology indications, and documentation to advance the identification of wound progress and healing parameters.
The level two or intermediate to advanced course incorporates the complexities of co-morbidities and the implications to healing. Evolving case studies that include strategies to identify early and intervene with appropriate and effective therapeutic modalities and adjuvant therapies to promote optimal care outcomes. Additional topics will include debridement modalities that include sharp debridement with topical anesthetics, suturing techniques and aligned consents vacuum assisted closure and documentation.
The third course in the series culminates with work being focused on program evaluation and outcomes. Topics will include performance indicators, program outcome measures, quality improvement and peer reviews. Course participants will also create a formulary for their practice setting, receive training templates and can review or develop policies, procedures, and protocols for their practice setting. Case reviews will be discussed with collaborative, solutions forum method.
All participants will be prepared to sit for certification in wound management through the existing certification board providers. For more information on how to enroll, contact the SON Continuing Education team at UNLV_NCCE@unlv.edu.
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