4/21/2014

1

THE 3 CS OF SKIN AND WOUND CARE

Building a Successful Skin and W ound Care Program by…

Focusing on the Clinician Component of Best Practices of

Skin and Wound Care

Present ed by Tara Robert s PT and Cari Normand PT, CW S

W HY THE 3 CS OF SKIN AND W OUND CARE ARE IMPORTANT…

In LTC and Skin and Wound Care Science there is a Lack of Focus on the

Clinician Component of Best Practices of Skin and Wound Care

W hile t he expert s cont inue t o pour t hemselves int o research and gain ground on est ablishing sounder “best pract ices,” I propose t hat healt hcare providers focus on t he clinician t o improve upon w ound care and w ound healing t hat has less emphas is on "best pract ice" and more emphas is on apt it ude, at t it ude

and applicat ion. For even t he best programs focused solely on “best pract ice” can complet ely miss t he boat on t he one common denominat or-

the clinician who is to carry out the “best practice”

BUILDING A SUCCESSFUL SKIN AND WOUND CARE PROGRAM…

Successful skin and w ound care programs can be achieved in three steps called the 3 Cs of Skin and Wound Care:

• W e must demand and achieve clinician COMPETENCE;

• By achieving clinician competence you gain clinician CONFIDENCE;

• And finally by ut ilizing CONTINUOUS QA pract ices you w ill achieve a successful, impactful, marketable skin and w ound care program w hile ensuring your clinicians have cont inued competence and thus confidence.

4/21/2014

2

TODAY’S OBJECTIVES…

• The part icipant w ill learn st rategies to ensure a clinician focused skin and w ound care program.

• The part icipant w ill learn st rategies for the LTC Prov ider to apply the 3 Cs to their organizat ion as it relates to skin and w ound care program efficiencies and success.

TODAY’S OBJECTIVES…

• The participant will be able to dev elop a strategic plan for a successful skin and wound care program.

• The participant will hav e an understanding of the importance of skin and wound care management and its role in the future of LTC.

QUALITY MEASURES

Funct ional Quality Measures :

March 28, 2014: CMS Website

• One file has been added t o t he Downloads section of this page: Technical Expert Panel on the Development of Cross-Setting Functional Status Quality Measures

• The Cent ers for Medicare & Medicaid Services contracted with RTI International to develop funct ional status quality measures for inpatient rehabilitation facilities (IRFs), long-t erm care hospitals (LTCHs) and skilled nurs ing facilities (SNFs). As part of the quality measure development work, RTI convened a technical expert panel (TEP) in Sept ember 2013.

• This report summarizes the feedback and recommendat ions provided by t he TEP regarding t he proposed funct ional status measures.

http://www.cms.gov/Medicare/Quality-Initiatives- Patien t-Assessment-I nstr uments/N urs ingHomeQualityI nits/NH QIQualityMeasures. html

4/21/2014

3

QUALITY MEASURES

• MDS 3.0 Measure (#0678): Percent of Residents W ith Pressure U lcers That Are New or W orsened (Short Stay) -100 or less days

• This measure captures the percentage of short-stay residents w ith new or w orsening Stage I I-IV pressure ulcers.

• MDS 3.0 Measure (#0679): Percent of High-Risk Residents W ith Pressure U lcers (Long Stay) -101 plus days

• This measure captures the percentage of long- stay , high-risk residents w ith Stage I I -IV pressure ulcers.

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/downloads/MDS30QM-Manual.pdf

SHORT AND LONG STAY DEFINED:

The quality measure short stay and long stay definitions are:

• The short s tay quality measures include all res idents in an episode whose cumulative days in t he facility is less than or equal t o 100 days at the end of the target period.. An episode is a period of t ime spanning one or more stays, beginning with an admission and ending w ith either a discharge or t he end of the target period (whichever comes firs t ). A t arget period is the span of time that defines the QM reporting period (e.g. a calendar quart er).

