Nurse driven outpatient wound center: Reducing readmission with wound care excellence

There is a growing need for new and innovative ways to care for patients in the ambulatory setting, including providing wound care for patients. A vascular surgery department in a large urban academic medical center noted there was an increasing number of patients with chronic wounds that needed weekly care. The number of patients, the time needed to provide wound care, and limited clinic space was creating a strain on traditional clinic hours. Collaboration between one of the vascular surgery advanced practice registered nurses (APRN) and vascular registered nurse (RN) led to the creation of a vascular wound clinic. Patients with chronic wounds were identified by vascular surgeons at one institution and referred to the wound clinic. A retrospective chart review was used to look at number of patients, number of visits per patient, surgical interventions, number of wounds closed, size of wounds, and complications. The ability to provide a single point of contact for the patient's vascular surgery and wound care needs allowed the clinic to provide comprehensive care for 29 patients and close more than 75% of wounds. The retrospective chart review found that patients receiving weekly wound care with clear communication from the multidisciplinary team, the nursing and nurse practitioner interventions kept most patients out of the hospital, with only two unplanned readmissions to the hospital, neither due to chronic wounds. This nursing led wound clinic was able to accommodate complex vascular surgery patients, heal chronic wounds, and decrease unplanned readmissions. Expanding the clinic to assist with limb salvage and more podiatric patients is providing a new patient base and improving the care for the community that it serves.