As an Integrated Wound Care (IWC) provider, you’ll be giving consultant-based wound healing services to skilled nursing, long term care, and rehabilitation facilities.
The provider, whether it be an MD, NP, or PA, will be assigned to cover a nursing home facility. They will travel there weekly, same day and time. IWC will also send a medical assistant to larger, more difficult homes, who can take notes for the provider, or help to turn and position patients for exams.
Each provider carries their own procedural supplies (dressings are provided by the facility), such as rulers, cotton applicator tips, curettes, debridement kits, suture removal kits, scalpels, lidocaine topical and injectable, and silver nitrate cautery sticks. Some will carry a tote, fanny pack, a bag on wheels, or just wear cargo scrubs and load the pockets!
The provider will usually meet with a nurse at the facility, who may be a dedicated wound nurse, unit manager, a director, or sometimes even a regular floor nurse. The nurse will usually have a med-style supply cart with several drawers full of wound care dressings and treatment supplies. Together, the provider and nurse will see any patient in the facility with a wound, rash, surgical incision, g-tube, or suspicious skin changes. The provider will perform a physical exam, assess the wound, and measure the wound if it is open.
The provider, whether it be an MD, NP, or PA, will be assigned to cover a nursing home facility. They will travel there weekly, same day and time. IWC will also send a medical assistant to larger, more difficult homes, who can take notes for the provider, or help to turn and position patients for exams.
Each provider carries their own procedural supplies (dressings are provided by the facility), such as rulers, cotton applicator tips, curettes, debridement kits, suture removal kits, scalpels, lidocaine topical and injectable, and silver nitrate cautery sticks. Some will carry a tote, fanny pack, a bag on wheels, or just wear cargo scrubs and load the pockets!
The provider will usually meet with a nurse at the facility, who may be a dedicated wound nurse, unit manager, a director, or sometimes even a regular floor nurse. The nurse will usually have a med-style supply cart with several drawers full of wound care dressings and treatment supplies. Together, the provider and nurse will see any patient in the facility with a wound, rash, surgical incision, g-tube, or suspicious skin changes. The provider will perform a physical exam, assess the wound, and measure the wound if it is open.
Some patients require a procedure to be performed, most common being a debridement. A debridement involves using instruments such as a curette, scalpel, scissors, and forceps to remove dead tissue from wound beds, which speeds up healing. Other procedures may include I&D (incision and drainage), applying a wound vac (negative pressure wound dressing to remove drainage), applying an Unna boot (compression wrap to leg), cautery (using a q-tip with silver nitrate on the end to chemically burn scar tissue and stop bleeding), biopsies, and sometimes even laceration repair.
The team then documents the findings, and what was done, on a spreadsheet that was made specifically for rounds, which contains a list of all patients previously seen, their wound type, location, prior measurement, and prior treatment. Any necessary treatment changes are decided upon. The team will also discuss additional workup as needed, which includes lab tests, imaging such as an X-ray, CT scan, MRI, a wound culture, or specialist referral/consultation. The wound treatments/dressings are then applied to the patient.
After all patients are seen, the provider will leave the facility. The provider may elect to do their own notes, or they may utilize our scribe service, which is a team of nurses trained to enter the provider notes. We have our own EMR with a form note, pre-populated with existing data. The new observations from the day’s visit will be entered, billing codes selected, and then signed by the next day. Our EMR is directly linked to some of the nursing homes, and we upload automatically the next day. For others, we manually upload the notes into whatever EMR they have. Some still prefer to only receive the notes in PDF or internet fax format. Then our work is done until rounds next week!
Some patients require a procedure to be performed, most common being a debridement. A debridement involves using instruments such as a curette, scalpel, scissors, and forceps to remove dead tissue from wound beds, which speeds up healing. Other procedures may include I&D (incision and drainage), applying a wound vac (negative pressure wound dressing to remove drainage), applying an Unna boot (compression wrap to leg), cautery (using a q-tip with silver nitrate on the end to chemically burn scar tissue and stop bleeding), biopsies, and sometimes even laceration repair.
The team then documents the findings, and what was done, on a spreadsheet that was made specifically for rounds, which contains a list of all patients previously seen, their wound type, location, prior measurement, and prior treatment. Any necessary treatment changes are decided upon. The team will also discuss additional workup as needed, which includes lab tests, imaging such as an X-ray, CT scan, MRI, a wound culture, or specialist referral/consultation. The wound treatments/dressings are then applied to the patient.
After all patients are seen, the provider will leave the facility. The provider may elect to do their own notes, or they may utilize our scribe service, which is a team of nurses trained to enter the provider notes. We have our own EMR with a form note, pre-populated with existing data. The new observations from the day’s visit will be entered, billing codes selected, and then signed by the next day. Our EMR is directly linked to some of the nursing homes, and we upload automatically the next day. For others, we manually upload the notes into whatever EMR they have. Some still prefer to only receive the notes in PDF or internet fax format. Then our work is done until rounds next week!
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