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Healing the gap

Toronto, August 19, 2015

By Geoff Koehler

Katie Marinzel uses a synthetic leg to teach how to assess an ulcer
During her Wound Care Fellowship, Katie Marinzel, a nurse with the Trauma and Neurosurgery Unit on 9CC, designed and led training to share best practices with her colleagues. In this photo she uses a synthetic leg to teach how to assess an ulcer. (Photo by Katie Cooper)

The wounds seen by wound care specialists can spark visceral reactions in some people, but for Katie Marinzel, they struck a chord.

Marinzel, a nurse with the Trauma and Neurosurgery Unit on 9CC, felt drawn to wound care management. In her first year at the hospital, she took all four wound care education courses available. When she heard that the Mobility Program was offering a 12-week Wound Care Fellowship, Marinzel was ready for her next challenge.

Patients who are immobile, have compromised circulatory systems or have diabetes are each prone to different types of complex wounds. Given the hospital’s expertise in critical care, cardiovascular issues and endocrinology, Marinzel saw something new nearly every day.

“Any patient at St. Michael’s with a complex wound can be referred to the wound care team for assessment and recommended treatment,” said Marinzel. “I spent January to March learning from our tremendous team and following those patients on the units or in clinic.”

Marinzel was required to complete a project to satisfy the fellowship. She chose to focus on quality improvement, addressing the learning needs for wound care among the nurses on 9CC.

“I knew from my own experience that it can be hard to accurately assess, let alone treat, some of the complex wounds our patients have and sensed others may have felt the same,” said Marinzel.

  Did you know?
  • Based on her Wound Care Fellowship project, Marinzel was one of two staff given the Award of Distinction for Research and Quality Improvement at the 2015 Trauma and Neurosurgery Program Awards. The award recognizes enthusiastic participation in the planning and sustainability of quality initiatives within the Trauma and Neurosurgery Program.

  • The St. Michael’s wound care team includes a nurse practitioner, a certified enterostomal therapy nurse, a clinical nurse specialist, an occupational therapist and four chiropodists. There is a weekly outpatient clinic, led by the nurse practitioner and the wound care team is available for consults throughout the hospital.

Marinzel surveyed nurses about what they knew about wounds and what more they wanted to learn. She also audited charts to get a sense of how wounds are documented in patient files.

Marinzel said nurses reported a lack of confidence in wound assessment terminology. She believed this knowledge gap affected the detail of wound data in some charts.

“With the help of the wound care team, I compiled resources, developed additional wound care education and trained 42 nurses across the Trauma and Neurosurgery Unit,” said Marinzel. “It was empowering to share what I’d learned with my colleagues, especially because it ultimately helps our patients.”

After the fellowship concluded in March, Marinzel returned to 9CC, but was recently seconded to the wound care team for the summer to provide temporary support. Her wound care experience won’t end there, however, as she’s set to begin her Masters of Clinical Science in Wound Healing at Western University in September.

“I can’t believe how much I’ve been able to achieve in my time at St. Michael’s,” said Marinzel. “The focus on wound care at this hospital is special and I can’t wait to come back after this next opportunity with even more knowledge to share.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.