Purpose: The role of the wound care nurse specific to critical care is key to identifying and preventing hospital-acquired pressure ulcers (HAPU), community-acquired pressure ulcers (CAPU), skin tears, and chronic wound infections. Every patient in the critical care area is high-risk for skin integrity issues due to incontinence, immobility, severe trauma and or disease, prolonged OR time, and poor nutrition. Many of these patients are also traveling between departments such as operating room, interventional radiology, and nuclear medicine, which place an increased risk of hospital-acquired tissue injury. In the critical care department the CWOCN is a team member with the managers, mentors, educators, and skin care resource personnel.

Objective: Staff is empowered with knowledge and specific interventions that are published in a skin care resource binder with policies, procedures, and protocols. A basic wound care program is offered monthly for new employees. Skin care and mobility bundles have been developed and implemented to assist in intervention priorities. Products, therapeutic surfaces, devices, and skin and wound care products are available on the unit. Prevalence studies, post Prevalence de-briefings are done monthly as well as unit-specific educational programs. Rounds and bed-side competencies are conducted weekly where documentation of the Wound Trending Record (WTR) is completed and audited. A multi-disciplinary wound care forum is offered monthly to discuss unique and interesting critically injured wound care cases.

Conclusion: A wound care clinician assigned to the critical care arena is an asset for this high-risk patient population that needs constant meticulous attention for prevention, early intervention, and treatment to prevent infection, delayed healing, and amputation. The opportunities are numerous, relationships rich and rewarding, and role deemed justified by response of staff, statistics, and interventions accomplished.