Use of the WTA in the acute care setting to increase accuracy and timeliness of pressure injury staging, and implementation of wound care.

Significance / Background: The Wound Treatment Associate (WTA^®) was developed by the WOCN society as a continuing education program to improve patient outcomes by preparing non-WOC certified nurses to provide optimal care for patients with acute and chronic wounds under the direction of a WOC specialty nurse, WOC advanced practice registered nurse (APRN), or physician.

Purpose: Many nurses within our institution were not accurately and consistently staging pressure injuries. Many times a patient would have a variety of pressure injury stages documented for the same pressure injury over their length of stay.

Intervention: A Pressure Injury action team was assembled of clinical leadership. Actions were taken to remove the responsibility of direct care nurses staging pressure injuries. The WTA program was implemented under the direction of the hospital Wound, Ostomy, Continence Nurses (WOC nurse). Four WTA cohorts have been educated resulting in 59 WTA graduates.

Evaluation: The WOC nurses in our institution are available to evaluate pressure injuries Monday – Friday. The WTAs are available to provide pressure injury staging and implement wound care recommendations on the evenings, weekends, and holidays when the WOC nurses are not available, thereby improving patient care and supporting the role of the WOC nurse and direct care nurse.

Discussion: The utilization of the WTA role has improved the accuracy of pressure injury staging and decreased documentation of pressure injury inaccuracies. It has increased the delivery of appropriate pressure injury wound care and prevention. Since the implementation of the WTA program we have seen a downward trend in hospital acquired pressure injuries.

Innovation: It is essential to increase the speed in which pressure injuries are assessed, staged, appropriate wound care is initiated, and pressure injury prevention is directed. The WTA role supports the WOC nurse role during off hours and decreases delay in patient care.