Pathway to excellence. A comprehensive clinical education platform from Smith & Nephew

Transcription

1 Pathway to excellence A comprehensive clinical education platform from Smith & Nephew

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3 Pathway to Excellence Support Each year, we train more than 150,000 healthcare professional around the globe. In addition to the array of educational programs and online training options we provide, we maintain a team of clinicians who are specialists in skin and wound care. This Clinical Team provides face-to-face education for large groups. This Team also provides live webcasts via C2B Connect expanding the opportunity for interaction with your staff.

4 Pathway to Excellence Support Each year, we train more than 150,000 healthcare professional around the globe. In addition to the array of educational programs and online training options we provide, we maintain a team of clinicians who are specialists in skin and wound care. This Clinical Team provides face-to-face education for large groups. This Team also provides live webcasts via C2B Connect expanding the opportunity for interaction with your staff.

5 Pathway to Excellence Support Each year, we train more than 150,000 healthcare professional around the globe. In addition to the array of educational programs and online training options we provide, we maintain a team of clinicians who are specialists in skin and wound care. This Clinical Team provides face-to-face education for large groups. This Team also provides live webcasts via C2B Connect expanding the opportunity for interaction with your staff.

6 1. AHRQ.gov. Accessed August 24, 2016 at professionals/systems/hospital/pressureulcertoolkit/putool1.html. 2. Sen el al. Wound Rep Reg 2009; Rice et al. J Med Econ 2014; 17(5): Engels D et al. Pressure injuries: Factors contributing to their development in the OR. AORN J. 2016:103(3); Smith & Nephew, Inc. Customer Care Center Fort Worth, TX T USA F Smith & Nephew, Inc. All rights reserved. Trademark of Smith & Nephew. MSBE UE

7 Classroom to Bedside A Pathway to Excellence program Healthcare today demands knowledge at the clinical decision point. The challenge is to find opportunities for learning that are not always in a traditional classroom. That s why Classroom to Bedside was designed to help connect learning to action. The program: Provides a clinical foundation for prevention and wound management Incorporates bedside tools to reinforce best practices Includes resources for continued education Offers product training components Helps bring focus to outcomes and patient satisfaction The lessons are provided in various formats so you can deliver education in a way that your staff wants it. Chaptered DVDs with brief lesson modules PowerPoint presentations for train-the-trainer Virtual webinar training by Smith & Nephew Clinical Team Topics include: Pressure injury prevention This lesson describes the anatomy and function of the skin. It teaches participants to identify risk factors for pressure injuries, and interventions for reducing skin breakdown. Wound assessment and documentation Accurate wound assessment is important to choosing an appropriate treatment plan. This lesson discusses the components of wound assessment and documentation, as well as identification of various tissue types. Managing non-healing wounds The factors that contribute to impaired healing and interventions to move the non-healing wound to closure are covered in this lesson. It teaches how to identify the TIME principles of wound bed preparation the major barriers to wound closure. Dressing selection To enable proper treatments options, it is important to understand dressing categories and negative pressure wound therapy. This lesson teaches these options and reviews the principles of wound management.

