Problem/Purpose
Negative Pressure Wound Therapy (NPWT) use has increased dramatically since inception in 1995.  Initially used in patient populations with chronic wounds such as pressure ulcers, the indications and positive outcomes associated with this type of therapy are continuously expanding.   Rockford Memorial Hospital is a 396 bed, Level One Trauma Center with multiple specialties including an outpatient Wound Center.  In 2000, NPWT was used on four inpatients for a total of 76 days of therapy.  In 2006, NPWT was used on 231 inpatients for a total of 1,992 days of therapy.  As the utilization of NPWT grew, it became evident that the limited FTE's in the Wound, Ostomy, and Continence Nursing role necessitated consideration of alternative methods of managing patients with these advanced dressings.

Method/Outcome
The plan that evolved included multiple partnerships, collaboration, accountability, small tests of change, support of leadership and enormous amounts of education.  Initially, nurses on two high-use units were targeted for education.   A partnership amongst the following stake holders developed: a) NPWT nurse consultants, b) wound, ostomy, continence nurses, c) unit managers, educators, preceptors, d) physicians, e) wound center nurses, f) skin team members, and g) case managers/discharge planners.   The progression of this project is described in detail in the presentation.

Challenges
While the use of NPWT continues to increase, it is still considered a low frequency skill on many of the nursing units.  Technology, vendors, techniques, and indications for this therapy will continually advance.  This necessitates that corresponding educational opportunities be provided, attended, and that competency is periodically reassessed.  Increased options of NPWT vendors also will play a roll in the efficacy of this practice innovation in the future.

Conclusion
A well-laid plan, with appropriate support and education, has gradually empowered the acute care nurses one Midwestern Hospital to manage patients who need NPWT.