Den sestry specialistky pro léčbu rány v univerzitní nemocnici

English language version

The wound management team is an independent entity within the hospital, comprised entirely of specialized nurses and operating without an assigned physician. This team is led by a consultant nurse and comprises seven nurses in both senior and junior roles at various levels of expertise. Administrative tasks and IT support are managed by an administrator. The team delivers clinical care six days a week, emphasizing flexible working hours that allow each member to have a unique schedule. A full-time position consists of 37.5 hours per week. Most team members prefer to distribute these hours over four or five working days, while I personally favour a schedule of three days, each lasting 11.5 hours, particularly to ensure adequate coverage for extensive academic and educational projects I am leading on. All team members commence their day at either 7:00 or 7:30.

For our daily operations, it is essential to have functional IT systems, as all patient documentation is stored electronically. We utilize an electronic patient record that includes requests for consultations. This record also allows for the storage of clinical photographs, enabling us to validate stage one and two pressure ulcers without the need for a patient visit. In addition, we have a system in place for the reporting of clinical incidents.  

We will gather at our computers at 7:30 to review the allocation list prepared by the administrator, which is based on reported clinical incidents and consultation requests we have received. We will examine the patient’s record, photographs, and, depending on the severity of the issue, determine whether to offer the patient a clinical visit, a phone call, or written advice in the patient’s record. On average, 40 patients require one of these forms of consultation each day.

Each day, a designated coordinator oversees consultation requests, manage telephone communications, and facilitate the seamless flow of daily activities. The coordinator assigns the names of specialized nurses to patients requiring clinical visits, complex dressings, or sharp debridement on that day. Generally, long-term patients are consistently assigned to the same nurse for continuity of care.

Around 09:00, the nurses will depart for clinical consultations for assigned patients across various departments. Unfortunately, our team does not have a designated inpatient clinic or clinical room available for patient examinations. The average number of patients assigned to each nurse per day is approximately five.

The most common types of consultations include diagnosis, care for leg ulcers, and the application of compression bandages. Additionally, the assessment and validation of various stages of pressure ulcers, management of surgical wounds with dehiscence, application of all forms of negative pressure therapy, and treatment of oncology wounds are also prevalent, along with a variety of other intriguing wound types and clinical situations.

Within this role, the specialist nurse is required to integrate educational activities for hospital staff, participate in team meetings, and work on tasks related to the assigned departments. Furthermore, she is involved in a range of projects that have been allocated to her.

In the forthcoming issue, I will provide insights from my time in the intensive care unit and explain the techniques implemented to prevent the occurrence of pressure damage  in patients who are critically ill.