Registered Nurse (RN) - Wound Care PRN - Outpatient

Facility: Douglas Hospital

Job Summary:

The Wound, Ostomy, and Continence Clinical Nurse (WOCN) functions under the direction of the Nurse Manager and provides acute and rehabilitative care for people with select disorders of the GI, GU and Integumentary systems. The WOCN serves as a resource to nursing and medical staff and is responsible for delivering in-depth, comprehensive patient care in complex multiple problem patient care situations. The WOCN can independently perform job functions.

The WOCN is a licensed caregiver who practices in a competent manner, upholds the voice of the patient, system policies and procedures while supporting service excellence goals in the clinical environment that employs a shared governance model. Clinical practice is executed using best evidence through continuous learning from formal education; active reading of professional literature; and reflective practice. He / She serves as a partner in care anticipating and providing for the patient care needs of his/her patients, families and significant others. Role specific competencies, responsibilities, and practice are guided by the WellStar Professional Practice Model, 5-Star Nursing.

It is expected that the WOCS nurse is certified, licensed, knowledgeable, and upholds the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. As a member of the patient services team, it is expected the individual upholds the voice of the patient, system policies and procedures while supporting service excellence goals.

Core Responsibilities and Essential Functions:

Exemplary Practice and Outcomes

- Acts as a consultant to the physician, providing evaluations of patients and developing individualized, evidence-based plans of care that address wounds, fistulas, ostomies, and continence issues at the specialist level.
- Responds to the physician consult request by writing orders within the WOCN scope of practice and standing orders for other nurses to follow. Determines type and frequency of wound/ostomy care provided to the patient using their expert judgment, including modifications as the patient’s condition changes
- Upon receiving physician order for consult, marks patients for ostomy surgery, selecting the best and alternative sites for the surgeon’s consideration, provides education to the patient and family pre- and post-op and guidance for psychosocial, sexual and body image adaption to promote optimal client outcomes.
- Performs the Nursing Process (assessment; diagnosis; identification of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence-based practice; analytical/critical thinking insuring that care is individualized; coordinating care through effective partnerships; caring is central to achieve optimal patient care outcomes
- Provides relationship-based care delivery patient-centered care by partnering with the patient and significant others (as appropriate) using comprehensive hand-off communication processes; interdisciplinary evaluation and communication (i.e., unit rounds, case reviews, peer review, etc.); just in time and planned patient teaching; keeping the patient informed using appropriate communication tools and making the patient’s goals the focus of the plan of care.
- Practices using current clinical practice standards with a focus on safety and quality
- When performing duties in outpatient Wound Care and Hyperbaric Unit:
- Demonstrates knowledge and understanding of the Healing Strategies for wound care and the role of HBO therapy, and the different approved clinical indications and treatment protocols for HBO treatment.
- Delivers care to the patient immediately prior to, during, and immediately following the HBO
- treatment that is consistent with existing policies and Healing Strategies within his/her scope
- of practice and documents all aspects of that care.
- Monitors and ensures the proper delivery of treatment gas as ordered.
- Monitors the patients continually during treatments for symptoms of oxygen intolerance, claustrophobia, hypoglycemic reactions, decompression sickness or any other adverse reaction to HBO treatments.
- Under the direction of the program manager or designee, appropriately intervenes in the
- event of an adverse reaction and follows established protocols.
- Demonstrates competence in reinforcing age specific patient and family education on
- common topics related to the HBO therapy and related underlying disease processes.
- Demonstrates competence in performing ordered treatments including but not limited to
- vital signs, blood sugars, and emergency procedures, consistent with existing policies
- and within his/her scope of practice.
- Documents required elements of each treatment in a clear, concise manner that includes a description of the chamber settings, duration of treatment, patient response to the procedure,
- and any other relevant observations.
- Chamber Operations
- Demonstrates and applies basic knowledge about HBOT chamber operations to ensure
- efficacy of treatment and safety of the patient and those in the immediate area.
- Demonstrates knowledge of the basic physiological principles/concepts of the HBO
- treatment and incorporates them into the treatment process.
- Operates controls to pressurize and depressurize the chamber according to prescribed
- policies for clinical indications and physician orders.
- Maintains accurate logs and records of the time, pressures, depths, etc. of chamber operations according to established protocols.
- Performs maintenance of the hyperbaric chamber (s) and related support systems under the guidance of the Program Director/Safety Coordinator.
- Cleans chamber following each treatment, according to recommendations of manufacturer,
- and in accordance with established facility infection control policies.
- Maintains emergency equipment and supplies located in the HBO area. Documents equipment checks as required by established policies. Teamwork and Collaboration

