Wound Ostomy Team and Emergency Room Collaboration

 WOUND OSTOMY TEAM AND EMERGENCY ROOM COLLABORATION

             At a Metropolitan surgical specialist hospital, the Wound Ostomy team and the Emergency Department (ED) identified an opportunity to improve collaboration and patient outcomes.  Prior to this initiative there was no clearly defined process for optimum wound/ostomy care and pressure ulcer (PU) prevention for ED patients.  Patients need knowledgeable nursing staff to assess and treat skin integrity concerns.  

             Based on findings from quarterly PU surveys, it was discovered that patients could be receiving treatment in the ED for 4-8hrs before being admitted to the inpatient area.  During this time patients may be lying on beds or stretchers for extended periods. The PU workgroup identified this as a potential risk for developing a PU after admission. Additionally, appropriate dressings and skin care products needed to be available to the staff. The PU workgroup and the Wound Ostomy team collaborated with their ED colleagues to develop access to expert resources, education and supplies necessary for treatment of ostomies and wounds and PU prevention.

            Several ED nurses were recruited as members of the wound ostomy resource team (WORT). The ED nurses shadowed the wound ostomy nurses to obtain a better understanding of wound and ostomy care and PU prevention.  In doing so, they became a specialty resource for their peers. The ED WORT members were also invited to join the PU workgroup.

            As a result of this collaboration there has been an increase in wound ostomy nurse consults from the ED and open communication between the teams. The ED nurses have demonstrated an increased knowledge of wound and ostomy care and PU prevention.  Outcomes will be measured by monitoring documentation of PU assessments and PU care by the ED nurse within the organization’s quality team.