Abstract: Identifying Practice Barriers and Patient Benefits in the Utilization of Human Cadaveric Skin Allograft in an Advanced Practice Critical Access Outpatient Wound Clinic (45th Annual Conference (June 22-26, 2013 ))

Nancy Chatham, RN, MSN, ANP-BC, CCNS, CWOCN, CWS¹, Michael Molyneaux, M.D.², Brittney Taylor, RN, BSN, FNP, student, St., Louis, University, School, of, Nursing³ and Christina Hardy, RN, BSN, WOCN, student³, (1)Passavant Physician Group, Advanced Practice Nurse, Jacksonville, IL, (2)Passavant Physician Group, Medical Director, Advacned Wound Healing and Hyperbaric Medicine at Passavant Area Hospital, Jacksonville, IL, (3)Culberston Memorial Hospital, Wound Clinic Staff Nurse, Rushville, IL

Topic Introduction: Access to advanced wound care specialists and technologies in-rural outpatient setting may seem out of reach due to a number of factors. Human cadaveric allograft is a beneficial advanced technology that can be used to treat chronic wounds. The method of preservation (cryo preserved) requiring a -80◦ freezer has been a barrier to use in rural practice. The advent of newer room temperature grafts has eliminated this problem and allows for easy integration of the product into rural clinic settings. Additional barriers included service location, clinic hours, reimbursement, and staff as well as patient perceptions of the use of cadaveric skin in healing their wounds.

Purpose: This case series will identify practice barriers and patient benefits with regard to the use of human cadaveric skin grafting in a critical access setting in three elderly patients.

Objective: Circumvent practice barriers through staff education on the benefits of utilizing allograft to treat chronic wounds. Educate patient and caregivers in regard to risk and benefit in the use of human cadaveric grafting to promote wound healing. Explore and facilitate product access through procurement, storage options, and billing /reimbursement process.

Outcomes: Exploring nursing perceptions and then providing nursing in-services on the use and benefits of cadaveric skin allograft in chronic wound care facilitated subsequent patient education on gifted human cadaveric skin. In working with the purchasing and billing personnel, a stream lined approach was created for these products. A room temperature stabile cadaveric allograft was identified eliminating the need for a sub zero freezer for storage and subsequent graft thawing. Patient benefits included wound bed coverage, migration of wound edges and granulation into cadaveric skin graft thereby promoting wound healing. In addition reduced subjective complaints of pain and a corresponding reduction in required pain medication were noted following cadaveric skin grafting.

1571 Identifying Practice Barriers and Patient Benefits in the Utilization of Human Cadaveric Skin Allograft in an Advanced Practice Critical Access Outpatient Wound Clinic