Family practice

Family Practice and Urgent Care

-Management of acute, chronic, and complex wounds in busy outpatient clinic. Provide supportive therapies including negative pressure wound therapy, total contact casting, multi-layer compression wraps, and use of skin substitutes.-Identify and evaluate patients for hyperbaric oxygen therapy (HBOT). -Assist clinic manager and physicians with billing and coding for all visits and procedures to assure correct clinic reimbursement.-Coordinate care with DMEs, home health care agencies, and outside specialists to provide patients with adequate level of support.

-Consulted by inpatient providers to evaluate and treat complex wounds in a large hospital setting, such as failed grafts/flaps, diabetic foot ulcers and pressure ulcers, non-healing surgical wounds, and fungating wounds.-Conducted root cause analyses for all hospital-acquired pressure ulcers and assisted in completing NDNQI quarterly surveys to identify areas for quality improvement.-Performed new graduate education quarterly on basic wound and ostomy care.-Developed comprehensive list of resources for indigent ostomy patients to enhance outcomes afterdischarge and created an ostomy troubleshooting guide to improve care and support of ostomates.

-Developed “Skin Champion” program within the facility, which included monthly meetings, casestudies, and educational hand-outs to promote preventative skin care education and reduce incidence of skin break-down.-Assessed patients, including history and physical information, social history, medications, and other risk factors for developing wounds and implement prevention interventions, as indicated.-Coordinated patient care with PT/OT, dietary, and physicians to ensure all factors of wound healing are evaluated, including the need for support surfaces, wheelchair evaluations, nutritional supplements, vascular consults, etc.-Managed and implemented appropriate treatments for skin tears, venous ulcers, arterial ulcers, pressure ulcers, diabetic foot ulcers, lymphedema, chronic wounds, minor burns, infected wounds, and surgical wounds with delayed healing within the CWON scope of practice; continually re-assess progress and update the physician, as needed.-Determined need for debridement and perform mechanical, enzymatic, chemical, and/or conservative sharp debridement, as indicated.-Performed on-going staff education on proper skin care in the elderly and high-risk populations, pressure ulcer prevention, and indications for dressing selection. Also performed new hire, annual, and on-going staff education on nursing competencies and evidenced-based practices.-Provided holistic assessment of patients with ostomies and continent diversions, including physical, medical, psychosocial, and cultural needs.-Provided on-going education about lifestyle modifications, pouching options, and dietary needs regarding to patients with ostomies, as well as assisting with difficult pouching situations

-Responsible for supervising, delegating, and ensuring safe and effective care of residents with concomitant and complex medical and psychiatric health issues.-Promoted holistic and comprehensive care to residents with varying physical needs, such as end-of-life care, maintenance long-term care, and physical rehabilitation for residents with recent strokes, traumatic brain injuries, fractures or orthopedic surgeries, or cardiac needs.-Created teaching material for patient groups (e.g. general health, coping skills, etc) and evaluated effectiveness of teaching on a routine basis.-Co-Instructor for “Charting Basics”, a class that reviewed the legal implications of charting andpromoted quality documentation for new employees-Part of an interdisciplinary team responsible for ensuring the success of a new psychiatric program through the use of effective communication, de-escalation techniques, and therapeutic negotiations.