Mastering the art of meetings

By Toni Ann Loftus, MBA, RN, MHA

Meetings are a powerful communication tool. They bring together people who can look at an issue from their own unique perspective and contribute to a solution acceptable to many disciplines. Generally, meetings are held to:

• discuss common issues
• brainstorm ideas for solving specific concerns
• make collaborative decisions about a shared concern or problem. (more…)

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2018 American Nurse Today Education Guide

Moving ahead with your nursing education

Deciding to continue your education is exciting as well as daunting. You’ll need support from your friends and family, as well as your colleagues and fellow students. But you also can get support from the nursing profession. In this article, you’ll find information about a variety of resources to aid you along this next step in your career.

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Ready, set, go… to school!

With 79.6% of employers now requiring or having a strong preference for nurses with a baccalaureate degree and a growing demand for nurses, there’s no better time to return to school.

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Frontiers of nursing education

edu frontier nursing education table contents laptop cap scrollIn the first quarter of the 21st century, nursing education is an amalgam of traditional classrooms, innovativeeducational tracks, and technology-enhanced training. This new frontier is geared toward the learning and lifestyle needs of students and the changing healthcare environment in which new RNs will care for patients.

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Is an accelerated nursing program right for you?

Are you up for the challenge of an accelerated nursing program? You can earn your degree quickly and be off the races in your career, but these programs require dedication, self-discipline, and an ability to immerse yourself in the learning experience.

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Returning to nursing school? Keys to success

edu retuning nursing school keys success table contents color pencilCongratulations! You have decided to pursue additional nursing education and been accepted at the program of your choice. You’re happy—right? But you also may be feeling a bit anxious, especially if you haven’t been in school for a while. This article offers tips about how to get organized and stay engaged with fellow students and faculty, as well as steps you can take to enhance your computer and writing skills.

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Ready to change specialties?

The opportunities within nursing are practically limitless. You can choose patient care, education, pharmaceutical sales, research…the list goes on and on. That’s part of the challenge. With so many choices, you need to know yourself and what you want as well as understand what will be required to get you to this next stage in your career.

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Lifelong Learning: Is a postmaster’s certificate the right option for you

edu lifelong learning postmasters certificate option table contents scrollPursuing a postmaster’s certificate is a great way to advance your career. As you explore program options, pay particular attention to admission requirements, program length, delivery method, and costs. You’ll want all of these factors to align with your professional goals and personal circumstances.

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Interprofessional education

Imagine the depth of knowledge you would gain by learning along side students in other healthcare disciplines. In education settings that embrace interprofessional education, students learn with, from, and about each other to enable effective communication and improve patient outcomes.

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Can nursing meet the 80/2020 goal?

In 2010, a goal was set to have 80% of nurses with BSNs by 2020. Read this article to find out what kind of progress we’ve made so far.

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Your doctorate and the path to persistence

High attrition rates for doctoral nursing students (reported to be as much as 50%) in the face of an increasing demand for PhD-prepared nursing faculty is a growing concern. So, what’s at the crux of this problem and how do we solve it? When I was a doctoral student, I researched how other doctoral students balanced work, family, and school. The goal was to learn more about the strategies used by these students.

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Wound care technology invented at S&T hits marketplace

Wound care technology invented at S&T

A glass-based wound care product that emerged from research by a doctoral student at Missouri University of Science and Technology has been approved by the U.S. Food and Drug Administration for human use and is now available on the commercial market.

Steve Jung laid the groundwork for the Mirragen Advanced Wound Matrix while earning a master’s degree in ceramic engineering and a Ph.D. in materials science and engineering at Missouri S&T. Jung is now chief technology officer at Mo-Sci Corp., a Rolla specialty glass manufacturer that continued the product’s development in collaboration with ETS Wound Care, also of Rolla. (more…)

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What does it mean to participate in a wound care clinical trial?

By Susan Beard, RN, BS, CWOCN

Suppose you’re reading an article on a new product that states the product has been through a series of clinical trials before marketing. What does this mean? Who was involved? As a clinician, could you initiate or be involved in a clinical trial of a new product? Who are clinical trial subjects, and what’s it like for them to be involved in a clinical study?