- The WOCN serves as clinical expert in various hospital committees, community groups and organizations (United Ostomy Association, Diabetic Outpatient Clinic and local home care agencies); leads outcome evaluations including quarterly NDNQI pressure ulcer prevalence; participates in improvement initiatives related to WOC nursing practice; evaluates and develops product formularies and algorithms to support best practices for the prevention and treatment of wound, ostomy and continence conditions and facilitates the needs of the bariatric population with specialty bed management.
- Coordinates the delivery and documentation of safe quality patient care which includes promotion of interdisciplinary communication and regular interdisciplinary planning/rounds; completion of timely documentation and promotion of a respectful, inclusive clinical environment
- Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and promotes the recruitment and retention of all healthcare team members.
- Participates and supports performance improvement inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating and/or leading such activities as well as, promoting an inter/intra-disciplinary process and actively supports/participates in shared governance at all levels in the system. Professional Development

- Ensures patient/family/staff confidentiality and corporate compliance for self (and accountability for team members) requirements including completing all required mandatory education and proficiencies.
- Serves as a preceptor (or mentor) for other professional nurses (and staff or students for all disciplines) to ensure that there is a current and future qualified workforce; modeling the professional practice of nursing and creating a healthy work environment Evidence Based Practice and Research

- Promotes Evidence based practice, nursing research and performance improvement in nursing. Participates in activities such as value analysis as part of the decision-making process in evaluating patient care products.
- Upholds all health care system/organizational policies and procedures and clinical competencies put forth by this job description and professional association including legal, regulatory and accreditation requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and WellStar Health Systems’ safety absolutes
- Participates in data collection, poses relevant clinical questions to advance evidence-based practice. Consults appropriate experts and uses appropriate resources, data, and evidence to address practice questions. Resources and Support

- Proactively plans for the care of patients across the care continuum in the course of giving direct patient care.
- Participates in the development of protocols and procedures when called upon or through self-initiation in collaboration with care managers and other members of the health care team to achieve best practice outcomes (i.e., decrease in re-admission rates; avoidable days; adverse events; etc).
- Supports efficient and effective use of human and material resources.
- Precepts specialty students (WOCN Program) and Nurse Practitioner students from Emory University WOCN Program, as well as KSU and distance learning students from across the United States.
- Provides education and orientation to new hires and at continuing education opportunities to existing nurses and NCAs, providing formal and informal education to all levels of staff to appropriately manage patients with wound, ostomy, and continence issues.

Required Minimum Education:

Graduate of an accredited/approved school of nursing:Baccalaureate degree in nursing (BSN) from an accredited school of nursing Preferred and
Nursing education from an accredited school of wound, ostomy, and continence nursing (WOCN) program and national certification in clinical specialty area Preferred and
When performing duties in outpatient wound care with hyperbaric unit National certification in the area specialty of Certified Hyperbaric Registered Nurse (CHRN) by the National Board of Diving & Hyperbaric Medical Technology Preferred

Required Minimum License(s) and Certification(s):

Reg Nurse (Single State) 1.00 Required
RN - Multi-state Compact 1.00 Required
Basic Life Support 2.00 Required
BLS - Instructor 2.00 Required
BLS - Provisional 2.00 Required

Additional Licenses and Certifications:

National certification in area of specialty Upon Hire Preferred

Required Minimum Experience:

Minimum 3 years as a staff nurse in an acute care setting.
Required

Required Minimum Skills:

Ability to read, write and speak English language, optimize the use of technology to support clinical care and holds basic computer skills;
Strong interpersonal, collaborative skills along with customer service skills required;
Ability to function in a fast paced environment and respond to emergencies using a decisive, composed and respectful manner;
Possesses excellent time management skills;
practices nursing using evidence and analytical skills along with strong critical thinking skills;
Knowledgeably upholds the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association.