"Discharge Me Home with My Wound Machine Right Now!!

Discharging a patient home with negative pressure wound therapy (NPWT) in an acute care facility can be a challenge for the healthcare team.  As WOC nurses, we were aware of the issue  first hand at our 800 bed acute care inner city hospital over the past four years.  The current process for discharging a patient home with NPWT equipment or durable medical equipment (DME) was driven by the WOC nurse because of the clinical data that was required to be entered about the wound on the DME request forms. The current order process had problems such as delays in obtaining an order for the home equipment from the physician, fragmented communication in regards to the delivery of the equipment to the patient, and poor follow up with the DME company by the requestor via phone calls due to the roaming nature of the WOC nurse in the hospital. A task force was formed to address the current process and our overall goals were to improve patient satisfaction which meant discharging the patient as soon as possible, which meant having a faster delivery of the NPWT equipment to the patient. The task force met and defined a new process for requesting NPWT DME that was trialed on a busy wound med/surg unit with six patients.  The facilitator now for the request would be the Care Transition Manager for that unit or CTM, with the WOC nurse completing the clinical data required on the request.   The new process has resulted in meeting our quality improvement goals of 1)  shorter ordering time to delivery of home NPWT equipment to the patient 24 hours prior to discharge usually ; 2) improved communication between the Care Transition Managers (CTM) and the WOC nurses; and 3) patient's appear to be satisfied with the new process; no complaints that the discharge was delayed because of no NPWT machine for the patient's home use.