Selection of a wound dressing requires a multifaceted approach. Currently, no dressing can meet all needs of a wound (infection prevention, promotion of re-epithelialization, moisture balance, etc.).1 Clinicians must weigh the benefits and drawbacks of the dressing or dressings chosen...
By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP
As I am sure we are all well aware, not everyone loves wounds, ostomies, and continence as much as we do. Some nurses just do not have the passion (or desire) to perform wound care and learn about different modalities. On the other hand, some nurses are so eager to learn, obtain certification, and be the unit-based experts! In my experience, taking a hands-on approach to wound care education has been the most successful in terms of teaching wound assessment and dressing changes/techniques.
Why Hands-On Education is Important in Wound Care
New employees often begin with a centralized nursing orientation, and then home in on unit-specific competencies and education. I have found that approximately four hours of hands on shadowing and performing treatments (wound assessment, measurements, identifying tissue types within wounds, periwound assessment, product application, etc.), leads to much better outcomes (in terms of what is learned), compared to lecture or distribution of handouts and self-study modules. Even those nurses who are 110% uninterested in wounds, ostomies, and continence have at least one takeaway point from hands-on wound education.
What do I focus on? First, wound identification: pressure vs. moisture/incontinence, diabetic ulcers, venous stasis, arterial wounds, surgical, etc. What is full-thickness vs. partial-thickness? The "thickness" question is almost always brought up! Seeing incontinence-associated dermatitis and a pressure injury (on an actual person) in the same day will certainly help with differentiation. Measuring is also covered – length x width x depth (straight depth vs. areas of tunneling, undermining). How much slough is too much when it comes to staging (or not staging) a wound? These are all things I find very important to cover in a hands-on orientation to the nursing unit.
What to Cover in Wound Care Training
Checklists are important when it comes to unit-specific competencies such as negative pressure wound therapy, hospital policy on staging, changing an ostomy pouch, and unit (or hospital) specific documentation. It is helpful to develop these tool, as well as update them at least annually based on new evidence, education, and when hospital policies are updated or changed.
I personally feel that in nursing school, wound assessment, measurement, and staging are not often explored in depth. These concepts are learned hands-on, once practicing. With that said, the wound, ostomy, and continence nurse specialist is the expert when it comes to sharing knowledge with others. Many of us do not realize it, but a huge part of our role is education (educating patients, staff, peers, etc.). Learning is a lifelong process, and we really have the opportunity to learn something (and teach) every day. Sometimes, sharing knowledge with another person makes more of a difference than we realize. When nurses know more, they're more comfortable performing the techniques, and also know when to notify us with concerns. This all ties back in to the importance of being a piece of the puzzle, the interprofessional team. Teamwork is what makes us the best! If we have good teamwork, networking, and collaboration, we will almost always have good outcomes.
About the Author
Holly is a board certified gerontological nurse and advanced practice wound, ostomy, and continence nurse coordinator at The Department of Veterans Affairs Medical Center in Cleveland, Ohio. She has a passion for education, teaching, and our veterans. Holly has been practicing in WOC nursing for approximately six years. She has much experience with the long-term care population and chronic wounds as well as pressure injuries, diabetic ulcers, venous and arterial wounds, surgical wounds, radiation dermatitis, and wounds requiring advanced wound therapy for healing. Holly enjoys teaching new nurses about wound care and, most importantly, pressure injury prevention. She enjoys working with each patient to come up with an individualized plan of care based on their needs and overall medical situation. She values the importance of taking an interprofessional approach with wound care and prevention overall, and involves each member of the health care team as much as possible. She also values the significance of the support of leadership within her facility and the overall impact of great teamwork for positive outcomes.
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.