Simple Wound Care Time Saving Tips

Submitted by Sheila Spear, RN, WCC

Many nurses who are performing the care of wounds are spending too much time. Good wound care does take some time. We should be better prepared and I hope to guide you to save some time in caring for the wounds you manage. Knowing the treatment is one key step in saving time. It means more than just reading the treatment sheet. So often, orders are written with little clarity for those who follow and have to perform the task. Every order should give specifi c details about the site, the cleansing, about packing, and about covering the wound being treated. Cleanse the right hip wound with NS spray, pat dry with 2- 4 x 4 gauze, pack with ¼ inch nu gauze (17” long) cover with ABD dressing and occlusively secure with paper tape. This gives you every detail about what you will need to perform the task.

The second best step and most important in saving time and improving healing for a wound is  gathering everything you need before you go into the room. The longer you leave a wound uncovered, the more time it takes for it to warm back up to adequate temperature for the healing  process to re-begin. So often, nurses are running in and out of the room looking for needed supplies, locking and unlocking the treatment cart, searching for tape, after the dirty dressing is removed from the site. This is detrimental to the resident and the wound. If you respect your resident you will change this practice to be better prepared.

Now there is one time per week that we have to make a thorough description for all wounds. This is in the regulations. In order for this to save time we should have a good guide / documentation tips readily available to meet documentation standards including references from professional sources such as; The Wound, Ostomy, and Continence Nurses Association, (www.wocn.org ) and/or the National Alliance of Wound Care (www.nawccb.org ). The more frequently we are performing this documentation, the faster we will become. It is best to start the description from the inside of the wound and work out. What does the inside look like? Assess viability, good tissue versus bad tissue. Is there granulation? Assess the color, pale, pink, or red? This tells you about circulation to the wound, or infection in the wound. Is the wound bed too wet or too dry? What do the edges look like? Are they white, (too wet) pink, red, (possible infection) or rolled and approximation halted? Now check out the outside perimeter? Is there tape irritation? Is there evidence of the wound getting bigger because there is still pressure on the site from poor or unprotected positioning?

When we first find an area of concern and the need for a treatment, this is when we look at outside factors concerning the resident as a person. Is the resident eating an adequate diet? Should staff be assisting the resident to eat because there is inadequate intake? How about lab values, albumin and pre-albumin? Above all how is positioning on all three shifts, in every chair or device the resident uses. Are there orders for or do we need to add protein supplementation? The body needs extra protein to repair and heal when there are wounds. The more you care for wounds the faster you become at the documentation part of the care. Truthfully this part takes longer that the actual wound care, but knowledge of what the treatment is and having the supplies gathered in advance are the two most important time saving factors in effective wound care. Good luck at becoming more proficient in your wound care efforts.
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