By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

Deciding on a blog topic for this month was simple. August 12th marked 18 years since my 47-year-old mother passed away due to pressure ulcer complications. A flood of memories came rushing through, realizing just how much wound care has evolved throughout the years. A feeling of "if I only knew then, what I know now" type emotions. I cannot help but have a great deal of heartfelt empathy for caregivers and their loved ones with chronic wounds. My personal experiences have led me to my sense of gratification in what I do every day.

When I was my mother's caregiver, I remember dreading the weekly wound care center appointments for her chronic diabetic ulcers. The stress alone of getting her dressed, in and out of the car, and waiting for long periods of time to see the physician, was physically draining for us both. After her leg amputation, she resided in a long-term care facility to receive physical therapy and wound care for her stage IV pressure ulcers acquired at the hospital. While in skilled care she had to be transported by ambulance to be taken to wound care appointments. The bumpy long rides, transferring back and forth from hospital bed to gurney caused severe pain. Not to mention the ambulance costs involved.

I am the wound care program director for AmeriWound; a physician-based group that provides advanced wound care to patients in the long-term care setting. Quality bedside wound care has exceedingly more advantages than disadvantages. I take pride in knowing that there are wound care specialist physicians delivering the best possible wound care treatment, decreasing healing time, all while preserving the quality of life of residents/patients.

The Advantages of Bedside Wound Care:

• Improves resident/patient comfort
• Multidisciplinary approach
• Expert wound care monitoring throughout resident's stay (Ftag 385)
• Weekly or twice weekly wound care rounds
• Conservative sharp debridement procedures
• Wound Nurse and Physician joint effort approach synchronizing documentation
• EMR documentation that is survey focused
• Enhanced pressure ulcer prevention and awareness
• Prevents worsening of wounds
• Premier wound care management
• Improves quality ratings
• Emphasizes facility quality of care
• Strengthens skin care program
• Augments comprehensive skin assessments
• Educational in-services to nursing assistants and nurses
• State Survey readiness
• Increased census
• Fewer bed holds
• Reduces liability risks
• Telemedicine and virtual medicine options
• Minimal disturbance to the patient's daily activities

The Disadvantages of Bedside Wound Care:

The following services cannot be provided and would need to take place in a hospital:

• Surgical debridement
• Hyperbaric Oxygen Therapy
• Diagnostic tests (transcutaneous oximetry testing, non-invasive vascular studies, etc.)

Pressure ulcer prevention fundamentals are the expected standard across the continuum of care. Long-term care and skilled nursing facilities have an opportunity to offer cutting-edge wound care for their residents with various wound types. The on-site possibilities offer an integrated approach to wound care. Advancing wound education and routine access to wound specialists will lead to more prospects among peers and referral sources. Wound management outcomes become a more attractive place for those individuals looking to place their loved ones.

About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.