Helping Bedside Nurses Provide Appropriate Wound, Ostomy and G Tube Care

PURPOSE: To provide readily available information on wound, ostomy and g tube care and lists of available supplies to bedside nurses. BACKGROUND: Our hospital had not had a Wound Care Department previously.  A “wound care” nurse with no formal training had provided the only direction. Many practices were outdated. No advanced wound care dressings were available. After two nurses were certified, one CWOCN and one WCC, an effort was made to provide consistent and evidence-based care. The hospital formulary was updated to include advanced wound dressings and appropriate ostomy supplies. In-services and “Nursing Grand Rounds” were presented to educate staff about the many changes being made. Confusion, uncertainty and frustration persisted. It became evident that a readily available, concise source of information was needed. METHOD: It was decided that a notebook for each nursing unit would be the best way of providing this information. Three-ring binders and sheet protectors were chosen to improve durability and allow for easy updates and additions. The Wound section includes basic principles of wound care, guidelines for dressing selection, lists of available supplies and samples of products that had been added to the formulary. The ostomy section includes a brief review of ostomy types, basic pouching principles and a list of available ostomy supplies. The g tube section includes descriptions of the types of tubes used in the hospital, appropriate care for each type, feeding and flushing recommendations and a supply list. RESULTS: Nursing directors reported positive reception of the books. Nurses were better able to choose appropriate wound, ostomy and g tube supplies and to provide evidence-based care. Supplies were more frequently ordered by the correct names, allowing Central Supply to fill orders without calls for clarification. With a recent change in vendors, an update is in progress to include new brands.