Changing the Way We See Wounds: Implementing an Inpatient Wound Care Team

The Inpatient Wound Care Team was designed to provide comprehensive care for patients hospitalized in a large academic medical center in the Southeast. The team is able to follow the patients throughout the continuum of acute care and inpatient rehabilitation. This standard of practice was implemented to facilitate the prevention, evaluation, and timely management of patients with wounds through quality, evidence-based care.

At the time of the Team-designed approach, there were only four wound, ostomy, and continence nurses (WOC nurses) available for inpatient care. The team now consists of twelve WOC nurses (one per 100 patient beds), two wound care technicians (WCT), one nurse practitioner, and one physician. The Wound Care Team was established to promote better patient outcomes by increasing awareness and identification of issues related to skin injuries via staff education, mentoring, increasing patient throughput by directing consults to proper services (i.e. surgery, nutrition, diabetes education, and others), and ensuring follow up for continued care as needed.  

A three-month pilot was conducted on eight nursing units. The identified units had the greatest opportunity to benefit from an increase WOC nurse presence. Education on pressure injury prevention and documentation were provided to staff. Rounding on the units Monday through Friday enabled the WOC nurse to assess patients, assist staff in a timely manner, and provide real-time education. At the conclusion of the pilot, Hospital Acquired Pressure Injuries (HAPI) decreased by 10% on all the units, length of stay (LOS) for patients with a pressure injury decreased by nine days compared to the previous year and cost reduction for patients with HAPIs was $12, 233, 234.