• The long st ay quality measures include all res idents in an episode whose cumulative days in t he facility is great er than or equal to 101 days at the end of the target period. An episode is a period of t ime spanning one or more stays, beginning with an admiss ion and ending with either a discharge or t he end of the target period (w hichever comes first). A t arget period is the span of time that defines the QM report ing period (e.g. a calendar quart er).

http://www.cms.gov/Medicare/Quality-Initiatives- Patien t-Assessment-I nstr uments/N urs ingHomeQualityI nits/NH QIQualityMeasures. html

LTC…A FUTURE VIEW: QUALITY MEASURES

“Hospitals worried about readmissions should focus on nearby nursing homes'

pressure ulcer stats, study suggests” by Tim Mullaney http://www.mcknights.com/hospitals-worried-about-readmissions-should-focus-on-nearby-nursing-homes-pressure-ulcer-stats-study-suggests/article/342220/

“Out of various quality measures, pressure ulcer prevalence in part icular predicts w hether a nursing home w ill readmit residents to the hospital,

according to new ly published findings in HSR: Healt h Ser vices Research.”

“Skilled nursing facilit ies w ith a high percentage of high-risk, long-stay

residents w ith pressure sores w ere more likely to readmit people to the hospital, the researchers found. The percentage of long-stay residents w ith an increased need for help also correlated w ith a facility 's readmission rate, they determined.”

4/21/2014

4

STATS… WHAT ARE THEY AND HOW DO I DETERMINE THEM?

• M DS dat a creat es t he CM S Qualit y M easures for I ndust ry Report ing and Benchmarking • Accuracy of MDS data is paramount. • QMs are part of the 5 Star Reporting and each of our performance in this area is found on

Nursing Home Compare website.

• QIs are triggered by specific responses to MDS elements and identify residents who either have or are at risk for specific functional problems needing further evaluation. QIs are aggregated across residents to generate facility level QIs, which is the proportion of residents in the facility with the condition. In a like manner, QIs can be aggregated across facilities to generate the state level QIs presented in these reports. QIs are not definitive measures of quality of care, but are "pointers" that indicate potential problem areas that need further review and investigation. These data, at a nursing home level, are used by State survey agencies to target survey and quality monitoring activities .

http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MDSPubQIandResRep/qireports.html

STATS… WHAT ARE THEY AND HOW DO I DETERMINE THEM?

Acquired Pressure Ulcer (PrU) Rates • In House Acquired Methodology : Number of Residents with newly Acquired

PrUs/Current Census x 100

• Left open to interpretation, Time Frames can be manipulated, Small vs. Large Census Variations, ultimately not a CMS Reportable Measurement versus…

• Pressure Ulcer Incidence Density Reporting (NPUAP):

• Incidence density is the best quality measure of pressure ulcer prevention programs, according to the National Pressure Ulcer Advisory Panel (NPUAP). Pressure ulcer incidence density is a computation based on the number of in-patients who develop a new pressure ulcer(s) divided by 1000 patient days. Using the larger denominator of patient days allows fair comparisons between institutions of all sizes.

• Maybe the fair solution? Yet to be determined or recognized by CMS.

http://www.npuap.org/?s=incidence+density

THE 3 CS OF SKIN AND WOUND CARE

“We don’t know as much as we think we know” -a quot e by David Thomas, M.D., FACP, AGSF, GSAF, CMD at the International Nursing Home Research Conference

Nurs ing homes should adopt evidence-based approaches t o pressure ulcer prevention and t reat ment, but significantly more research is needed t o support this goal, a professor of geriat ric medicine said in November.

“W hat we have been facing in the care of pressure ulcers in nursing home is dogma. W e desperat ely need people in nurs ing homes to do clinical research,” said David Thomas, M .D., of the Saint Louis University School of Medicine, where the Internat ional Nurs ing Home Research Conference was held Nov. 22nd and 23rd.

There are only 51 research papers on pressure ulcers in world literat ure, Thomas said in an art icle by Elizabet h Newman of McKnight’s…

http://www.mcknights.com/thomas-additional-pressure-ulcer-research-tr ials-a-must/article/328490/ and http://www.mcknights.com/pressure-ulcer-treatments-should-be-re-evaluated-expert-says/article/322469/

4/21/2014

5

THE 3 CS OF SKIN AND WOUND CARE

Further, McKnight’s Tim Mullaney ironically brings “clarity” concerning w ound care “confusion” in his t it led art icle, “W ound care research is poor, show s lit tle progress tow ard advanced treatments, analy sis finds.”

Research on w ound care therapy tends to be poor and reveals few insights for new treatment opt ions, according to Johns Hopkins researchers.

http://www.mcknights.com/wound-care-research-is-poor-and-has-few-answers-review/article/333861/

THE 3 CS OF SKIN AND WOUND CARE

• LTC providers need to start somew here regardless of w hat ex perts and research do or don’t know .