8 Note Leg ulcers with rheumatoid arthritis, colitis, hyperthyroidism, sickle cell anemia, neuropathies or skin cancers should be referred promptly for medical assessment. N. B. Some leg ulcers are of mixed etiology and therefore may exhibit a combination of these characteristics. Site Size Edge Floor Edema Staining ABI Pulses Pain Management gaiter area, usually large shallow exuding/ generalized always >0.8 normal some Compression medial with diffuse granulating (dependent) Optimize the local wound malleolus edges environment Review contributing factors Establish maintenance plan any part usually deep with dry localized never <0.8 reduced or present, Reduce/eliminate cause of leg, small cliff edge (necrotic) absent especially Improve perfusion commonly at night Manage contributing below the (elevated) factors ankle Pharmacotherapy Vascular rehabilitation Angioplasty/surgical intervention Optimize wound environment Assess the infection Osteomyelitis any part often very of leg, small commonly below the ankle & on the foot deep with dry cliff edge (necrotic) (callus) localized never not reliable not reliable none neuropathy Wound Management Smith & Nephew, Inc., Starkey Road, P.O. Box 1970, Largo, FL 33779, USA Customer Care Center: , Telephone: , Fax: RA7500 Patient education Smoking cessation. Wash and inspect feet daily. Do not soak feet. Moisturize feet, not between toes. Avoid bathroom surgery. Notify physician at once should a blister or sore develop. Routine podiatry visits. Protect from mechanical, chemical, thermal trauma. Debridement WC Bedside tools: Support your core formulary to simplify decisions and help reduce product waste Reinforce knowledge for non-wound experts Guide bedside decisions and care Drive clinical best practices with supportive bedside tools: Wound Assessment Guide *smith&nephew Skin and wound quick reference guides Wound Assessment Guide Wound measuring guide Pearls of Wisdom Product application videos Skin care report booklet Lower extremity ulcers differential diagnosis Venous ulcers Arterial ulcers Pressure ulcer/injury staging badge Diabetic ulcers Differential diagnosis card Guide to The Wound Institute Let Smith & Nephew help you create a Pathway to Excellence. Pathway to excellence: A comprehensive clinical education platform from Smith & Nephew Smith & Nephew, Inc. Customer Care Center Fort Worth, TX T USA F Smith & Nephew, Inc. All rights reserved. Trademark of Smith & Nephew. All trademarks acknowledged. MSBE UE

9 PST... Practice Success Through Prevention Knowledge is the path for the non-licensed caregiver to be confident at the bedside. The PST program is a complete series of skin care lessons that teaches the importance of: Understanding skin Preventing skin breakdown Maintaining skin integrity The program: Lesson modules with individual tests to assess understanding Introductory overview Lesson 1: normal skin attributes Lesson 2: skin integrity Lesson 3: managing fragile, dry or thin skin Lesson 4: moisture associated skin damage Lesson 5: reportable skin conditions Instructor tool kit Certificate of Completion Sample illustration of Report Booklet Study notes for each lesson module Product application demos

10 PST...Practice Success Through Prevention DVDs Modules are available in Acute Care or Long Term Care setting. Instructor tool kit The PST report booklet brings the importance of skin assessment to the bedside with a simple method of designating the body location and condition observed. Each module includes a PowerPoint version of the lesson for Trainer use, and optional study note pages for the student. The DVD includes an interactive test section that reinforces correct answers as the student completes the test. With successful completion of the PST lessons, a Certificate of Completion can be awarded to validate the student s new knowledge. Study notes Product application demos Proper use and application of skin care products is essential to maintaining skin integrity and prevention of skin breakdown. The product application section demonstrates the correct way to use and apply cleansers, moisturizers, protectants, skin preps, and antifungals. Certificate of completion Skin care report booklet Pathway to excellence: A comprehensive clinical education platform from Smith & Nephew Smith & Nephew, Inc. Customer Care Center Fort Worth, TX T USA F Smith & Nephew, Inc. All rights reserved. Trademark of Smith & Nephew. All trademarks acknowledged. MSBE UE

11 Supporting bedside tools The true test of a healthcare professional s knowledge is at the bedside. The tools in the Pathway to Excellence educational program were created to reinforce the learning and best practices of the lesson elements. Quick Reference Guides At the bedside, good skin and wound management depends on reducing clinical practice variation by compliance with a facility s treatment and product selection guidelines. Proper product utilization may also help reduce costs by lowering product waste. The Quick Reference Guides for both skin and wound care are customizable templates that include your facility s guidelines and product formulary to support the bedside decisions. TIMESaver Connect Effective wound management requires removing the barriers to healing as outlined in the TIME principle: Nonviable Tissue; Infection Management; Moisture Imbalance; Epidermal Margin. The TIMESaver helps connect wound assessment education with proper product utilization. It helps the caregiver focus on the three essential platforms of skin and wound care delivered at the bedside Prevention, Exudate Management, and Infection Management. Skin and wound quick reference guides TIMESaver Connect Wound Assessment Guide Proper assessment and documentation is critical to determining the correct intervention. The accurate evaluation of the wound type, tissue involvement, size, and other factors not only guides treatment options, but also aids communication and validates outcomes. Pocket-sized, the Wound Assessment Guide is a ready reference for all of the components of a wound assessment based on best clinical practices. TIMESaver Connect *smith&nephew *smith&nephew Wound Assessment Guide Wound Assessment Guide

