Nutritional considerations in patients with pressure ulcers

Optimizing nutritional status is a key strategy both in preventing and managing pressure ulcers. In patients across all care settings, compromised nutrition— as from poor intake, undesired weight loss, and malnutrition—increases the risk of pressure ulcers. It contributes to altered immune function, impaired collagen synthesis, and decreased tensile strength. In many cases, malnutrition also contributes to wound chronicity and increases the risk for delayed and impaired wound healing. In…more

Nutritional Supplements

BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Wound healing and nutrition go hand in hand. Without adequate fluids, calories, and protein, wound healing can be delayed.

Protein is extremely important in wound healing. Patients with wounds require almost double the protein intake (1.2 to 1.5 g/kg/day) of those without wounds. All stages of wound healing require adequate protein. The basis of the human…more

Managing chronic venous leg ulcers — what’s the latest evidence?

Chronic venous leg ulcers (CVLUs) affect nearly 2.2 million Americans annually, including an estimated 3.6% of people over the age of 65. Given that CVLU risk increases with age, the global incidence is predicted to escalate dramatically because of the growing population of older adults. Annual CVLU treatment-related costs to the U.S. healthcare system alone are upwards of $3.5 billion, which are directly related to…more

Pressure Injury Prevention: Managing Shear and Friction

Let us start off this post with a typical scenario. You walk into any facility or institution and you see a patient slouched in their wheelchair, with no wheelchair cushion. You notice part of their brief hanging out of the top of their pants, so you assume the patient may be incontinent. So let’s think about this for a minute. We most likely have friction, shear, and moisture going…more

Frequently asked questions about support surfaces

The National Pressure Ulcer Advisory Panel (NPUAP) describes support surfaces as “specialized devices for pressure redistribution designed for management of tissue loads, microclimate, and/or other therapeutic functions.” These devices include specialized mattresses, mattress overlays, chair cushions, and pads used on transport stretchers, operating room (OR) tables, examination or procedure tables, and gurneys. Some support surfaces are part of an integrated bed system, which combines the bed frame and support…more

Understanding NPUAP’s updates to pressure ulcer terminology and staging

On April 13, 2016, the National Pressure Ulcer Advisory Panel (NPUAP) announced changes in pressure ulcer terminology and staging definitions. Providers can adapt NPUAP’s changes for their clinical practice and documentation, but it’s important to note that, as of press time, the Centers for Medicare & Medicaid Services (CMS) has not adopted the changes. This means that providers can’t use NPUAP’s updates when completing CMS assessment…more

Preparing the wound bed: Basic strategies, novel methods

The goal of wound-bed preparation is to create a stable, well-vascularized environment that aids healing of chronic wounds. Without proper preparation, even the most expensive wound-care products and devices are unlikely to produce positive outcomes.
To best prepare the wound bed, you need to understand wound healing physiology and wound care basics, as well as how to evaluate the patient’s overall health and manage wounds that…more

Clinician Resources—May/June 2016

This issue we focus on resources to help clinicians protect themselves from injuries and engage in a healthier lifestyle.

OSHA safety website
A hospital is one of the most hazardous places to work, according to the Occupational Safety and Health Administration (OSHA). The agency provides a wealth of information on how to protect hospital workers as part of its website Worker Safety in Hospitals: Caring for Our Caregivers. PDF resources…more

Quiz Time 5/13/16

Which statement about hyperglycemia and mortality in patients receiving nutritional support is correct?

a. Compared to parenteral nutrition (PN), general nutrition (EN) increases hyperglycemia risk nearly twofold.
b. Compared to EN, PN increases hyperglycemia risk nearly twofold.
c. Patients whose blood glucose (BG) level stays above 220 mg/dL during PN therapy have an increased risk of death.
d. Patients whose blood glucose (BG) level stays above 220 mg/dL…more

Clinician Resources

Check out the following resources, all designed to help you in your clinical practice.
Human trafficking resources
Victims of human trafficking often suffer tremendous physical and psychological damage. Clinicians play an important role in identifying potential victims so they can obtain help.
Here are some resources to learn more about human trafficking.
• “Addressing human trafficking in the health care setting” is an online course that includes a downloadable quick-reference…more