• Our start ing point needs to be w ith w hat w e “do know ” as it relates to the clinicians w ho are providing the skin and w ound care - regardless of research, product, w ound type, assessment or resident populat ion mix .

• There is much variat ion in understanding w hat are the "best pract ice" standards for w ound care and w ound healing.

• W ound Care programs are complicated by many factors and is a constant ly evolv ing and many t imes confusing science.

THE 3 CS OF SKIN AND WOUND CARE

• Controlling variables in skin and w ound care programs is difficult but key so healthcare prov iders can attempt to ident ify the root cause.

• There is even a greater variat ion in clinician apt itude, att itude and applicat ion as it relates to w ound care and w ound healing.

• These are variat ions w e can control or at least standardize and influence to achieve successful LTC Skin and W ound care programs.

For these reasons, Healthcare providers should focus on the clinician to improve upon wound care and wound healing.

4/21/2014

6

THE 3 CS OF SKIN AND WOUND CARE

• W e should t ake an approach t hat has less emphas is(not abandoning) on

"best pract ice" and more emphas is on clinician apt it ude, at t it ude and applicat ion.

• For even t he best programs focused solely on “best pract ice” can complet ely miss t he boat on t he one common denominat or of a successful program- the clinician w ho is t o carry out t he “best pract ice”.

This is done in three steps called…

The 3 C's of Skin and Wound Care!

THE 3 CS OF SKIN AND WOUND CARE

• W e must demand and achieve clinician COMPETENCE;

• By achieving clinician competence you gain clinician CONFIDENCE;

And finally

• By ut ilizing CONTINUOUS QA pract ices you w ill achieve a successful, impactful, marketable skin and w ound care program w hile ensuring your clinicians have cont inued competence and thus confidence .

THE 3 CS OF SKIN AND WOUND CARE

By implementing the 3 C’s of Skin and W ound Care, prov iders can improve their overall success in w ound prevent ion and healing by first addressing their clinicians-the constant-and improve your facility ’s ability to adjust and react to- the variables- of a skin and w ound care sy stem.

4/21/2014

7

THE 3 CS OF SKIN AND WOUND CARE

Before w e ex plore the 3 Cs, it is important to recognize the primary roles of the CNA, Nurse and Therapist in a successful skin and w ound care program.

• All clinicians can fall into one or more categories labeled Preventer, Predictor and Promoter but each has a primary role in skin and w ound care and ult imately w ound healing.

THE 3 CS OF SKIN AND WOUND CARE

The CNA is primarily a Preventer-The Most Important Player.

• CNAs should be focused on carry ing out the established plan of care that addresses risk. A CNA’s role does not end there. CNAs are key to early detect ion of declines and potent ial skin issues. The Nurse/Therapist to CNA relat ionship is pow erful and important. Empow ering the Preventer to act on behalf of the resident to challenge and shape the plan of care is paramount to a successful program.

THE 3 CS OF SKIN AND WOUND CARE

The Nurse is primarily the Predictor-

• Nurses are focused on ident ify ing those at risk and predict ing potent ial for w ound development as w ell as predict ing overall healing potent ial based on assessment and health information. Nurses establish the primary plan of care for the CNAs to carry out based on these predict ions. Predict ion is repeated through rout ine re-assessment by the Nurse and must include CNA feedback to ensure t imely and adequate adjustment to the plan of care.

4/21/2014

8

THE 3 CS OF SKIN AND WOUND CARE

The Therapist is primarily the Promoter-

• Therapists are focused on promoting w ell-being, maintaining highest level of mobility and teaching the importance of good skin care, disease management and compliance to established plans of care. Therapists also prov ide w ound healing promotion through w ound healing modalit ies, act ive w ound care including various types of debridement as w ell as ident ify ing and teaching the most appropriate turning, reposit ioning and transfer protocols. Like Predict ion, Promotion st rategies are also rout inely re-assessed by the Therapist and also must include CNA feedback to ensure t imely and adequate adjustment to the plan of care.

THE 3 CS OF SKIN AND WOUND CARE

Now that we understand the roles of our LTC clinicians in a successful Skin and Wound Care Programs, lets explore

The 3 Cs…

THE 3 CS OF SKIN AND WOUND CARE: COMPETENCE

Competence:

There are many w ays to ensure competence. The Preventer, Predictor and the Promoter all must achieve competence.

4/21/2014

9

COMPETENCE: CNA

CNA (Preventer) Competence: As prev iously stated the CNA is t ruly the most important clinician for prevent ion.

