{"id":1112,"date":"2024-05-11T15:26:10","date_gmt":"2024-05-11T19:26:10","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=1112"},"modified":"2024-05-11T15:30:06","modified_gmt":"2024-05-11T19:30:06","slug":"2-5-6","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-5-6\/","title":{"raw":"2.5.6 Wound Management","rendered":"2.5.6 Wound Management"},"content":{"raw":"Importance of Wound Management in LTC\r\n<ul>\r\n \t<li>Integral to effective care in varied domains: education, research, leadership, consultation\/collaboration, optimizing health systems (policy\/legislation), role integration<\/li>\r\n \t<li>Intersects with many of the other competencies:\r\n<ul>\r\n \t<li>Person-centred care<\/li>\r\n \t<li>Comprehensive primary care<\/li>\r\n \t<li>Critical thinking<\/li>\r\n \t<li>Acute episodic illness (cellulitis, skin tears, ED diversion)<\/li>\r\n \t<li>Chronic disease management<\/li>\r\n \t<li>Procedural care in LTC (ABPI, biopsies, debridement)<\/li>\r\n \t<li>Palliative approach to care<\/li>\r\n \t<li>Geriatric pharmacotherapy (treating cellulitis, osteomyelitis, skin cancers)[footnote]Harrison et al., 2010[\/footnote]<span style=\"font-size: 14pt\">[footnote]McDonald, 2018[\/footnote]<\/span><span style=\"font-size: 14pt\">[footnote]Bacon, 2010[\/footnote]<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2>NP Role in Wound Management<\/h2>\r\nClinical:\r\n<ul>\r\n \t<li>Ensure accurate diagnosis of wound(s) identified<\/li>\r\n \t<li>Treat\/manage acute wounds: surgical sites, lacerations, skin tears<\/li>\r\n \t<li>Differentiate between chronic stasis dermatitis and cellulitis<\/li>\r\n \t<li>Treat\/manage chronic wounds with evidence informed care: diabetic foot ulcers, venous\/arterial\/mixed leg ulcers, pressure injuries, maintenance\/palliative wounds, malignant wounds, skin cancers<\/li>\r\n \t<li>Prescribe appropriate medications and treatments<\/li>\r\n \t<li>Preventing unnecessary transfer to acute care facilities<\/li>\r\n \t<li>Engaging in resident-centred care with a palliative approach to care to avoid unnecessary diagnostic interventions and\u00a0 referrals to specialists<\/li>\r\n \t<li>Order specialized equipment for prevention and\/or treatment of wounds<\/li>\r\n<\/ul>\r\nIdeally will involve a team-based, step process which involves a plan for continuous quality monitoring and reassessment.\r\n<ul>\r\n \t<li>Assess and\/or re-assess<\/li>\r\n \t<li>Set Goals<\/li>\r\n \t<li>Assemble the Team<\/li>\r\n \t<li>Establish and Implement a Plan of Care<\/li>\r\n \t<li>Evaluate Outcomes[footnote]Orstead et al., 2018[\/footnote]<\/li>\r\n<\/ul>\r\nLeadership Role:\r\n<ul>\r\n \t<li>Health promotion\/illness prevention in skin surveillance protocols, screening tool implementation\/monitoring<\/li>\r\n \t<li>Understanding\/promoting Quality Improvement Practices and key indicators of excellent care in the LTC sector<\/li>\r\n \t<li>Increasing capacity with bedside education of frontline staff<\/li>\r\n \t<li>Participating in an interdisciplinary wound care team for the facility<\/li>\r\n<\/ul>\r\nResearcher &amp; Systems Influencer Role:\r\n<ul>\r\n \t<li>Documentation and data analysis in regards to wound incidence and prevalence<\/li>\r\n \t<li>Improving documentation tools for wound management<\/li>\r\n \t<li>Considering trials for new care pathways which may have benefit for resident care<\/li>\r\n \t<li>Policy\/political action (advocacy) for both the NP role, scope of practice barriers and to constantly improve resident care especially in terms of access to appropriate adjunctive therapies and advanced products<\/li>\r\n \t<li>Cost-effective care<\/li>\r\n<\/ul>","rendered":"<p>Importance of Wound Management in LTC<\/p>\n<ul>\n<li>Integral to effective care in varied domains: education, research, leadership, consultation\/collaboration, optimizing health systems (policy\/legislation), role integration<\/li>\n<li>Intersects with many of the other competencies:\n<ul>\n<li>Person-centred care<\/li>\n<li>Comprehensive primary care<\/li>\n<li>Critical thinking<\/li>\n<li>Acute episodic illness (cellulitis, skin tears, ED