Role of the APRN Wound Care Clinician in the Management of Lower Extremity Arterial Disease Wounds

    loading  Checking for direct PDF access through Ovid

Excerpt

Approximately 8.5 million Americans have lower extremity peripheral arterial disease (PAD), and an estimated 202 million individuals are affected worldwide.1 The prevalence of PAD has increased by 24% globally over the last decade alone, and the epidemic of diabetes mellitus is a major contributing factor.2 Diabetes increases the risk of foot ulcers due to peripheral nerve and circulation issues, leading to infection, gangrene, and amputation in some instances.3
The advanced practice registered nurse (APRN), who is board certified in wound care by the Wound Ostomy Continence Nursing Certification Board (WOCNCB), is instrumental in providing expert, evidence-based wound care and is in a position to play an increasing and pivotal role in the care of patients presenting with acute and chronic extremity wounds. The APRN wound care specialist working in an outpatient specialty clinic most likely will see a large proportion of patients presenting with PAD wounds and will be ordering vascular workups, evaluating diagnostic tests, and initiating and revising individualized treatment plans in order to accelerate wound healing and prevent further complications.
Lower extremity wounds can be complex and require the advanced knowledge and skill of the APRN wound specialist. Advanced practice wound care clinicians (CWCN-AP or CWOCN-AP) are uniquely qualified by their education, clinical preparation, and experience, all validated by their WOCNCB certification, to provide a much needed collaborative approach to wound care management in patients with complicated nonhealing wounds related to lower extremity arterial disease or LEAD. The addition of a certified wound care advanced practice nurse substantially complements and enhances the multidisciplinary team. In many cases, the APRN wound care nurse also serves as the specialist health care provider spanning multiple areas that may encompass acute, ambulatory, extended care, and telehealth care settings. It is anticipated that the need for APRNs providing specialty wound care will only increase.
Validating specialty practice through certification is essential to quality care. The WOCNCB clearly identified the need to recognize the knowledge and skills of the advanced practice wound care nurse and developed a certification examination based upon the current practice of APRN wound care specialists. The examination encompasses the major role components of the APRN within the context of advanced wound care. When preparing for this examination the WOCNCB expects the test taker to be well versed in the principles of basic wound care and apply these principles in complex wound care scenarios. Preparation should include a comprehensive review of basic wound care and wound care problems not routinely encountered in daily practice.
The review questions presented here focus on lower extremity wounds. Without looking at the answer or the rationale, attempt to answer the question. The question rationale will facilitate your review of content as well as help you sharpen your test-taking skills. The examination is designed for entry-level advanced practice. To learn more about how to prepare for certification as a CWCN-AP or CWOCN-AP, please visit the AP-exam preparatory resources available on the WOCNCB Web site: http://www.wocncb.org.
1. Gerhard-Herman MD, Gornik HL, Barrett C, et al 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(12):e726–e779.MDGerhard-HermanHLGornikCBarrett2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesCirculation2017135e726–e779
2.
    loading  Loading Related Articles