12 Pressure ulcer staging system Definition Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. Description The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. Stage I may be difficult to detect in individuals with dark skin tones. May indicate at risk persons (a heralding sign of risk). Definition Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. Description The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. Deep tissue injury may be difficult to detect in individuals with dark skin tones. Evolution may include a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar. Evolution may be rapid exposing additional layers of tissue even with optimal treatment. Definition Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister. Description Presents as a shiny or dry shallow ulcer without slough or bruising.** This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation Smith & Nephew, Inc. All rights reserved. Trademark of Smith & Nephew. Registered US Patent & Trademark Office. Definition Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. Description The depth of a stage III pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and stage III ulcers can be shallow. In contrast, areas of significant adiposity can develop extremely deep stage III pressure ulcers. Bone/tendon is not visible or directly palpable. Definition Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling. Description The depth of a stage IV pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and these ulcers can be shallow. Stage IV ulcers can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis possible. Exposed bone/tendon is visible or directly palpable. Definition Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed. Description Until enough slough and/or eschar is removed to expose the base of the wound, the true depth, and therefore stage, cannot be determined. Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as the body s natural (biological) cover and should not be removed. MSFE USE Note Leg ulcers with rheumatoid arthritis, colitis, hyperthyroidism, sickle cell anemia, neuropathies or skin cancers should be referred promptly for medical assessment. N. B. Some leg ulcers are of mixed etiology and therefore may exhibit a combination of these characteristics. PICO application Discussed indications, contraindications, precautions for use of PICO NPWT Troubleshoots loss of seal at dressing site (if applicable) Demonstrates PICO dressing application Product/task Completed ALLEVYN Life Advance Foam Wound Dressing PICO device Discussed an understanding of the visual alarms associated with the PICO Identify mechanism of action for ALLEVYN Life Hydrocellular Foam Dressings. NPWT device Describe the appropriate wound types for which ALLEVYN Life is indicated. Identifies the battery life associated with the PICO device and the therapy time State change frequency for ALLEVYN Life. for the single use negative pressure wound therapy system. Demonstrates ability to load batteries inside of pump and attach to the PICO IODOSORB Cadexomer Iodine Gel dressing Identify the mechanism of action of IODOSORB Gel. Describe wounds for which IODOSORB Gel is indicated. State the change frequency for IODOSORB Gel. 24/7 Clinical Hotline NPWT (6798) Describe contraindications for IODOSORB Gel. This Hotline is available to support your needs for: General system operations Assessing problems ACTICOAT Antimicrobial Barrier Dressing Dressing application maintaining a tight seal Identify mechanism of action of ACTICOAT. Troubleshooting alarms State whether ACTICOAT is bactericidal or bacteriostatic. Additional information available at: Describe wounds for which ACTICOAT is indicated. Understands the importance of removal during MRI procedures. DURAFIBER Absorbent Gelling Fiber Dressing State the mechanism of action of DURAFIBER. Describe wounds appropriate for DURAFIBER. Describe proper application of DURAFIBER. Name Date Evaluator NPWT device: PICO Completed gaiter area, usually large shallow exuding/ generalized always >0.8 normal some Compression medial with diffuse granulating (dependent) Optimize the local wound malleolus edges environment Review contributing factors Establish maintenance plan any part usually deep with dry localized never <0.8 