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Ragen Wilmoth

Iredell Health System’s Skilled Nursing Facility is proactively seeking to improve its wound care and reduce its number of patient injuries, and the results are clear — in just two years, the facility has cut its facility-acquired pressure injuries (FAPIs) by more than 90 percent.

The drastic decline is largely attributed to accurate assessment of wounds, diligent heel elevation, and frequent repositioning to relieve pressure in at-risk areas. In 2017, 17 FAPIs occurred at the facility. In 2018, that number was cut to 7. And as of Oct. 4, the facility had seen just one FAPI in 2019, even while increasing in patient volume 21 percent from year to year. Meanwhile, Iredell Memorial Hospital has decreased its number of hospital-acquired pressure injuries (HAPIs) from 88 in 2017, to 46 in 2018, to 25 so far this year.

While the Health System has always continuously strived to reduce both FAPIs and HAPIs, more significant efforts began in 2017 when Jessica Hicks, the skilled nursing facility’s director of nursing, and Catherine Koutroumpis, Iredell Health System’s wound ostomy continence nurse, recognized the need to train employees on advanced wound care techniques. Together, the two worked to identify an employee who could become the facility’s wound resource champion and undergo extensive training, and then help train others to become champions themselves. Ragen Wilmoth was the perfect fit.

Wilmoth recently completed the Wound Treatment Associate (WTA) Program. She is the second to complete the program since the Wound Ostomy Continence Nurses (WOCN) Society brought the program to Iredell County.

“There was an opportunity for improvement of care in this field on our unit. Part of this role is to share knowledge and be an agent for change. This certification and the preparation course have helped to improve patient outcomes,” Wilmoth said. “I feel proud that I was central to this effort.

“With the pretty awesome teamwork of our nurses, CNAs, and unit clerks on this unit, we have been able to improve the prevention of pressure injuries.”

The WOCN Society created the WTA Program as a continuing education program to fulfill the growing need for wound care knowledge and skin health in healthcare. Under the direction of a WOC specialty nurse or licensed practitioner, the WTA Program prepares non-certified wound care nurses to provide optimal care within their scope of practice for patients with acute or chronic wounds.

Along with completing the WTA Program and passing the WOCN Certification Board Exam, Wilmoth performed an in-person session which included Semmes-Weinstein monofilament testing, an ankle brachial index (ABI) test, negative pressure wound therapy, and application of multi-layer compression wraps. She accumulated more than 20 clinical hours under the direct supervision of a wound care expert.

“I am proud to say I am the first Certified Wound Treatment Associate nurse at Iredell Health System, with many thanks to the great preceptorship from Cat Koutroumpis and Libby Maclean,” Wilmoth said.

Each week, Iredell Skilled Nursing residents receive a thorough assessment of each pressure injury by their WTA-Certified nurse.

“Our Iredell Skilled Nursing residents are receiving optimal wound care during their stays with us,” Wilmoth said. “Residents should be proud to visit our facility, not only because of our five-star rating but because of the outstanding wound care they will receive if they were to need it.”

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