Question: Patients present to the wound care practitioner in a myriad of ways, how does the practitioner decide how to manage the wound?
Answer: For the clinician today, the job of selecting a dressing can be daunting. The first step in wound dressing selection is to apply the four basic goals of wound healing.
If we take the 4 principles of dressing selection and expand upon Ovington’s methodology, the practice of dressing selection using goals, form, and function, we will have a systematic way to select the proper dressings. A nursing assessment of the wound, patient, and setting must occur prior to selecting the dressing. It is essential that the dressing match the patient, the wound, and the setting in order to obtain the optimal result.
Ovington gives an all-purpose performance-based approach to using wound dressings by asking six basic assessment questions when deciding on a wound dressing:
Cost effectiveness of the product will need to be considered during the selection process. This means understanding indirect costs as well as the direct cost involved in wound care. Direct cost examples include, but are not limited to the primary and secondary dressings, pharmacy, caregiver time, and diagnostic procedures. Indirect costs are similar to overhead costs, and include examples such as increased length of stay, treatment complications, and litigation. The clinician should read published studies critically to take cost-per-unit outcome into account to determine if treatment measures are indeed cost effective. Sometimes the most expensive product can be less expensive in the long run because it leads to faster healing with a reduced amount of complications.
Reference: Larson-Lohr V, Norvell H, Josefsen L, Wilcox J et al. Hyperbaric Nursing and Wound Care. Flagstaff, AZ: Best Publishing Company: 2010.
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