Section 14 Interdisciplinary Care Concepts

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Section 14Interdisciplinary Care Concepts
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Wound Care Team

• A multi-disciplinary skin care team can play
  significant roles in contributing to the primary
  goal of a successful wound and skin therapy
  program

In-house Wounds
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Team Members

• Patient and
• Administrator, CNA, Charge Nurse, Director of
  Nursing, Dietician, Materials Management/Central
  Supply, MDS Coordinator, Medical Director,
  Medical Sales Consultant, Nurse Practitioner,
  Physician, Physical Therapist, Social Services,
  and Wound Care Consultant.

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Purpose

• First priority is development of objectives,
  goals, and designation of responsibilities within
  the team

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Leader

• Responsible for communication, scheduling of
  tasks, events, and meeting facilitator

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Goals

• Decrease incidence of acquired pressure ulcers
• Improve wound healing times
• Development of standardized wound care protocols
• Education of facility staff, residents and
  families
• Cost effective solutions with positive clinical
  outcomes

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Continuity of Care

• Team should be involved in discharge planning
• Patient/Caregiver teaching regarding appropriate
  wound care done prior to discharge
• Wound care team should work with discharge
  planner in ensuring adequate supplies, pressure
  reduction devices, and other durable medical
  equipment will be available in the home

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Controlling Wound Care Costs

• Treatment Costs for Healing
• Stage 2 pressure ulcer - 10.63/day
• Stage 3-4 pressure ulcer - 20.40/day
• Average Healing Rates non-complicated wounds
• Stage I 14 days
• Stage II 45 days
• Stage III 90 days
• Stage IV 120 days
• Total Cost of Healing Stage 4 complicated ulcer
  37,000

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Cost Control

• Review supply purchase and utilization history of
  wound care supplies
• Determine actual utilization,
• brands, duplications, costs
• Review your supply contract
• with vendor
• Terms, length of contract, services provided

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Resource Utilization

• Wound care is a complex specialty area that
  requires CONSTANT monitoring and an enormous
  amount of education
• Utilize product representatives, ET nurses, Other
  WCCs, Podiatrists

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Communication with Physicians

• Routinely contact the physician to notify him /
  her of the patient's progress
• Even if the wound is unchanged, it is a good way
  to let the physician know that you are attending
  to this patient in a vigilant manner

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When Calling The Physician

• The patient
• Vital signs
• Wound's location
• Wound Measurements
• Condition of the surrounding tissue
• Condition of the wound base
• Any indications of infection
• Does the wound look like its healing, worsening
  or remaining stagnant?
• Current treatment and a review of the past
  treatment

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What if the doctor orders an inappropriate
treatment??

• Share your ideas for treatment, ask for trial
  period
• Get a copy of AHCPR guidelines for Doctor
• Have product representative visit his office for
  inservice on new products
• Calmly express your concerns

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Conflict/Change

• Conflict a struggle between opposing or
  incompatible behaviors is a part of every
  healthcare organization

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Conflict Resolution

• Timing and location can be crucial. Individuals
  should not attempt to resolve a problem when
  emotions are out of control and a fight could be
  provoked. In most cases, a private setting is
  best for confrontation

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Credibility

• WCCs need to display credibility
• Consistent verbal and nonverbal messages must be
  established with a self-confident tone and manner
• A WCC can establish credibility by being fair and
  consistent in interpersonal relations

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What Does 99.9 Quality Mean?

• 22,000 checks deducted from the wrong account
  each HOUR
• Your heart fails to beat 32,000 times each year
• Two unsafe landings at OHare Airport EACH DAY
• 500 incorrect surgical operations performed each
  week

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Recertification Requirements

• For recertification of WCC credentials,
  certificants must meet the following
  criteria1.  Active unrestricted license as a
  Registered Nurse, Licensed Practical/Vocational
  Nurse, Physical Therapist, Nurse Practitioner, or
  Physician in the United States.2.  Current "WCC"
  status.3.  Completion of certification
  examination OR by meeting requirements of the
  Continuing Education Outreach Program (CEOP). 

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Continuing Education Outreach Program (CEOP)

• To renew WCC credentials by the CEOP program,
  renewal candidates must meet all of the
  following1.  Continuing Education - Proof of
  60 contact hours of continuing education related
  to wound or skin care management is required.  A
  contact hour is defined as a unit of measurement
  that describes 1 hour of an approved organized
  learning experience.
• (Note A contact hour is different from a CEU.
  One CEU 10 contact hours) To receive credit
  for the contact hours, the educational program
  must be an approved/accredited program by the
  ANCC-COA, APTA, or state board governing your
  primary license.

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Continuing Education Outreach Program (CEOP)

• 2.  Community Outreach Project  Each renewal
  candidate must provide proof of
  participation/direction in a Community Wound Care
  Service offering. The community service offering
  may be at a local, state, regional, national, or
  international level but must be related to wound
  care services for the consumer/patient.
  Examples may include Community diabetic foot
  clinic, volunteering WCC's expertise in
  consultation to the "uncovered" and/or needy
  patient,  Wound Care Education presentation  to
  community, senior centers, college/high school
  students, nursing homes, or service groups.  WCC
  may contact NAWC for approval of ideas

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  Each renewal candidate must provide proof of
one of the following

• a.  Publication - Publication of a wound care
  article or research project in a book, journal,
  newsletter, or chapter of a book used for
  healthcare professionals or consumers.  Your name
  must be published as the author to qualify.

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  Each renewal candidate must provide proof of
one of the following

• b.  Presentation - Presentation of a wound care
  white paper or wound care poster  designed for
  healthcare professionals or consumers.

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  Each renewal candidate must provide proof of
one of the following

• c.  Leadership in a Professional Wound Care
  Organization - Leadership demonstrated  in a
  volunteer capacity of a local, state, regional,
  national, or international professional
  woundcare  organization.  You must be an officer
  or board member.

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  Each renewal candidate must provide proof of
one of the following

• d.  Research - WCC may conduct a research project
  in wound care.  WCC's name must be identified as
  the primary or co-primary investigator, or
  project director

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National WCC Directory
www.nawccb.org
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