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Monday, June 17, 2013
  Clinical Accuracy Spoken Here  

Wound Care: Pressure Ulcers
Indicate Poor Quality

Two significant aspects of hospital-based wound care have already been singled out for reduced reimbursement under Medicare and as indicators of poor quality by the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JC). These are hospital acquired:

  • Pressure Ulcers – Stages III and IV
  • Surgical site infections (SSIs)

Reduced reimbursement will radically increase the accountability of hospitals for patients' outcomes following discharge.

[Reference: Wound Care and Payments, Module A, Prevalence and Pathophysiology]
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  Excellence in Case Mgmt  

Wound Care: An Educational Void

Knowledgeable HCMs are uniquely positioned to follow the spectrum of patient care and advocate for wound care best practice interventions. However, no evidence-based core curricula exist to educate practitioners about this topic. When considering the clinical importance and financial impact, it is surprising that clinicians receive little education on the science and care of wounds. This educational void could account for some of the treatment myths which continue in use such as "wet to dry" dressings. The Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) offer an accredited certification program.

[Reference: Wound Care, Module E, CM Role]
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  Improving Patient Care...  

Wound Care: Most Pressure
Ulcers can be Prevented

Standardized risk assessment tools are important to predict pressure ulcer risk.

Research showed the Braden Scale offered the best balance between sensitivity and specificity and the best risk estimate.

Risk assessment tools are definitely better predictors of pressure ulcers than nursing judgment.

Consistent use of clinical guidelines can effectively define early intervention for prevention of pressure ulcers.

[Reference: Wound Care and Payments, Module B, Assessments and Complications]
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