Improving Nurse Managed Wound Care in Urgent Care

Frequent follow-up visits for wound care due to substandard nurse-managed wound care in urgent care settings has been attributed to a lack of education and standardization of care. The purpose of this project was to improve knowledge and increase confidence in nurses who provide wound care in the targeted Urgent Care settings of a large academic health system through the development and implementation of an evidence-based wound management protocol. This project assessed the current standard of practice in urgent care via retrospective chart review, staff knowledge and comfort with wound care through pre and post survey. After a systematic literature review, a clinical practice guideline was created and digitally integrated into the institution's electronic health record as a dot phrase. Staff received training before implementation of the intervention. After a two-month implementation period, a chart review was conducted to determine the impact of the intervention. During the study period, a total of forty-eight patients were seen for wound care; 13 visits were excluded from the study due to improper staff managing care. Of the 35 remaining patients, the dot phrase was utilized 20% (n=7) of the time. All seven of these patients had wound measurements and care plans documented. Nurses reported a reduced amount of time spent charting and providers reported improvement with monitoring wound progress. Follow up visits were significantly reduced in this group as evidenced by 85% (n=6) of these patients having only had one return visit following the initial intervention. While the sample was small, the results showed an increase in complete and standardized wound care documentation, as well as a reduction in follow up visits. This project showed potential for improved clinical outcomes in wound care, fewer follow up visits, reduction in time spent documenting care, and improved wound care documentation. Findings suggest that a reduction in the cost of wound care may also be realized. Further study of clinical and cost outcomes using the wound care guideline will need to be done.