Wound Care: Moving Toward HealingPage 12 of 13

10. Summary

Collaboration on wound healing with multiple disciplines benefits patients in many ways. Registered nurses, physical therapists, occupational therapists, social workers, case managers, and nutritionists are valuable resources that help guide wound prevention and healing.

As the population ages, there is a decrease in independent functioning and ability to accomplish activities of daily living. Mobility and activity are areas that continue to keep the skin healthy. Limited range of motion, difficulty in ambulation, inability to reposition self, and risk of falls are all enemies to the skin.

Continual support from multiple disciplines and a collaborative approach are the best defenses against skin breakdown. Many interventions come from brainstorming with the patient and family as well as other healthcare professionals. If patients are unable to reposition themselves at home, physical therapists can educate caregivers on ways to reposition the patient without injuring themselves. Without a healthy and dedicated caregiver, the patient will not remain healthy at home.

Treatment selection for healing can vary based on the healthcare professionals’ knowledge, skills, and behaviors. The more often we reach out to other disciplines, the more it empowers us by increasing competency and confidence, which leads to higher quality patient care. Effective and appropriate product selection is valuable in both long-term care and home care since it can reduce the number of agency visits and, thus, cost to the patient.

Wounds should always be decreasing in size. As a general rule—no matter what area of practice, acute care, home care, or long-term care—if there is not a reduction in size of an acute wound by 40% percent after 4 weeks, re-evaluate the treatment plan and discuss other options. For a chronic wound, if there is no change in size after 6 weeks of therapy, the treatment plan must be changed (Livingston, 2009).

Continual education to the patient and caregiver on the stages of wound healing may solicit information about what is occurring when you are not there. Tell the patient that a stagnant or deteriorating wound is an indication that there is a problem. An open discussion with the caregiver and patient can lead the patient to admit they are not wearing their off-loading shoe all the time or the caregiver to disclose not repositioning every 2 hours.

Since you understand the wound healing process, and when it is not occurring, you need to relay this information to the patient and determine why progress has slowed or stopped. Encourage the patient and caregiver to be part of the problem-solving process; allow them to understand they are a valuable piece of the puzzle.

Wound care is a unique and complicated specialty that offers the privilege of working with many disciplines and caregivers. Wound care is a difficult topic that can either intimidate or empower a caregiver. You continually touch the lives of wound care patients and caregivers, which gives you the ability to improve their quality of life. Being able to provide support and education for patients, caregivers, and fellow professionals is a rewarding experience. There will always be a new product to learn and a new skill to master.

Encouraging and empowering caregivers is vital to patients’ progress toward healing and independence. Simple conversations ease anxiety and promote interaction between the patient and caregiver. Successful patient outcomes require a team approach with all disciplines and family members working together toward the goal stated by the patient. Different patients will have different goals for their wound care. Your ability to adjust wound care education to meet the needs of the caregiver and patient will result in the best patient outcomes.

Wound care is a valuable and necessary skill. Aim for improving quality of life and you can never go wrong!