A clinical trial starts as an idea. As clinicians, we often use our critical-thinking skills to imagine a product or method of practice we think could be created or improved on to better meet our patients’ needs. The idea begins to grow and a series of events begins. (more…)

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Helping Sandwich Generation nurses find a work-life balance

By Kari Olson Finnegan, BSN, and Liz Ferron, MSW, LICSW

If you have at least one parent age 65 or older and are raising children or financially supporting a child age 18 or older, you’re part of the Sandwich Generation. Coined in 1981 by social worker Dorothy Miller, the term originally referred to women, generally in their 30s and 40s, who were “sandwiched” between young kids, spouses, employers, and aging parents. While the underlying concept remains the same, over time the definition has expanded to include men and to encompass a larger age range, reflecting the trends of delayed childbearing, grown children moving back home, and elderly parents living longer. The societal phenomenon of the Sandwich Generation increasingly is linked to higher levels of stress and financial uncertainty, as well as such downstream effects as depression and greater health impacts in caregivers. (more…)

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An easy tool for tracking pressure ulcer data

pressure ulcer tracking tool

By David L. Johnson, NHA, RAC-CT

As a senior quality improvement specialist with IPRO, the Quality Improvement Organization for New York State over the past 11 years, I’ve been tasked with helping skilled nursing facilities (SNFs) embrace the process of continuous quality improvement. A necessary component of this effort has been to collect, understand, and analyze timely and accurate data. This article discusses a free tool I developed to help SNFs track their data related to pressure ulcers and focus their quality improvement efforts for the greatest impact. (more…)

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Ramblings of an Itinerant Wound Care Guy

Renaissance and the New Golden Rule

by Dr. Michael Miller

To paraphrase Carol Ann from the Movie Poltergeist…”He’s Baaaaaaaaack” !  At the end of this past May, I had a sudden and disappointing parting of the ways from my prior blog host when I discovered the newest version of the Golden Rule…those that have the gold, make the rules. Is it possible to be too opinionated? Does the textual asbestos statement at the bottom of almost every web page regarding the dissociation between the hosts and the writer’s opinions really have any meaning?  I am nonetheless extremely grateful to my prior hosts for allowing me the bytes to educate, illuminate and aggravate. The silent majority, mostly practitioners and patients who appreciate the inside story versus those with the gold (who don’t mind independent thinking, as long as it comes in their flavor of Kool-Aid) have both spoken.

But as PT Barnum said “’There’s no such thing as bad publicity’ and so, recognizing that more and more people are looking for a shoulder to cry on, a voice of reason, and the company that misery loves, “Ramblings of an Itinerant Wound Care Guy” re-emerges with this blog.  I want to assure you that I have always relished comments and criticism both of which are proudly posted along with the blog, as long as you agree with me.

But enough fanfare and bravado and back to the bastion of wound dabblers anonymous.  My three-month involuntary hiatus did little to quench the fires of indignation regarding medicine in general and wound care in particular.  I had the great honor recently of meeting one of the creators of the wound care protocols for a large wound management organization.  My initial disdain at our handshake turned to admiration as he explained with great pride, how the guidelines were created for diagnosis and care at their facilities.  His background in wound care was impressive and his passion for care was the purest.  However, in keeping with the mantra that “No Good Deed Goes Unpunished”, he related how his master plan had become intellectual oatmeal as the docs and nurses reverted to prior, Neanderthal practices.  One of the major flies in his ointment was the fact that at least one facility under management had a huge number of men over 70 in treatment including hyperbarics with 100% having the diagnosis of venous insufficiency.  Not a single mention of an arterial or diabetic etiology.  When he brought it to the medical directors attention, the response was simply that was what had been diagnosed.  He has since gone on to what he hopes are greener pastures. As far as the pitiful remnants of the wound caregivers he left behind, we agreed that they all deserve to be patient in their own centers.

To my prior readers who once again have elected to join in on the cacophony of intolerance or a newbie who on the advice of a friend decided to see what that crazy guy is writing about this month, I offer you my thanks and a promise to ignore the golden rule whenever and wherever I can.  And by the way…the opinions of the statements made in this blog do not reflect those of the web site, the publisher or the editors…Got it.

