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Author: Deborah Nelson BSN, RN, CWOCN
Objective
Empirically, we observed peri-wound maceration, epidermal stripping and poor adhesion with the bordered foam dressing on formulary. We converted our entire bordered foam dressing formulary to a newly redesigned dressing with enhanced absorption and greater flex with movement. The new design enabled us to change the policy for routine dressing changes from every 3 days to every 7 days.
Method: We compared similar periods pre and post implementation of the new dressing to determine the impact of efficiency of the new dressing design on the number of dressing changes per patient, clinical outcomes and patient/staff satisfaction.
Results
5 patients with 10 wounds had length of stay during which WOC nurse assessed the wound more than once which enabled evaluation of dressing performance and wound volume reduction. 7 of the 10 wounds archived 57.8% reduction in wound volume (average 67% progression wound healing). Wound nurse and staff evaluations indicated that new dressing absorbed better, adhered without medical adhesive-related skin damage and improved patient comfort. Dressing utilization per patient for the quarter following full implementation of the new formulary was reduced in comparison to the utilization with prior formulary.
Extending the dressing wear time required re-educating staff with focus on undisturbed wound healing. Processes utilized to support the change in practice included extensive education: on-line and at bedside. A multi-disciplinary skin champion team was formed to augment education and best practice. EMR prompts were updated to facilitate the selection of clinical basis for dressing change outside of the protocol.
Conclusion
Converting our wound care formulary to single, more efficient, flexible bordered foam dressing improved patient healing outcomes, patient, staff and WOC satisfaction and reduced the number of dressings utilized per patient.