Negative pressure wound therapy (NPWT) applies a vacuum to wounds; this draws out fluid and increases blood flow, aiding the healing process. For a hospital, the choice of NPWT system is a serious one; Medicare expenditures related to wound care run into the billions, and NPWT expenditures account for a large portion of a hospital’s associated wound care costs. The complexity of managing these systems often discourages any attempts to change, even when newer systems present clear advantages in terms of cost and patient experience.
“It’s like, you don’t change a batter’s stance when he has a great average,” says Michelle ‛Mickey’ Monte MSN, RN, a clinical nurse educator at Buffalo General Medical Center, part of Kaleida Health. “Change is scary. When you multitask like nurses do, you don’t really have time to learn new stuff.”
Choosing a new NPWT system
Monte knows better than most of the challenges involved. She recently orchestrated a transition of the NPWT system at Kaleida, a system with over 1,400 beds. Monte recalls the impetus to make the change began with a plastic surgeon, Dr. Danielle Dauria, who was exposed to different NPWT devices at her wound clinics.
“She was using NPWT systems (or wound vacs) from different companies,” says Monte. “She suggested we pull in a couple alternative NPWT devices and have the nurses and doctors evaluate which one is easier to use.”
When the dust settled, the clear winner was Medela Healthcare, a global manufacturer of healthcare products. “We weighed the pros and cons of each manufacturer, and Medela had more pros than cons,” Monte says. “It’s easier to use, has fewer notification noises, intelligently designed, and it’s lighter.” In general, the pump is very quiet as it operates. This is important, as loud pumps disrupt sleep and act as stressors. Having a low-profile, quiet option is a key priority.
Choosing a new system was just the first step, however. Now Monte, in her role as clinical nurse educator, had to oversee a transition involving nearly 3,000 nurses across multiple sites.
Organized and methodical
Monte decided to begin with the largest hospital in the system — Buffalo General Medical Center. Step one was to create awareness by posting short videos to their internal website, explaining the product and how it was used. “We assigned it to every nurse in the whole system, and we gave them one month to watch. Then they had to print out a certificate and attest to watching it. This way I knew they were prepared to come to a hands-on class.”
The hands-on training classes were assisted by Carol Davis, RN, BSN, CWOCN, a clinical sales specialist from Medela, who embedded herself in the process. “Carol’s amazing,” says Monte. “She listened, and she made herself available. We covered the weekends, the day shifts, and the night shifts. A class every hour — we trained 686 nurses in two weeks.”
When one site began the hands-on classes, the next site would begin the web video training. This staggered approach kept everything organized while Monte ensured compliance. “I sent out daily reminders — send your staff!”
100 percent success
Monte says the changeover was a complete success. “It went over well — a lot of people say they like the Medela NPWT device a lot more. Everything was positive.” She also notes significant savings for Kaleida Health as a result of the change.
For anyone faced with leading a similar NPWT changeover, Monte has some simple advice. “First, make everyone aware of how important wound and skin care is. The more publicity you can manage, the better. Next, be open to different products — ease people in with a trial. And finally, be organized. Have a plan — and remember that change is good.”
Jeff Somers, [email protected]