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					               R E G I O N A L      I N I T I A T I V E S




     Development of a

     Wound/Skin Program
     A Model for Wound Caring in the Central East Region of Newfoundland


                              BY     The development of a wound/
                 Delilah Guy         skin-care program can be a
                                     challenging process that requires
                                     strong co-operative, collaborative
                                     and communicative efforts among
                                     team members — from adminis-
                                     trators, nurses, doctors, the
                                     rehabilitation disciplines to home     James Paton Memorial Hospital.

                                     support and, most especially,            The Regional Wound/Skin Care      As a result, information on best
                                     patients with wounds.                  Committee was formed in 1995,       practices has been shared and
                                       This article illustrates how         with a chair and six members.       adopted throughout the region.
                                     the Central East Region of             Amalgamation of services across     Becoming an ET Nurse in 1999
                                     Newfoundland has faced the             the region resulted in better       greatly increased my involvement
                                     challenges and changes in wound        representation and an increased     in wound care, and I became
                                     caring and effectively adopted         number of members. Over             the Chair of the Regional Wound/
                                     current evidence-based and best        time, sub-committees for product    Skin Care Committee and Resource
                                     practices in wound care.               evaluation, support surfaces and    Nurse in 2000.
                                                                            policy-making emerged, and a
                                     Background                             vascular surgeon joined the         What Is Our Concept?
                                     The Central East Health Care           team. The committee identified      We use a comprehensive, patient-
                                     Institutions Board in Newfoundland     and prioritized such issues as      centred approach to guide our
                                     was founded in 1994 and covers         increase of services, duplication   efforts in wound caring. To
               Delilah Guy, RN,
             BN, ET, is the Chair    six facilities with acute and long-    of wound/skin-care products,        meet the needs of a patient
                  of the Regional    term-care settings that provide a      complicated and compromised         with a wound, a collaborative,
                Wound/Skin Care      range of services across the region.   wounds, aging population and        communicative, co-operative and
                Committee of the     James Paton Memorial Hospital          inconsistent wound-care manage-     multidisciplinary team approach is
              Central East Health    (located in Gander) is the regional    ment across the region in acute,    encouraged in all acute, long-term
          Care Institutions Board    referral centre. With a population     long-term and home-care settings.   and home-care settings. Each
          in Newfoundland. She                                                                                  discipline has roles and responsi-
                                     of about 12,000, Gander serves
          is the Patient Educator
                                     a catchment population of              One Person Can                      bilities. Overall, an effective
         and Discharge Planner,
                                     53,000 for primary care and            Make a Difference                   treatment plan is devised and
            Surgical Floor, James
                                     117,000 for specialized services       My consistent attendance at the     implemented with a best-designed,
       Paton Memorial Hospital.
        She has been honoured        in ophthalmology and orthopedics.      CAWC and CAET conferences has       best-planned and best-assigned
            by the CAWC for her      The hospital has a rated capacity      allowed me to share relevant        approach to which each of
         contributions to wound      of 92 beds, with an occupancy          information about current trends    the team members adheres.
                caring in Canada.    level of 90%.                          in wound care with my colleagues.   Compliance to the specialized

36   Wo u n d C a re C a n a d a                                                                                         Vo l u m e 1 , N u m b e r 1
treatment protocol is encour-
aged for both the patient
and the health-care provider. In
this model, nurses become
more directive and decisive,
resulting in a more nurse-driven
process, and there is a strong
and consistent link regarding
wound caring within the
community-care setting.
   To ensure this approach
remains effective, we promote
empowerment through educa-
tion. Through continual educa-
tional upgrading and the follow-
ing of the principles of wound
care based on research and
best practices, our wound/             Regional Wound/Skin Care Committee. From left to right. Sitting: Goldie Bath, Nurse Manager; Delilah Guy, Chair;
skin-care management and               Madeline Adams, Team Leader; Edith Norman, Staff Educator. Standing: Wanda Curlew, Team Leader; Joan Stoyles,
intervention have changed signif-      Dietitian; Karen Bennett, Occupational Therapist; Eydie Parsons, Nurse Manager; Shirley Nolan, Supervisor, Long-term
                                       Care; Dr. John Haggie, General-Vascular Surgeon; Marlyce Green, Facility Manager, Long-term Care. Absent: Faye Best,
icantly. We believe in the strategy    Surgical Team Leader; Arlene Martin, CCU/ICU Team Leader; Nancy Wright, Continuing Wound Care Nurse; Brenda
that education of a patient,           Howell, Nurse Manager, Long-term Care.
caregiver and health-care
provider is the key to a proactive     care providers, and are bound to          appropriate mattresses for              for quality assurance and
program of prevention and timely       a high standard of practice.              wound prevention                        Pressure Ulcer Prevention
and appropriate interventions.                                                   Purchase of specialized beds            (Study results: Acute care:
   We make sure we are con-            What Have We                              for compromised sites (ICU/             4.9% compared with AHCPR
stantly exposed to different           Accomplished?                             palliative orthopedics units)           of 9.2%; Long-term care:
trends in wound-care manage-           As the governing body, we have            for wound prevention as well            4.2% compared with AHCPR
ment and best practices by             made great changes in wound               as accessibility and availability       between 9% and 23%)
participating in research, case        caring in our region. The follow-         of wound carts to all units to
studies, poster presentations          ing are the highlights:                   save nurses time and effort          Summary
                                                                                 Consistent educational               The changes we have made in
  As a team, we have turned to both                                              development in the area              wound care throughout our
                                                                                 of wound care for RNs                region have had a significant
     science and art to guide us in                                              and LPNs                             positive impact on our patients
                                                                                 Creation of a regional
  caring for our patients with wounds.                                                                                with wounds. As a team, we
                                                                                 computerized wound/skin              will continue to be committed to
                                                                                 tool guide for consistent            helping patients with wounds by
and product evaluation. Due to           Adaptation of the regional              assessment and documentation         optimizing the healing process,
innovation and the high-tech             wound/skin-care manual                  Policy on Photography 2002           using a consistent, current,
health care we provide, we               Creation of the regional poster         for accurate wound assess-           co-operative and co-ordinated
consider ourselves to be advanced        aimed as a guide for wound/             ment and documentation               patient-centred approach.
wound carers. We have turned to          skin-care management                    Policy on Skin Breakdown                The advancements in wound
both science and art to guide us         Regional standardization of             Prevention, Braden Scale             care in our region have made us
in caring for our patients with          categorized products for cost           by Computer 2003 for                 all very proud of our accomplish-
wounds. We consistently demon-           effectiveness                           prevention and intervention          ments. We are hopeful that our
strate a commitment to our               Regional standardization of             Regional Prevalence Study            story can serve as an inspiration
patients, their families and health-     wound support surfaces and              2002 (first in Newfoundland)         to others.

Vo l u m e 1 , N u m b e r 1                                                                                                 Wo u n d C a re C a n a d a      37

				
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