diversion)<\/li>\n<li>Chronic disease management<\/li>\n<li>Procedural care in LTC (ABPI, biopsies, debridement)<\/li>\n<li>Palliative approach to care<\/li>\n<li>Geriatric pharmacotherapy (treating cellulitis, osteomyelitis, skin cancers)<a class=\"footnote\" title=\"Harrison et al., 2010\" id=\"return-footnote-1112-1\" href=\"#footnote-1112-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"McDonald, 2018\" id=\"return-footnote-1112-2\" href=\"#footnote-1112-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/span><span style=\"font-size: 14pt\"><a class=\"footnote\" title=\"Bacon, 2010\" id=\"return-footnote-1112-3\" href=\"#footnote-1112-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>NP Role in Wound Management<\/h2>\n<p>Clinical:<\/p>\n<ul>\n<li>Ensure accurate diagnosis of wound(s) identified<\/li>\n<li>Treat\/manage acute wounds: surgical sites, lacerations, skin tears<\/li>\n<li>Differentiate between chronic stasis dermatitis and cellulitis<\/li>\n<li>Treat\/manage chronic wounds with evidence informed care: diabetic foot ulcers, venous\/arterial\/mixed leg ulcers, pressure injuries, maintenance\/palliative wounds, malignant wounds, skin cancers<\/li>\n<li>Prescribe appropriate medications and treatments<\/li>\n<li>Preventing unnecessary transfer to acute care facilities<\/li>\n<li>Engaging in resident-centred care with a palliative approach to care to avoid unnecessary diagnostic interventions and\u00a0 referrals to specialists<\/li>\n<li>Order specialized equipment for prevention and\/or treatment of wounds<\/li>\n<\/ul>\n<p>Ideally will involve a team-based, step process which involves a plan for continuous quality monitoring and reassessment.<\/p>\n<ul>\n<li>Assess and\/or re-assess<\/li>\n<li>Set Goals<\/li>\n<li>Assemble the Team<\/li>\n<li>Establish and Implement a Plan of Care<\/li>\n<li>Evaluate Outcomes<a class=\"footnote\" title=\"Orstead et al., 2018\" id=\"return-footnote-1112-4\" href=\"#footnote-1112-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/li>\n<\/ul>\n<p>Leadership Role:<\/p>\n<ul>\n<li>Health promotion\/illness prevention in skin surveillance protocols, screening tool implementation\/monitoring<\/li>\n<li>Understanding\/promoting Quality Improvement Practices and key indicators of excellent care in the LTC sector<\/li>\n<li>Increasing capacity with bedside education of frontline staff<\/li>\n<li>Participating in an interdisciplinary wound care team for the facility<\/li>\n<\/ul>\n<p>Researcher &amp; Systems Influencer Role:<\/p>\n<ul>\n<li>Documentation and data analysis in regards to wound incidence and prevalence<\/li>\n<li>Improving documentation tools for wound management<\/li>\n<li>Considering trials for new care pathways which may have benefit for resident care<\/li>\n<li>Policy\/political action (advocacy) for both the NP role, scope of practice barriers and to constantly improve resident care especially in terms of access to appropriate adjunctive therapies and advanced products<\/li>\n<li>Cost-effective care<\/li>\n<\/ul>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1112-1\">Harrison et al., 2010 <a href=\"#return-footnote-1112-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-1112-2\">McDonald, 2018 <a href=\"#return-footnote-1112-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-1112-3\">Bacon, 2010 <a href=\"#return-footnote-1112-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-1112-4\">Orstead et al., 2018 <a href=\"#return-footnote-1112-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":45,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1112","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1112\/revisions"}],"predecessor-version":[{"id":1115,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1112\/revisions\/1115"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1112\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=1112"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=1112"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=1112"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=1112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}