The Preventer prov ides the “by the minute” rout ine care that ult imately determines the success of a skin and w ound care program. W ithout the CNA’s buy in and applicat ion of prevent ion st rategies, no program can succeed.

COMPETENCE: CNA

Competency for CNAs consists of several pertinent areas including but not limited to: 1. Understanding their key role in prevent ion 2. Understanding how the skin w orks 3. Importance of and performance of turning and reposit ioning 4. Hydrat ion and nutrit ion importance 5. Ident ify ing declines in condit ions and new skin issues and report ing

t imely and appropriately

COMPETENCE: CNA

Strategies to gain competency and empower your CNAs may include but not limited to: 1. Compliance to prov iding a solid and consistent orientat ion on skin and w ound care developed by the Interdisciplinary Team. 2. CNA class on skin and w ound care tailored to their skill level. Include competit ions and prizes to make it fun. 3. W ound care vendors prov iding t raining on prevent ion products.

4/21/2014

10

COMPETENCE: CNA

Strategies…

4. Turning, reposit ioning and transfer t raining w ith return demonstrat ion 5. Restorat ive nursing t raining focusing on how to carryout mobility , Range of Mot ion, pain management, and device/splint management w ith skin checks 6. Ident ify ing a st rong lead competent CNA to be an influence and peer reference.

COMPETENCE: NURSE

Nurse (Predictor) Competence: LTC nurses vary in skin and w ound care ex pert ise. LTC providers often t imes do not have the benefit of facility level or Regional W ound Care Ex perts or Specialists to direct ly support their facility nurses. I t is certainly beneficial to have such support but it is not impossible to gain nursing competence w ithout it . Adequate and thorough predict ion does not require specializat ion just competence in risk and know ing your available resources.

COMPETENCE: NURSE

Competency for Nurses consists of several pertinent areas including but not limited to: 1. Understanding their role in predict ion of risk for developing skin issues; 2. Understanding how the skin w orks; 3. Importance of monitoring and enforcing turning and reposit ioning; 4. Appropriately seeking Registered Diet ician intervent ion for max imum hydrat ion and nutrit ion plans.

4/21/2014

11

COMPETENCE: NURSE

Strategies…

5. Act ing upon declines in condit ions and new skin issues quickly through thorough assessment and seeking necessary referrals;

6. Skills check off for non-sterile dressing changes and NPW T dressing changes;

7. Ensuring opt imal Preventer and Predictor communicat ion and empow ering the Preventer.

COMPETENCE: NURSE

Strategies to gain competency and empower your nurses may include but not limited to: 1. Compliance to prov iding a solid and consistent orientat ion on skin and w ound care developed by the Interdisciplinary Team; 2. Thorough in-serv icing on product formulary , assessment and documentat ion standards; 3. W ound care vendors providing training on prevent ion products.

COMPETENCE: NURSE

Strategies…

4. Turning, reposit ioning and transfer t raining w ith return demonstrat ion; 5. Restorat ive nursing plan development w ith assistance of therapy focusing on mobility , Range of Mot ion, pain management, and device/splint management w ith skin checks; 6. Ident ify a st rong lead competent Nurse to be an influence and peer reference-doesn’t have to be cert ified, ex pert or specialist…Just Competent.

4/21/2014

12

COMPETENCE: THERAPIST

Therapist (Promoter) Competence: LTC Therapists ex pert ise in skin and w ound care also varies prov ider to prov ider. Invest ing in Therapy w ound care ex perts could pay off as there is great potent ial to reduce unnecessary outsourcing of w ound care serv ices and the potent ial to ex ponent ially improve prevent ion and healing t imes. Highly skilled Therapists in the area of skin and w ound care can be your internal resource for consistent ly achiev ing and maintaining competence for the

Preventer and the Predictor. This can only be done by achiev ing Promoter competence first .

COMPETENCE: THERAPIST

Competency for Therapists consists of several pertinent areas including but not limited to: 1. Understanding their role in predict ion of risk for developing skin issues and how skilled therapy can impact risk; 2. Understanding how the skin w orks; 3. Importance of monitoring and enforcing turning and reposit ioning and how to teach other clinicians and the resident the importance of and

safety during and use of posit ioning devices.

