Wound care made easy across the continuum: from aute care to long term acute care and beyond

The  Long Term Acute Care Hospitals (LTACH) treat patients with complex wounds. The challenges of complex wounds at times may  lead to duplicating treatments that failed in the acute care hospital. Improving communication between the acute care certified wound care nurse (CWCN ) and the LTACH can improve  patient care

Purpose: Develop a process to improve wound  care when transitioning to the LTACH.

Process: The LTACH referral process includes a registered nurse  meeting with the patient. The LTACH CWCN  meets  the patient and CWCN when the wound care is especially challenging.  As the wound care is observed a  photo of each step of the treatment is taken by the acute care CWCN and then  used by the patient and LTACH staff .

This process was utilized for three patients.  The patients had large abdominal wounds. Two of the patients  also had enterocutaneous fistulas (ECF). ECF most  times are difficult to manage. The photo (picture) book allowed nursing staff other than the CWCN to perform the wound treatment with guidance.  As the patient’s wound evolved the photo book was updated to outline the recent changes in the wound treatment.  One patient went on to have a  closure procedure , one transitioned home in 2 weeks and the other wound closed leaving the ECF to be managed. Prior to discharge the home care nurse met the patient and the CWCN to observe wound treatment. An updated picture book was provided for use at home.

Results: A  communication process such as a wound picture book can be a useful tool to improve care when transitioning from an acute care hospital  to a LTACH. Further study to determine the effect in the home setting is needed.