RN, Wound Ostomy, Forbes

Essential Responsibilities: Utilizes the nursing process when directing or delivering care to patients with WOC needs, including assessment, diagnosis, outcomes identification, planning, and implementation (e.g., coordination of care delivery, health teaching and promotion, consultation), and evaluation Utilizes and maintains current physical, psychosocial, clinical assessment, and therapeutic communication skills to determine individual patient needs and expected outcomes Participates in committees or task forces related to wound, ostomy, and continence issues Provides consultation for individuals with altered skin integrity (e.g., pressure ulcers, draining wounds, fistulae) to develop individualized plans of care and attain expected outcomes Provides guidance to staff in implementing protocols to identify, control, or eliminate etiologic factors for skin breakdown, including selection of appropriate support surfaces As applicable, with a physician's order, provides appropriate debridement of devitalized tissue (e.g., conservative sharp debridement, silver nitrate [AgNO3] cauterization of nonproliferative wound edges, hypergranulation tissue, or to control minor bleeding) Provides appropriate education to patients, caregivers, and staff regarding skin care, wound management, care of percutaneous tubes, and draining wound/fistulae management Validates pressure ulcer data collection for nursing quality indicators (e.g., pressure ulcers and restraint use) Provides pre- and postoperative education to patients who are undergoing ostomy surgery (and their families), with consideration of the need for physical and psychological adaptation As applicable, marks the stoma site preoperatively by determining the appropriate site for stoma placement with consideration of the patient's anatomical markings, physical capabilities, and lifestyle Assesses the stoma and stoma functioning and initiates appropriate procedures for stoma care (e.g., removes rod/sutures, measures/fits a pouching system, teaches care of stoma/peristomal skin and pouch) Provides appropriate educational information to patients, including postoperative and discharge instructions about care, referrals, and supply needs. Serves as a resource for patients after discharge through telephone consultation or outpatient services Identifies risk factors for urinary or fecal continence disorders Assesses patients with urinary and/or fecal continence disorders Establishes an appropriate management program to include dietary and fluid management; bowel training or stimulated defecation program; bladder retraining, prompted voiding, or a scheduled voiding program; pelvic muscle reeducation without biofeedback; indwelling catheter management; recommendations regarding containment/absorptive products and devices and skin care; and education and counseling for patients/caregivers. Identifies patients requiring referral for assessment/management of complex urinary or fecal continence disorders. Participates in developing and implementing procedures and protocols, based on current national guidelines, to deliver care to patients with the following: Urinary or intestinal disorders resulting in the need for an ostomy; Conditions requiring wound management; Impaired or altered skin integrity; Urinary and/or fecal continence issues Assists the nursing and medical staff in maintaining current knowledge and competence in WOC care by providing the following: Formal or informal continuing education programs; Clinical rounds; Lunch and learn sessions; Orientation sessions; Collaborative practice committees; Nursing councils Attends continuing education programs related to WOC nursing to maintain current knowledge and skills Collaborates with leadership and multidisciplinary clinical practice teams to establish protocols which support best practices to achieve optimal clinical benefits for patients needing WOC care. Maintains and submits required activity and statistical reports to the appropriate department supervisor Contributes to the selection of cost-effective supplies and equipment related to WOC care, which might need to be individualized for different units/departments. Participates in policy review and development as it relates to wound, skin care and ostomies. Collaborates with frontline managers and staff on data collection including prevalence studies and the review of reports related to hospital acquired pressure injuries for purposes of determining accuracy, recommending interventions and educational opportunities.