COMPETENCE: THERAPIST

Strategies… 5. Act ing upon declines in condit ions and new skin issues quickly through responding t imely to referrals from nursing and physicians; 6. Skills check off for non-sterile dressing changes, NPW T dressing changes, Compression Therapy , Unna’s Boots, etc.; 7. Addit ional skills check offs for all types of debridement techniques and w ound healing modalit ies;

8. Ensuring opt imal Preventer and Promoter communicat ion and empow ering the Preventer.

4/21/2014

13

COMPETENCE: THERAPIST

Strategies to gain competency and empower your Therapists may include but not limited to: 1. Compliance to prov iding a solid and consistent orientat ion on skin and w ound care developed by the Interdisciplinary Team; 2. Thorough in-serv icing on product formulary , assessment and documentat ion standards; 3. W ound care vendors prov iding t raining on prevent ion products;

4. Skin and W ound Care Documentat ion and billing standards rev iew .

COMPETENCE: THERAPIST

Strategies…

5. Assist ing in developing restorat ive nursing plans for mobility , Range of Motion, pain management, and device/splint management w ith skin checks as w ell as deem CNA and Nurses competent in restorat ive nursing through skills check offs; 6. Ident ify a st rong lead competent Physical Therapist to be an influence and peer reference; 7. Develop and train on w heelchair, cushion and therapeutic support

surface formulary related to risk levels.

SUGGESTED AREAS FOR COMPETENCIES

BY DISCIPLINE OR EXPERTISE Competencies are needed for all clinicians:

*Hand-w ashing

*Turning, Posit ioning and Transfers

*Skin and W ound Care Orientat ion Policy and Procedure Content

*Therapeut ic Support Surfaces

4/21/2014

14

SUGGESTED AREAS FOR COMPETENCIES

BY DISCIPLINE OR EXPERTISE Additionally, Nurses require competency in:

*Braden or Norton Risk Tool

Nurses and Therapists require competency in:

*Non-Sterile Dressing Changes

*Negative Pressure W ound Therapy

*Unna’s Boots and Compression W rapping

*Mist Therapy

Therapists require competency in:

*W ound Healing Physical Agent Modalit ies

SUGGESTED AREAS FOR COMPETENCIES

BY DISCIPLINE OR EXPERTISE Therapists(refer to state practice act) and Certified Wound Specialists(nurses or therapists) require competency in:

*Debridement

*Silver Nit rate Applicat ion

*Doppler for ABI

THE 3 CS OF SKIN AND WOUND CARE: CONFIDENCE

Confidence:

All clinicians w ill gain confidence by repet it ion and consistency of the provider (facility ) to support them.

4/21/2014

15

CONFIDENCE

Strategies to ensure the Preventer, Predictor and Promoter achieve confidence in Skin and Wound Care include, but are not limited to:

• Facilit ies should never assume clinicians “get it”.

• Provide repeat t rainings;

• Do unannounced skills check offs ex . Non-sterile dressing change;

• Avoid making changes to formulary unless sy stematically rolled out;

• Demand quarterly t rainings to your staff by your formulary vendors;

• Don’t forget the night shift !

CONFIDENCE

Strategies…

• Create a meaningful rew ard sy stem for your staff w ho are compliant, posit ive and achieve outcomes.

• All levels including administ rat ion needs to know the program, the formulary and understand and promote the philosophy of skin and w ound care for your facility so staff can be confident and never feel undermined.

• Empow er your staff, w hich means you believe they are competent, w hich will breed confidence.

• Seek specializat ions for staff members that show interest in the area of skin and w ound care.

• Create a culture that encourages and establishes the ex pectat ion for skilled therapy part icipat ion in the w ound care program.

USE OF FACETIME VIA IPHONE

FaceTime can be a very s imple way to assist your clinicians in gaining confidence in all areas of w ound care.

FaceTime is “real t ime” and leaves no evidence behind that can create a HIPPA issue.

Considerat ion by each end user for privacy during FaceTime is key as well as consent from t he res ident or RP.

Regional Expert or Compet ent Clinician can supervise advanced skills like debridement and help direct t he clinician during their learning phases.

FaceTime can eliminat e the need for outsourcing wound care, can reduce expense, can ensure proper assessment and timely interventions to achieve expedited healing and ult imately gain clinician confidence.

A specific benefit of reducing or eliminating outsourcing is that it encourages the facility’s ownership of the wound care program and the necessity for a comprehensive treatment plan to established by the Interdisciplinary Team. Outsourcing typically only deals with which dressing to use or leads to more extreme measures that are not necessarily needed.

