099 Returning Skin and Wound Care to the Bedside: One Hospital’s Journey Through Process Improvement

An initiative to bring wound care “back to the bedside” was introduced in a large teaching hospital. Wound consultation was available from either a nurse or physician member of a hospital‐based wound team. Confusion over whom to consult coupled with multiple product options led to decreased critical thinking at the bedside. The volume of consultations precluded follow‐up visits by the team, further fragmenting care. The proposed solution included partnering with a sole vendor to standardize wound products and assist with education on product selection and function. New policies and procedures were created. Each patient unit was staffed by a Nurse clinical specialist as part of a hospital‐wide “Magnet” application process. This individual assumed the role of “skin care leader” and was required to attend two in‐depth educational programs. All skin care leaders were required to become part of a hospital‐wide quarterly prevalence and incidence project. The wound nurse assumed a more “consultative” role for the skin care leaders who subsequently assisted the end user in this model; the bedside nurse. This paradigm shift in care did not result in any statistically significant changes in wound incidence and reintroduced skin care as an integral component of the assessment and care for the bedside nurse. This presentation will describe the process in detail. Acknowledgments:  This study was supported with an educational grant from Smith and Nephew, Largo, FL.