PURPOSE: Malnutrition can increase the risk of skin breakdown and impair wound healing. Early assessment of patients’ nutritional status is crucial for predicting and preventing skin breakdown and/or further wounding, especially given the high acuity level of our acute rehabilitation (AR) patients. Laboratory values such as albumin and prealbumin are now known to be altered by inflammation and are not valid in assessing for malnutrition in patients with recent inflammatory triggers (acute disease/injury). Patients’ transfer records do not always provide information on the patient’s nutrition status or skin condition. A recent two month study found 50% of our patients had malnutrition and 51% of these patients had pressure ulcer (PrU) assessed by the RD and WOC nurse on admission. This joint assessment facilitates more accurate determination of patient’s nutritional needs and prediction of the course of wound healing and risk of skin breakdown. OBJECTIVE: To illustrate how sharing office space promotes collaboration between the RD and WOC nurse and how early identification of malnutrition is crucial for accurate PrU risk assessment and intervention. METHOD: RDs and WOC nurses exchange patients’ information during the joint assessment and daily basis. We will present dialogs and benefits of our discussion in the “room together” from our experiences. DISCUSSION: The estimated cost to heal a PrU ranges from $3500 to $60,000 with litigation costs ranging into the millions. In our 96 bed AR hospital, we have three WOC nurses and three RDs who share an office. This higher than typical RD and WOC nursing staffing levels can be justified by the avoidance of a single hospital acquired PrU. The room together aides in reducing costs by enhancing staff performance and efficiency.CONCLUSION: We recommend a shared Wound-Nutrition office to facilitate accurate PrU risk assessment and early intervention, reducing costs and improving patient outcomes.
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