reduced or present, Reduce/eliminate cause of leg, small cliff edge (necrotic) absent especially Improve perfusion commonly at night Manage contributing below the (elevated) factors ankle Pharmacotherapy Vascular rehabilitation Angioplasty/surgical intervention Optimize wound environment Assess the infection Osteomyelitis any part often very deep with dry localized never not reliable not reliable none Patient education of leg, small cliff edge (necrotic) neuropathy Smoking cessation. Wash commonly (callus) and inspect feet daily. Do below the not soak feet. Moisturize ankle & on feet, not between toes. the foot Avoid bathroom surgery. Notify physician at once should a blister or sore develop. Routine podiatry visits. Protect from mechanical, chemical, thermal trauma. Debridement Not completed Wound Management Smith & Nephew, Inc., Starkey Road, P.O. Box 1970, Largo, FL 33779, USA Customer Care Center: , Telephone: , Fax: RA7500 Cleanse the wound in accordance with normal facility procedures. Select appropriate dressing size. Cleanse the periwound skin and remove excess moisture. Do not use emollients on periwound skin as it will affect adherence of the dressing. Remove the protector film and anchor the adhesive side to the skin and smooth the dressing to ensure there are no creases. Do not stretch the dressing. Wound management by secondary intention on shallow, granulating wounds, chronic and acute exudative wounds, full and partial thickness wounds such as pressure ulcers, leg ulcers, DFU s, infected wounds, malignant wounds, surgical wounds, 1st and 2nd degree burns, donor sites, skin tears and fungating ulcers. ALLEVYN LIFE is suitable for use on fragile skin. ALLEVYN LIFE contributes to pressure ulcer prevention on intact skin as part of a pressure ulcer prevention protocol. WC Supporting bedside tools Wound Measuring Guide A small, paper ruler in a handy pad, this bedside tool reminds of the importance of accurate measurement. And, with space provided for the patient s name and the date, it equally prompts documentation of the wound s progression. Wound measuring guide Differential Diagnosis: lower extremity ulcers and pressure ulcer/injury stages Etiology of a wound is a key aspect of wound management. Treatment plans are based on the type of wound and the underlying conditions that contribute to the development of the wound. This reference tool helps at the bedside to differentiate the wound type or stage through photos and general descriptions and symptoms that are found with a particular wound. Pressure Ulcer/Injury Badge The badge gives the wearer a quick, pictorial guide with descriptions to pressure ulcer/injury stages as outlined by the National Pressure Ulcer Advisory Panel. Stage I Deep tissue injury Stage II Stage III Stage IV Unstageable *smith&nephew Lower extremity ulcers differential diagnosis Venous ulcers Site Size Edge Floor Edema Staining ABI Pulses Pain Management Arterial ulcers Diabetic ulcers Differential Diagnosis: lower extremity ulcers and pressure ulcer/injury stages Pressure ulcer/injury staging badge Pearls of Wisdom To deepen understanding of specific conditions that have important significance for skin, four papers full of wisdom are available. Topics include dermatitis, Clostridium Difficle, friction/shear, and superficial fungal infection. The papers explain each condition, its cause and symptoms, and how to effectively treat the condition. Pearls of Wisdom Skills competencies Understanding the role of various therapies and product types is central to improved clinical outcomes and to reduced human and economic costs. The skill competency tools including skills checklists and certificates of completion help assure that each staff member knows when to use specific products and how to properly apply them. Competency checklist Competency checklist performance criteria Skills competencies Driving to zero Pressure ulcer prevention* ALLEVYN LIFE competency checklist performance criteria Name: Evaluator: ALLEVYN LIFE application Date: Completed Not completed Intended use Pathway to excellence: A comprehensive clinical education platform from Smith & Nephew Smith & Nephew, Inc. Customer Care Center Fort Worth, TX T USA F Smith & Nephew, Inc. All rights reserved. Trademark of Smith & Nephew. MSBE UE