Dawn Engels, MSN, RN, CNS, CWOCN, CWCN-AP, Clinical Nursing Support, Cone Health, Greensboro, North Carolina. Melody Austin, MSN, RN, CNS, CWOCN, CWON-AP, Clinical Nursing Support, Cone Health, Greensboro, North Carolina. Sherry Doty, MSN, RN, CNS-BC, CWOCN, CHC, Clinical Nursing Support, Cone Health, Greensboro, North Carolina. Karen Sanders, MSN, RN, FNP-BC, CWON, Clinical Nursing Support, Cone Health, Greensboro, North Carolina. Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Clinical Nursing Support, Cone Health, Greensboro, North Carolina.
J Wound Ostomy Continence Nurs. 2020 Sep/Oct;47(5):450-455. doi: 10.1097/WON.0000000000000697.
Managing patients during the coronavirus disease-2019 (COVID-19) pandemic, and the associated severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) in particular, required the nimble responsiveness for which WOC nurses are known. Problem-solving skills were needed to continue the level of WOC nursing services expected by patients, families, and professional colleagues, while reducing the hours we were physically present at our clinical facility. In order to respond to these demands, our team realized it must create an innovative approach to provide efficient, cost-effective consultations during this global crisis. This Challenges in Practice article summarizes our experience with use of telemedicine technologies to perform remote consultations within the acute care setting.
Case 1 was a 52-year-old woman with a history of paraplegia. She had several pressure injuries but had not received topical care for these wounds prior to admission. A consultation for the WOC nurse was requested and performed via telehealth services on a day our team was working off-site. This case illustrates the process our team used to perform a virtual consultation and demonstrates how the use of images placed in the electronic medical record aided in developing an effective plan of care. Case 2 was a 48-year-old man who tested positive for COVID-19. He developed bilateral unstageable pressure injuries on his cheeks after being placed in the prone position for a prolonged period while critically ill. This case describes multiple technologic platforms used for telemedicine consults in a patient with COVID-19 requiring isolation.
Remote consultation by WOC nurses was possible in our healthcare system because of previous experience using telemedicine technology and well-established collaborative relationships with providers and bedside nurses. By expanding our use of telemedicine technology, we were able to provide ongoing care to a patient without COVID-19 who had WOC consultation needs, and a patient with strict isolation demands due to COVID-19.
在 2019 年冠状病毒病（COVID-19）大流行期间管理患者，特别是与严重急性呼吸系统综合征相关的冠状病毒 2（SARS-CoV-2），需要我们 WOC 护士所擅长的灵活响应能力。需要解决问题的能力来继续为患者、家属和专业同事提供我们期望的 WOC 护理服务水平，同时减少我们在临床设施的实际工作时间。为了应对这些需求，我们的团队意识到必须创造一种创新方法，以便在这场全球危机期间提供高效、具有成本效益的咨询服务。本文总结了我们在急性护理环境中使用远程医疗技术进行远程咨询的经验。
案例 1 是一位 52 岁的女性，有截瘫病史。她有几个压疮，但在入院前没有接受过局部治疗。要求 WOC 护士进行会诊，并通过远程医疗服务在我们团队在外地工作的一天进行了会诊。该案例说明了我们团队使用虚拟咨询的过程，并展示了如何在电子病历中放置图像来帮助制定有效的护理计划。案例 2 是一位 48 岁的男子，COVID-19 检测呈阳性。他在病重期间长时间处于俯卧位后，两侧脸颊出现不可分期的压力性损伤。该案例描述了 COVID-19 患者需要隔离时，用于远程医疗咨询的多种技术平台。
由于先前使用远程医疗技术的经验以及与提供者和床边护士建立的良好合作关系，我们的医疗系统中可以进行远程咨询。通过扩大远程医疗技术的使用，我们能够为一位没有 COVID-19 但有 WOC 咨询需求的患者，以及一位因 COVID-19 而有严格隔离要求的患者提供持续的护理。
