Starting a consulting business

wound care business consult

By Donna Sardina, RN, MHA, WCC, CWCMS, DWC

Starting your own consulting business is an exciting and rewarding experience: You’re the boss; you’re in charge. The question is, do you have what it takes? Along with the excitement of being the boss comes the responsibility of decisions and commitment. Your decisions will affect whether the business is a failure or a success.

To succeed in consulting, you must be an expert at recognizing problems and shaping solutions to those problems, and you must possess excellent time-management and networking skills. If you think you have what it takes to be a consultant, read on. This article gives an overview of the process.

Nature of the business

Businesses hire consultants for their expertise to help them identify problems, supplement staff, institute change, provide an objective viewpoint, or teach.
Examples of specific services you can offer include single patient reviews, serving as a member of the wound care team, making wound rounds on all patients, providing education, patient teaching, protocol development, and troubleshooting. These services are provided in many settings—long-term care, home care, long-term acute care, rehabilitation hospitals, acute-care hospitals, insurance companies, and primary-care provider groups. (more…)

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Wet to Dry

By: Nancy Morgan, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC

In the modern world of wound care, there are many treatment options. Surprisingly though, we are still seeing orders for those dreaded wet-to-dry dressings. Using a wet-to-dry dressing involves placing moist saline gauze onto the wound bed, then allowing it to dry and adhere to the tissue in the wound bed. Once the gauze is dry, the clinician removes the gauze, with force often required. This has to be repeated every 4 to 6 hours. Wet-to-dry dressings are a nonselective debridement method that harms good tissue as well as removes necrotic tissue. It keeps the wound bed at a cool temperature and it at risk for bacterial invasion, as bacteria can penetrate up to 64 layers of gauze! It’s one of the most painful procedures for our patients, and this was one treatment that as a nurse I never wanted to do. In fact, I have heard of nurses who would remoisten the gauze before removal to make the treatment more bearable for patients.

Are you seeing a lot of these dressing still used in current practice? What types of settings are they still being used in consistently? How are you dealing with the prescribing clinicians who continue to order this treatment even though it’s considered a substandard practice for wound care?

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DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.

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I call shotgun!

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC

Ahhh—the front seat, shotgun, the good spot, the privilege-to-sit-in and most coveted of all positions when riding in a car. Those are great words if you’re the caller to stake your claim for the front seat, but not so great if you’re the one stuck in the back seat.

In the world of health care, wound and skin care unfortunately never gets to ride shotgun. It seems like we always get the back seat unless there’s a problem. Think back to your college days. Do you remember Wound and Skin Care 101 and the torture of memorizing all 2,000 wound care products on the market, the endless case studies and wound differentiation quizzes? No? Well neither do I. If your schooling was like mine, you learned about sterile dressing changes, wet-to-dry dressings, Montgomery straps, and if you were lucky, how to apply an ostomy bag.

Granted, I went to nursing school in the 1970s. But things haven’t changed much. Wound care still gets the back seat when it comes to educational priorities. A survey by Ayello, Baranoski, and Salati of 692 registered nurses found that 70% considered their basic wound care education to be insufficient and fewer than 50% of new nurses believed they could consistently identify pressure ulcer stages. Another survey of nursing textbooks revealed students could be exposed to as few as 45 lines of text on pressure ulcers.

It’s not just lack of nursing education, but also poor physician education. As reported in a poster by Garcia and colleagues, only 8 of 50 medical residents scored more than 50% on a 20-question test measuring pressure ulcer knowledge, with a high score of 65% (range, 13.04% to 76.09% correct).

It’s time for a change, and I’m excited to be a part of a new tool to help move wound and skin care education to the front seat: Wound Care Advisor, the official journal of the National Alliance of Wound Care (NAWC). With its “Don’t just tell me, but show me” approach, the journal will feature plenty of photographs, step-by-step instructions, and video how-to’s. If you’re like me and prone to attention deficit, you’re in luck. We’ll keep things practical and to the point, with a “learn it today and do it tomorrow” mantra.

Another cutting-edge feature of the journal is the electronic-only format; this isn’t a print journal. The no-paper format will help us declutter our lives and minimize our ecological footprint. Not to worry, though: With our print-on-demand feature, you can always print out individual articles or even the entire journal if you want.

