For this episode, I speak with Brittany Hoang, NP CWON, about common wound nursing pitfalls including admitting a patient with wounds, wound vac trouble shooting, ostomy care, and wounds related to oxygen administration and COVID-19.
Wounds on Admission
- Use your hospital’s basic wound dressing protocol — probably wet to dry dressing.
- Best case scenario: Propose a wound dressing to the primary doctor if you know the wound care consult will be delayed
Wound Vac Pearls
- If a leak is detected, removed the soiled dressing (if needed), cleanse surrounding area with warm water and wash clothes, pat dry, apply skin prep, and cover with transparent dressing
- If the wound vac loses suction for >2 hours, remove the dressing and apply wet to dry dressing until the vacuum dressing can be reapplied
- To prevent soiling and leaks, consider a fecal management system or a stool thickener
- If possible, change the ostomy bag early in the morning when the least amount of urine or stool may come out
- Use the patient’s own routine and supplies. Patients know their ostomies best!
- While changing the bag, keep the surrounding area clean by using gauze, a tampon, or suction to catch anything that may come out of the stoma
- How to Change an Ostomy Bag for Nurses
Pressure Injuries (PIs)
- Talk with your charge nurse or unit manager at the beginning of your shift about resources needed to turn/reposition your patients. It is in their best interest (and yours) that you have the staff you need to reposition your patients q2h in order to prevent hospital acquired pressure injuries (HAPIs).
- Set a timer to remind yourself to reposition your patients
COVID Pressure Injuries
- COVID-19 Related Resources for Pressure Injury Prevention. This site includes best practices for proning your patient.
- Article regarding what appears to be deep tissue injury in COVID patients: Skin Manifestations with COVID-19: The Purple Skin and Toes that you are seeing may not be Deep Tissue Pressure Injury