A lot of nurses don't understand how to identify some of the terms, some of the words that we use associated with wound assessment. Things like undermining, tunneling, they're not quite sure how to differentiate between the two. Certainly, there are so much confusion in identifying the difference between eschars and soft necrotic tissue and slough. Go through this expert home health training article to know more about the wound assessment home health rules and guidelines.
Remember that eschar can be different colors. Eschar often mimics skin pigments. And so, it's important for nurses to get into the habit even. Encourage them to put a glove on and run their glove finger over the tissue that they are assessing because they'll very quickly be able to tell the difference between eschar and maybe what might be a healed scarred wound.
A self necrotic tissue is different from slough. So, eschar sort of progresses from a dry, non viable tissue that is unstageable to softer necrotic tissue. And once that comes up, there's a lost treaty slough. And so it's very helpful if you can help your nurses differentiate between the types of tissues. And even tendons sometimes get mistaken for a yellow eschar or yellow nonviable tissue. And honestly there is nothing like putting clean gloves on and really feeling structures. It helps you identify what's going on in the wound.
Resources: Nursingquality.org is a helpful home health training website, for anybody who needs help with improve their accuracy in assessment. But there are some pressure ulcer stages and they're just excellent one CEU pressure ulcer staging PowerPoint. And there's also a wound pipe differentiating between wound pipes that are very domain to the home care nurse, the photographs of phenomenal. And you should encourage nurses to go through it on their own.
If you are the educator or the clinical mentor or maybe the manger in your home care agency, it goes through these CE programs. You can get to them from the homepage of this website. Go through these yourself. And then take your nurses through them. And if you have time you can do it as a group.
Also on the NPUAP home health training website is a free downloadable handout that it not only has the descriptions of stages but it also has nice diagrams, colored diagrams that really help nurses understand the levels of tissue injury and how that correlates to staging. And so, those websites, those are two free resources that you might want to look at.
Bring in Models: Remember that when you bring models as an adjunct that nurses can actually see, it really helps. Depending on the format of your in-service, you can also just make sure that nurses can accurately measure wounds because we know that that's another important issue with OASIS-C. Where do you get links? Where do you get wits in-depth? How do you do that? And so, this is great to enable your staff to validate their ability to identify staging, to identify wound types and then also to do an accurate assessment.
Now, if you're on a bit of a budget and another fun thing that you could do that can also help you particularly if you identify certain problems with your CMS OASIS being accurately completed is Play Doh. You can construct model that will highlight the problems and issues that you've identified in your agency. But then you can also use it to have your nurses come in. And you should try to buddy up nurses so that they don't feel threatened that having them do their wound assessment together and actually write it out or type it out just as they might or maybe complete your computer documented form, if you used an electronic medical record so that you can make sure that they're meeting your standards for documentation.
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