In keeping with NAWC principles, Wound Care Advisor is geared toward all care settings and a multidisciplinary audience. This isn’t just the NAWC journal; it’s your journal. We need you to help us move wound care from the back seat to the front seat of the car by sharing your knowledge and passion for wound and skin care. Call or e-mail us your case studies, best practices, tools, forms, wound photos, or even feedback about the journal.

I truly believe that together, you, I, NAWC, and Wound Care Advisor can move wound and skin care education to the front seat. I look forward to working with you on the ride to the coveted shotgun seat.

Donna Sardina, MHA, RN, WCC, CWCMS
Editor-in-Chief
Wound Care Advisor
Cofounder, Wound Care Education Institute
Plainfield, Illinois

Selected references
Ayello EA, Baranoski S. Examining the problem of pressure ulcers. Adv Skin Wound Care. 2005; 18:192-194.
Ayello EA, Baranoski S, Salati DS. A survey of nurses’ wound care knowledge. Adv Skin Wound Care. 2005;18(5 Pt 1):268-275.
Ayello EA, Meaney G. Replicating a survey of pressure ulcer content in nursing textbooks. J Wound Ostomy Continence Nurs. 2003;30(5): 266-271.
Garcia AD, Perkins C, Click C, Bergstrom N, Taffet G. Pressure ulcers education in primary care residencies. Poster session presented at 19th Annual Clinical Symposium on Advances in Skin & Wound Care. September 30-October 3, 2004; Phoenix, Arizona.

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Editorial Advisory Board

Editor-in-Chief

Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Co-Founder
Wound Care Education Institute
Lake Geneva, IL

Editorial Advisory Board

Nenette L. Brown, RN, PHN, MSN/FNP, WCC
Wound Care Program Coordinator
Sheriff’s Medical Services Division
San Diego, CA

Debra Clair, PhD, APN, RN, WOCN, WCC, DWC
Wound Care Provider
Alliance Community Hospital
Alliance, OH

Kulbir Dhillon, NP, WCC
Wound Care Specialist
Skilled Wound Care
Sacramento, CA

Fred Berg
Vice President, Marketing/Business Development
National Alliance of Wound Care and Ostomy
St. Joseph, MI

Cindy Broadus, RN, BSHA, LNHA, CLNC,
CLNI, CHCRM, WCC, DWC, OMS

Executive Director
National Alliance of Wound Care and Ostomy
St. Joseph, MI

Gail Hebert, MSN, RN, CWCN, WCC, DWC, OMS
Clincal instructor
Wound Care Education Institute
Plainfield, IL

Joy Hooper, BSN, RN, CWOCN, OMS, WCC
Owner and manager of MedicalCraft, LLC
Tifton, GA

Catherine Jackson RN, MSN, WCC
Clinical Nurse Manager
Inpatient and Outpatient Wound Care
MacNeal Hospital
Berwyn, IL

Jeffrey Jensen DPM, FACFAS
Dean & Professor of Podiatric Medicine and Surgery
Barry University School of Podiatric Medicine
Miami Shores, FL

Rosalyn S. Jordan, RN, BSN, MSc, CWOCN, WCC
Director of Clinical Education
RecoverCare, L.L.C.
Louisville, KY

Jeff Kingery
Vice President of Professional Development
RestorixHealth
Tarrytown, NY

Jeri Lundgren, RN, BSN, PHN, CWS, CWCN
Vice President of Clinical Consulting
Joerns
Charlotte, NC

Nancy Morgan, RN BSN, MBA, WOC, WCC, DWC, OMS
Co-Founder, Wound Care Education Institute
Plainfield, IL

Steve Norton, CDT, CLT-LANA
Co-founder, Lymphedema & Wound Care Education, LLC
President, Lymphedema Products, LLC
Matawan, NJ

Lu Ann Reed, RN, MSN, CRRN, RNC, LNHA, WCC
Adjunct Clinical Instructor
University of Cincinnati
Cincinnati, OH

Bill Richlen, PT, WCC, CWS, DWC
Owner
Infinitus, LLC
Chippewa Falls, WI

Cheryl Robillard,PT WCC, CLT
Clinical Specialist
Aegis Therapies
Milwaukee, WI

Stanley A Rynkiewicz III, RN, MSN, WCC, DWC, CCS
Administrator
Deer Meadows Home Health and Support Services LLC
BHP Services
Philadelphia, PA

Donald A. Wollheim, MD, WCC, DWC, FAPWCA
Owner and Clinician, IMPLEXUS Wound Care Service, LLC
Watertown, WI
Instructor for Wound Care Education Institute
Plainfield, IL

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