Shared Decision Making in Advanced Wound Management Practice

Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, we’ll discuss educating patients on advanced wound care technologies with Ms. Kara Couch. She’s a certified wound care nurse practitioner, the Director of Wound Care Services at George Washington University Hospital, and an Associate Research Professor of Surgery at the School of Medicine and Health Sciences at the George Washington University. Here’s Ms. Couch now.

Ms. Couch:
So I’ve been a wound care nurse practitioner for 23 years, and I’ve seen a lot of changes in the different technologies over the years. And we’ve moved to more advanced technologies rather than standard or “standard” dressings, and we’ve had a lot of really good advancements which allow the patients to have longer time between dressing changes to promote what’s called undisturbed healing. And that really gives the patients a lot of freedom back in their life, when they’re not having to change dressings three times a day, which is what we did when I started out on a surgical floor years and years ago when I was still a bedside nurse. So, typically, the patients are really happy with the advancements we’ve made, and we do our best to keep things as simple as possible. And if it’s some sort of device that has to be on them, it’s portable, lightweight, and easy for them to adapt into their home environment.

When it comes to educating patients on newer options that we have for treating their wound, I like to give them as much information in a simplified form as possible, where I will tell them, we can use option A, which would require a dressing change daily, or we can use option B, which would be changed every three days. We talked about things like, are they going to be covered by their insurance? Is there any out-of-pocket cost? In general, most advanced wound care dressings are covered by all insurances through a durable medical equipment provider, and as long as they have active insurance, we can order supplies and have them be sent to their home typically within 48 to 72 hours. Pretty much people want to know “How quickly are we going to heal? How long is this going to take?” And although I don’t have a crystal ball, you can give some information that, if you choose option A, I suspect that it will take a little bit longer than if we use option B, and patients often find that that’s very helpful so that they can be part of the shared decision-making for this.

When it comes to looking at patient involvement, I always think about the fact that it’s a team sport. I need them as an equal partner in the process to ensure that we’re going to get the best possible outcome that they want. And sometimes the outcome is not healing per se, but it’s helping to manage drainage, odor, or pain—things like that for the patients, which are critically important. So really, that’s one of my basic jobs, to work with the patient to understand what they need so we can develop a plan together to ensure success.

Announcer:
That was Ms. Kara Couch talking about how we can navigate conversations with patients about advanced wound care technologies. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!