Wound Care in the SNF -Reply

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From: andy.whitener@... (Andy Whitener)

To: ptmanager@...

My question regarding wound care in a SNF is more from a business

perspective. Financially, is it more advantageous to have the nursing

staff manage all skilled wound care or therapists ? (assuming both have

the appropriate skills) Is this best decided patient by patient depending on

the minutes of therapy might consume ? Or is there a simple answer

dictated by the regs?

Andy Whitener

Gainesville, Ga.

>>The question you pose should be considered from the patient's need

perspective --in other words -- if the patient's wound is affecting movement

or the patient's ability to move and function then a PT consult/evaluation

and/or Rx is indicated - - the need for the PT skilled services should be

rendered by a PT consult if uncertain -- utilizing wound care teams assists in

decreasing unnecessary services and appropriating the wound care needs to the

appropriate discipline or disciplines -- wound healing for chronicity can be

quite tricky and the multidisciplinary consideration generally is of both

financial and patient improvement benefit....quicker care in minutes may not

lead to the most appropriate long term results -- yet, co-involvement with

wound care may .... does the patient require a dressing change and debridement

or mobility activity to bring new cellular activity to the wound site....

Is there ever a simple response to health care or the individual needs of a

patient's changing/adapting systems? Probably not -- health care regs try to

simplify -- but ranges & guidelines with some flexibility for appropriation

would be the ideal ---

although we each have the same systems -- we are unique in many ways with our

multisystems responses -- ie someone with a cardiac condition will respond

differently to a wound than those with a neurological condition....

however if you have a non-healing diabetic wound on your ankle that is

affecting your capabilities to move and function your system may require the

skills and knowledge of a PT to assist in the greatest recovery to restore

movement and function...

Hope this helps some & encourages others to speak to the issue....

thanks~g