Long-Term Care

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC With approximately $20 billion being spent a year on advanced wound care supplies, cost containment is a sought after goal. Long-term care facilities battle cutting costs under one reimbursement system like everyone else, but I assure you this challenge can be simplified, while continuing to bolster quality of care. I have learned that to contain cost, you must use experience, knowledge, and strong project management. So how do we accomplish this? I have broken down a cost containment plan for your long-term care facility. These key points will help you.

by Lydia A Meyers RN, MSN, CWCN At the start of December, I was looking at graduation from my Master's Degree program and the completion of my final paper. A capstone to the Master's program is much like the dissertation to the doctoral program. My journey has been long and along the way I have increased my base of knowledge. What I have learned on this journey will enhance my practical knowledge of wound care and patient care. I learned that health care must change, and we must look hard at how we are doing business and be willing to challenge the status quo. Health care needs highly knowledgeable leaders to assure patients receive quality care by being good stewards of the money given to promote that care. The provider must be educated to assure the patient's wishes are followed first and always.

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS Worldwide Pressure Ulcer/Injury Prevention & Awareness Day is November 21st. This day is considered pretty much a holiday at my home. I have Stop Pressure Ulcer tee shirts, and I order a cake or STOP sign cookies every year from the bakery in memory of my mother. To some it might sound crazy, but my life was strongly impacted forever in 1996 after my mother passed away in my arms at only 47 years old because of complications of diabetes and what was called at that time "multiple decubitus." The image and smell will never leave my mind. It changed my life forever as a daughter, a caregiver, and later as a wound nurse. I needed more answers to heal my heart. How could my mother acquire such horrible wounds while at the hospital to get better? My mind was twirling nonstop with the 5Ws. Who, what, when, where, why? So, then it began. I wanted to learn everything I could. This ended up being sort of my therapy, which transitioned into my passion and purpose.

By Karen Zulkowski DNS, RN, CWS I have talked about treating wounds, assessing wounds and care planning, but have not discussed the patient as a person. I always talk to the patient and family about options for care, how aggressive they want to be in their treatment plan and explain to them what I am doing and why I am doing it. The importance of this communication process is one of the reasons why I got involved in the Wound App project. I realized rural facilities don’t have wound expertise available and additional testing may mean many miles of travel. The consultation plan calls for patient/family involvement. But the communication with the patient and family is important regardless of how or where you are doing wound care.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC Substandard documentation tops the list of mistakes for long-term care facilities. It involves "all hands in the chart" so to speak. This encompasses all disciplines, from the nursing assistant to the physician. Discrepancies and gaps in documentation put your facility at risk of litigation. Impeccable documentation is essential in defending any case. Your facility must have a "safety net" in place. This "safety net" consists of educating staff about the importance of timely and detailed documentation not only for the facility, but for their license. Often times, clinicians are not aware of the legal repercussions of their actions. Surveyors will also consider other related Federal Tags (F-Tags) during investigations for compliance.

By Aletha Tippett MD For over a decade now I have treated wounds in palliative care patients and non-palliative care patients. The “funny” thing is that there is no difference in how I treat these wounds, all are approached the same way, with similar treatments used. As I teach more and more about palliative wound care, it seems obvious to me that all wounds and all people deserve this approach. Who does not deserve less pain? Who deserves to be embarrassed by wound odor? Who deserves to have an infection? Who deserves a lesser quality of life? When asked these questions I would think the answer would be NO ONE.