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Introduction

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Wound care programs are becoming more prevalent and may exist in a variety of health-care settings. In general, the program will either be inpatient based or outpatient based, thus serving two distinct patient populations, each with its own set of challenges.

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In the inpatient setting, there really is no question as to whether to start a program. At the very least, a plan to prevent skin breakdown should be in place. In most facilities a formalized wound care program is also a necessity.

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Outpatient wound care programs are not quite as clear-cut. Many factors need to be taken into account. These will be explored in more detail later in the chapter.

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Inpatient Wound Care Program

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Based on the type of inpatient facility, the extent of the wound care program may vary. For example, due to a shorter average length of stay, a short-term acute care program would usually be different from a program in an intensive care unit or a longterm acute care facility in which patients remain longer. The components listed in this chapter will illustrate a very comprehensive wound care program. The reader will need to identify the interventions most appropriate for the specific patient population to be served.

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Team Members

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Getting the right combination of health-care practitioners is vital to the success of any wound care program. Choose clinicians that have a passion for wound care and who want to be team players. Appointing someone to head a wound care program or to be a member of the wound team rarely works. A significant commitment needs to be made to properly managing patients with wounds as well as staying informed of the rapid changes occurring within this specialty. A clinician without the interest and drive to follow through in these areas can be a detriment to the program as a whole, and patient outcomes will likely suffer.

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Likewise, wound management programs are not as successful when there is only one person who ostensibly "holds" the same knowledge as a transdisciplinary team. What happens during times that clinician is not available? No single person can be present 24 hours a day, 365 days a year. There needs to be a team approach so that patient care is consistent and thorough. Only a transdisciplinary team consisting of several practitioners with experience in specific areas of expertise can ensure that patient wound care is optimal.

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What should be the makeup of this team of experts? Possible members include therapists (physical and/or occupational), dietitians, nurses, nursing assistants, orthotists/pedorthists, and podiatrists, as well as case managers, social workers, materials managers, and billing and coding specialists. In addition, there are a multitude of physicians that may be a part of the team. These may include infectious disease specialists, plastic surgeons, vascular surgeons, internal medicine physicians, dermatologists, hyperbaric medicine specialists, ...

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