4/21/2014

16

THE 3 CS AND FACETIME EFFECT

Increased number of available competent therapists by 63%

Decreased number of facilit ies outsourcing w ound care by 85%

THE 3 CS AND FACETIME EFFECT

Decreased in house acquired rate by .52%

Decreased QM for High Risk from 9.2 to 7.2 or by 22%

THE 3 CS OF SKIN AND WOUND CARE: CONTINUOUS QA

Continuous QA:

W ithout cont inuous Quality Assurance no facility can confident ly know their staff is competent or confident in skin and w ound care. Areas QA should focus on include but are not limited to

• Review ing the skin and w ound care sy stems:

• Do they w ork?

• Are w e compliant to them?

• Do w e get the desired outcomes w e w ant?

4/21/2014

17

CONTINUOUS QA

• Training and Orientation:

• I s it prov ided and provided consistent ly?

• I s it appropriate and contain all necessary information?

• Are competencies performed and validated?

• Facility Wound Caseload:

• Acquired vs Admit w ith rates;

• Staffing to volume and ex tent of w ounds is appropriate;

• Product and prevent ion tools (Par Levels) are adequate and available to the clinicians.

CONTINUOUS QA

• Community Recognition and Referral Sources:

• I s your facilit y know n for “good” or “bad” w ound care?

• I s w ound care your niche?

• Are your vendors reflect ing pos it ively or negat ively on your facilit y?

• Do you market your t eam’s specializat ions and advanced w ound care approach es?

• Survey Success:

• I s your skin and w ound care syst em support ing good survey out comes?

• Do your Human Resource records show current compet encies?

• Does your s t aff demonst rat e confidence during t he survey process?

• Are your vendors access ible and support ive during t he survey process?

LTC…A FUTURE VIEW FOR QUALITY MEASUREMENT

Quality Assurance and Performance Improvement

CMS QAPI VIDEO

• https://w ww.youtube.com/w atch?v=XjkNNEjO_Ec#t=542

• http://w ww.cms.gov/Medicare/Prov ider-Enrollment-and-Cert ificat ion/QAPI/NHQAPI.html

4/21/2014

18

THE 3 CS OF SKIN AND WOUND CARE: TRADE SECRETS

Invest in an Ex pert and then t rain the Trainer.

Start w here your staffing is st rongest and most stable and w here you w ill get immediate buy in. Then use this success to mentor other sites and ex pand.

Try FaceTime.

Establish ex pectat ions for report ing t ime frames, standardize content and force rev iew cycles.

Max imize your vendor resources for educat ion and support .

Organize your promot ional materials and be consistent in your delivery to your stakeholders.

THE 3 CS OF SKIN AND WOUND CARE: TRADE SECRETS

Establish and priorit ize need for oversight.

Meet educational needs rout inely and be able to ident ify deficits for “ex tra” t raining.

Commit to a thorough orientat ion program at all levels.

Anticipate barriers.

Be posit ive and ex pect push back.

Survey your teams and humble yourself to the results to improve the program.

THE 3 CS OF SKIN AND WOUND CARE: ASK YOURSELF

Does your organizat ion “assume” you have an effect ive and marketable skin and w ound care program or does your organizat ion “know ” it? The only w ay to know it is to do the homew ork. I f you are not sure how to get started consider researching the CMS Quality Assurance and Performance Improvement (QAPI) program for guidance at

http://cms.gov/Medicare/Prov ider-Enrollment-and-Cert ificat ion/QAPI/NHQAPI.html.

4/21/2014

19

THE 3 CS OF SKIN AND WOUND CARE: GET BUSY!

The science and philosophy surrounding skin and w ound care to define best pract ice is constant ly evolv ing. Meanw hile, adopting the 3 Cs approach, LTC providers can achieve competence and confidence for the constant of skin and w ound care-your clinicians-and by apply ing continuous QA achieve success.

THE 3 CS OF SKIN AND WOUND CARE: FINAL ADVICE

Consider a 4th C: Consistency…

Your staff w ill benefit most by your support and approach to a skin and w ound care program being CONSISTENT!

Consider a 5th C: Creativity…

As long as your residents’ needs are met there are no other rules! Make it fun, be unique and connect w ith your team’s creat iv ity.

THANK YOU!

Tara Roberts PT

318-286-3533 Cell

484-233-8069 Fax

Troberts1@Comcast.net

Troberts@Nex ion-health.com

Cari Normand PT, CW S

318-780-3747 Cell

414-375-3668 eFax

Cnormand@Nex ion-Health.com