Healing Open Wounds

CMHS’s dedicated Wound Care Team is invested in daily patient care and advancing research in the field.

Caring for patients with long-term open wounds is a rewarding but little-known specialty in medicine. For CMHS nurses Daphne Hodges, BScN, RN, CWOCN, and Isabel Jimenez Pantoja, RN, BSN, CWS, the COVID-19 pandemic that led to more hospitalized patients with a tracheostomy in their neck has allowed these veteran nurses to help many more patients while finding new ways to further improve wound care treatment.

Daphne is a Certified Wound, Ostomy, and Continence Nurse and CMHS’s Clinical Coordinator for Inpatient Wound and Ostomy Care. Isabel is a Certified Wound Specialist. Together, as a team, they have over 25 years of combined specialized experience. Both treat patients at Community Memorial Hospital – Ojai Valley Community Hospital and at the Continuing Care Center in Ojai. They go wherever patients need them including the emergency room, operating room and Neonatal Intensive Care Unit — wherever a patient has a difficult open wound that needs assessing or special care.

Working with the physicians, these specialized nurses manage wounds that patients come in to the hospital with: acute and chronic wounds including surgical wounds, diabetic foot ulcers, and wounds related to poor blood flow. They also manage new ostomies for patients who had their colon or bladder removed.

“We spend a lot of our time hands-on with our patients and we do follow-ups to make sure we are seeing progression,” Daphne said.

Helping Patients Whose Wounds Won’t Heal​

A normal wound should mostly progress to healing in a week or two, and it’s a serious concern if it doesn’t. Daphne and Isabel often see their patients several times a week throughout their hospital stay to check for improvement. They also ensure patients have a home health care plan in place after release from the hospital, are connected to CMH’s outpatient wound care clinic, or have follow-up care with the right doctor after leaving the hospital.

It’s especially gratifying for Daphne and Isabel when they discover previously unknown underlying conditions that patients have which are preventing their wounds from healing, which happens often. Conditions related to poor blood flow, infection, or uncontrolled diabetes can block or slow healing, they said. Chronic wounds can be overlooked.

“People don’t realize that it’s abnormal to have a wound that is open for more than a couple of months,” Daphne said. Discovering the reason is one way CMHS’s wound care nurses really make a difference. She said, “This takes nursing beyond what we would have imagined. It’s really rewarding.”

Sharing Research & New Protocols

The Wound Care Team also shares their expertise with their peers. Last year, Daphne co-published new research in the Wound Management Journal focusing on wound healing and inflammation. This year, she and Isabel helped develop an internal protocol to reduce pressure injuries in patients with tracheostomies. With an increase last year of COVID-19 patients hospitalized with ventilators and tracheostomies, they recognized that this was an issue needing extra attention and worked together with the critical care team including surgeons, nurses and respiratory therapists as a team to achieve improved patient outcomes. Their work has been successful.

“We have not had one single pressure injury develop under that tracheostomy protocol over this past year and throughout the pandemic,” Daphne said proudly.

In March, Daphne presented their work on tracheostomies virtually at the annual National Pressure Injury Advisory Panel Conference, and their research will also be presented at two other conferences this year. In addition, Daphne was a presenter for a live webinar held in February that shared the Wound Care Team’s findings and success with regards to the work done on tracheostomies at CMH. This information reached over 1,400 attendees across the United States and internationally. Because of her expertise with pressure injuries, Daphne has been active with professional organizations and is a member of the new National Pressure Injury Advisory Panel’s Prophylatic Dressings Standards Initiative Task Force. Both Daphne and Isabel also enjoy serving on various committees at CMHS.

If you have a wound that won’t heal: Contact your doctor or the CMHS Center for Wound Healing at 805-585-3086.

Support group for ostomy patients hosted by CMHS: Email oaventuracounty@gmail.com to learn about a virtual support group for ostomy patients that will launch online in May.