To Certification and Beyond: Creating a Wound Care Fellowship Improves Outcomes

Background

An academic medical center encouraged clinical nurses to obtain wound care certification by hosting a four-day educational program offered by the Wound Care Educational Institute. Twenty nurses attended the course and passed the national certification exam. The didactic learning experience and certification alone, however, did not adequately prepare these clinical nurses to be a local resource on their unit. The Wound, Ostomy Continence (WOC) Nurse developed a creative method for knowledge translation and sought budget approval for a position to support a mentored “Wound Care Fellowship”.  

Purpose

In phase one of the fellowship, wound care fellows spend four consecutive Wednesdays with the WOC nurse performing wound rounds and one day observing in the outpatient wound care clinic. The WOC nurse provides one-to-one mentoring focusing on assessing wounds, accurately staging pressure ulcers, developing plans of care, and educating patients and clinical nurses on pressure ulcer prevention and wound management. A completed wound care consult includes an uploaded photo and automatically populates an order set that the provider submits after interprofessional collaboration. After completion of phase one of the fellowship, the wound care fellow delivers a scholarly presentation of case studies and lessons learned at a monthly Skin Care Champion meeting.

Outcomes

The second phase of the fellowship pairs two wound care fellow “graduates” who round with greater independence but with oversight of the WOC nurse mentor as needed. Post fellowship data demonstrates that when wound care fellows evaluate patients, there was increased accuracy of wound type and pressure ulcer staging, increased implementation of evidence-based prevention strategies, enhanced documentation with inclusion of wound photography, activation of wound care order set, and reduction in variation of practice.

A wound care fellowship experience mentored by a WOC nurse provides an innovative, valuable and highly satisfying educational opportunity that positively impacts patient outcomes.