RN Wound Ostomy

Scope of Work

The hospital based Wound Clinician serves as a clinical resource and consultant for the acute care of inpatients with disorders of the gastrointestinal, genitourinary, and integumentary systems. The care extends to those with acute and chronic wounds (for example, complex draining wounds, fistulae, pressure injury, vascular ulcers), ostomies, percutaneous tubes and continence disorders. Professional responsibilities are carried out through direct patient care, clinical consultation, education, research and administration.

• General duties/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.

Wound/skin care

• Provides consultation for individuals with altered skin integrity (e.g., pressure injuries, 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.
• Provides appropriate education to patients, caregivers, and staff regarding skin care, wound management, care of percutaneous tubes, and draining wound/fistulae management.
• Provides consultation for negative pressure wound therapy, (including subsequent dressing changes) provides collaborative care which includes patient’s next care setting.
• Validates pressure injury data collection for nursing quality indicators.

Ostomy care

• Provides pre- and postoperative education to patients (and their families) who are undergoing ostomy surgery, with consideration of the need for physical and psychological adaptation.
• 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.

Continence care

• 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 recommendations regarding containment/absorptive products and devices and skin care; and education and counseling for patients/caregivers.

Education

• 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.
• Orientation sessions.
• Attends continuing education programs related to WOC nursing to maintain current knowledge and skills.

Research

• 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.

Administrative duties

• Maintains and submits required activity and statistical…