Expansion of the Wound Care Program in Home Care by Incorporating the WTA Nurses to Increase the Reach of the CWOCN

Purpose: Our agency covers a large area that includes 17 counties. We have 3 full time CWOC nurses that see patients throughout these counties. To facilitate meeting the needs of our wound care patients, we have elected to have our field nurses, in geographically identified areas, trained as WTA’s. To date we have 32 WTA’s.

Challenges: The first was to utilize the WTA’s in the most efficient manner. The second challenge was how to keep the WTA competent and informed.

Method: Written guidelines and a referral process/flow chart were developed. This prevented the WTA’s from getting direct referrals without going through the CWOC nurse. The CWOC nurse receives the referral, determines if the patient needs to be seen by the CWOC nurse or the WTA nurse. If it is appropriate for the WTA nurse, it is then assigned to them. Once the WTA sees the patient, a case conference is conducted to determine what the appropriate wound care may be or that the case is more complicated and requires a CWOC nurse follow-up. If the case is not requiring the CWOC nurse, it is then determined if the WTA nurse needs to follow up with this patient and re-evaluate.

To address competency and growth, a shared governance WTA Practice Committee was established. The group developed their mission statement and purpose, identified key competency skills, and meeting structure. Meetings will be quarterly with educational presentations and competencies will be held bi-annually.

Conclusion: Utilizing the WTA’s has allowed a quicker response to meeting the needs of our wound care patients, it has increased staff satisfaction and allowed them to advance along established career ladders.