Patient education is key to wounds prevention

Central to the care and support patients receive at a skilled nursing facility is prevention and care for wounds. 

This is because patients typically enter a skilled nursing care facility with a number of chronic conditions such as diabetes, kidney disease, vascular conditions, anemia, or other chronic conditions that can affect the skin. Wounds can be caused by conditions affecting a patient’s vascular system as well as conditions that affect a patient’s ability to move and reposition on his own. 

When veins and arteries are damaged, this can limit the nutrients and oxygen to the skin tissue that normally supports healthy skin and wound healing. Also, when patients are not able to reposition on their own it presents a risk of pressure injury to tissue.

Wounds can be a stumbling block on patients’ road to recovery. They range from being a nuisance to debilitating – completely preventing an individual from being able to reach their goals in therapy. Simply put, someone who is uncomfortable has a hard time reaching new milestones in their overall health.

SKLD physicians and wound care nurses work tirelessly to prevent wounds from occurring in the first place, as well as to heal those wounds that patients can have upon arrival. 

Pavlina Novay, RN, BSN, who is wound care certified by NAWCCB, at SKLD Beltline in Grand Rapids, Michigan focuses on wound care and infection prevention. One of the most important roles Pavlina plays in her position, besides caring for her patients’ wounds, is to educate residents on the importance of wound care and prevention.

Pavlina says, “One of the main reasons for wound care in our facility is to provide the best possible environment for the wound that supports wound healing.” Not only does Pavlina perform the treatment of dressing the wound, but she also works with a dietitian for nutrition-focused care and provides supportive surfaces for the patient. She oversees daily care, monitoring and management of wound care as a team. 

Patient education is key to prevent wounds for patients with chronic conditions

Patients enter SKLD Beltline’s facility with a number of chronic conditions that affect the vascular system. When the body doesn’t have enough blood to flow to the skin, it begins to slowly degenerate. The veins and arteries are not flexible enough without proper movement and support to receive the necessary nutrients and air. When this happens, conditions are favorable for a wound.

Some may see wounds as not as important or life-threatening as other chronic diseases or health emergencies, but Pavlina is passionate about educating otherwise. If left unchecked, these chronic conditions could lead to a patient needing amputation or fatally suffering from sepsis. 

Pavlina says,

“It’s so important to educate patients and their families why they need to take care of their bodies and stay on top of their health.” 

SKLD Beltline resident Betty Kramarz says, “Pavlina has been following my wound healing from the beginning of my ulcerated heel and it is finally healed, thanks to her persistence. She continues to check in with me weekly and has done a great job!”

How SKLD Beltline’s wound care team manages wounds

Personalized treatment for each wound care patient

To properly begin to heal a wound, Pavlina and then team focus on relieving pressure. This means that patients must reposition themselves frequently to help alleviate pressure and allow the healing process to occur. 

For the topical treatment, each patient’s wound is assessed, cleaned and re-dressed according to the physician order. Some patients’ wounds require a new dressing multiple times a day, while others just need it changed once or twice weekly depending on each wound and condition. 

After each dressing, Pavlina makes sure to explain exactly what the status of the wound is and gives an update on the healing process. Pavlina says, “The patients should be involved in their care because it’s important that they know what the situation is and what we can do to promote healing.”

It’s crucial to follow up on wounds and watch them closely to monitor healing and prevent infection. “If we see that a wound is not healing the way it should, we can as a team address possible causes and adjust the course of treatment,” says Pavlina.

Supportive tools and devices for healing wounds

To ensure proper treatment, the wound care team needs to make sure to use the correct supportive devices. Based on the patients’ needs, the care team may provide an air pressure mattress, a floating booth, position wedges, an air cushion for wheelchairs or other supports to help take the pressure off the wound.  

There are many tools and devices to relieve pressure so that tissue isn’t deprived of oxygen and nutrients. Pavlina encourages patients to reposition in order to offload pressure from the surface, allowing blood and oxygen to be delivered to the tissue.

Proper nutrition to promote wound healing

In her care, Pavlina works closely with a dietitian to help the wound healing process. Eating more protein helps support new tissue growth and development, and avoiding “junk” food can help minimize inflammation. 

Pavlina works closely with a dietitian and physician to provide a well-rounded treatment. “It’s a team effort,” says Pavlina.

Education to prevent wounds

There are patients who know they have a chronic condition but are still not motivated to make necessary changes until they are forced to. “It’s very sad, but we have patients who didn’t take care of their chronic conditions, such as diabetes, until they lose a part of their body such as their toe or a foot. Patients sometimes don’t realize how important it is until something dramatic happens.”

Because of this, Pavlina is constantly working with wound care patients to promote education on wound care. “When patients know more about their condition and learn how it will affect their skin, they are more motivated to make changes, comply with the treatment plan and improve their diets.” 

While Pavlina is caring for her patients, she explains how eating better and prioritizing repositioning themselves can help with wound healing. “Sometimes if the patient understands why it’s so important to reposition themselves, stick to a diet and make changes, they will be more likely to do just that.” 

However, there are patients who are stuck in their old ways. “They have been dealing with these conditions for a long time and we have limited compliance with them. They aren’t able to prioritize taking care of their body to promote healing,” says Pavlina.

Pavlina is still hopeful and makes an extra effort to have conversations with her patients in almost every interaction.

Support from family for wound care treatment

The first question patients and family members ask a wound care team is: “How long is this going to take?” The answer is different for each patient and exactly how long it will take cannot fully be determined right away. 

For a healthy person, a small wound could be gone in a couple of days. For a patient with diabetes, for example, the wound could take months to heal. 

Although the wound care team isn’t able to pinpoint the exact timeline for healing, they do encourage the family to stay involved to expedite the process. Pavlina’s best advice for families of a wound care patient is to support the patient and help throughout the treatment. “Educate yourself on the reasons why wounds happen so that you can help motivate your family member. Encouraging them to comply with the treatment and nutrition plan to promote the most efficient wound healing.”

Pavlina has seen life-changing results when a family helps support the wound care patient. “There are just too many success stories. They recover, the wound heals and they move on with their lives. When we remove the dressing to find a healed wound, seeing the patient’s happy face is a great moment. We live for those moments.”

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