Until we ramble next time.

Click here to return to Dr. Miller’s Ramblings of an Itinerant Wound Care Guy Blog page.

 

Disclaimer: The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, Wound Care Advisor. All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.

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How to love and care for yourself unconditionally

By Yolanda G. Smith, MSN, RN, CCRN

Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you:

  • have trouble falling or staying asleep?
  • smoke, drink, or eat to reduce tension?
  • have headaches, back pain, or stomach problems?
  • get irritated or upset over insignificant things?
  • have too much to do and too little time to do it?

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2014 Journal: January February Vol. 3 No. 1

Wound Care Advisor Journal 2014 Vol3 No1

When and how to culture a chronic wound

Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise.

Most chronic wounds are colonized by polymicrobial aerobic-anaerobic microflora. However, practitioners continue to debate whether wound cultures are relevant. Typically, chronic wounds aren’t cultured unless the patient has signs and symptoms of infection, which vary depending on whether the wound is acute or chronic.

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A case of missed care

By Lydia A. Meyers RN, MSN, CWCN Missed care, a relatively new concept in the medical community, refers to any part ofrequired patient care that is omitted of delayed. It’s not the same as a mistake or error, but like them, missed care can negatively affect patient outcomes. I want to share the case of a patient admitted into home…

Avoid surprises when connecting between care settings

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN As wound care clinicians, we know that an interdisciplinary, holistic approach to prevention and management of a wound is crucial to positive outcomes, no matter where the patient is being seen. Yet too often when a patient transfers from one care setting to another, the only wound information that’s communicated is the…

Clinical Notes: diabetic foot osteomyelitis, BIA, footwear

Antibiotics and conservative surgery yield similar outcomes in patients with diabetic foot osteomyelitis A study in Diabetes Care finds that anti­biotics and surgery have similar outcomes related to rate of healing, time of healing, and short-term complications in patients who have neuropathic forefoot ulcers and osteomyelitis, but no ischemia or necrotizing soft-tissue infections. “Antibiotics versus conservative surgery for treating diabetic…

Clinician Resources

Greet the new year by tapping into some new resources. Free app for patients with Crohn’s Disease GI Buddy is a free tool from the Crohn’s & Colitis Foundation of America that patients can use to stay on top of managing their Crohn’s Disease or ulcerative colitis symptoms. Patients can record what they eat, track their treatment and well-being, and…

Fifty shades of wound care at home

By Beth Hoffmire Heideman, MSN, BSN, RN, WCC, DWC, OMS Fifty shades of wound care at home refers to treating the whole patient and the patient’s caregiving supporters—not just the wound. Only by understanding the nuances, or shades, of a patient and his or her environment can clinicians best achieve desired outcomes. Wound healing in home care depends on teamwork.…

Have you made your New Year’s resolutions?

Aresolution is a serious decision or determination to do, or not to do, something. Traditionally, most New Year’s resolutions focus on self-improvement: losing weight, giving up a bad habit, exercising more, being a better person. Because most of us spend about half of our waking lives at work, perhaps our work lives should be the subject of some of our resolutions. Here…

How to apply a spiral wrap

By Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS Each issue, Apple Bites brings you a tool you can apply in your daily practice. Description The spiral wrap is a technique used for applying compression bandaging. Procedure Here’s how to apply a spiral wrap to the lower leg. Please note that commercial compression wraps come with specific instructions for…

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

Managing venous stasis ulcers

By Kulbir Dhillon, MSN, FNP, APNP, WCC Venous disease, which encompasses all conditions caused by or related to diseased or abnormal veins, affects about 15% of adults. When mild, it rarely poses a problem, but as it worsens, it can become crippling and chronic. Chronic venous disease often is overlooked by primary and cardiovascular care providers, who underestimate its magnitude…

Mastering the art of meetings

By Toni Ann Loftus, MBA, RN, MHA Meetings are a powerful communication tool. They bring together people who can look at an issue from their own unique perspective and contribute to a solution acceptable to many disciplines. Generally, meetings are held to: • discuss common issues • brainstorm ideas for solving specific concerns • make collaborative decisions about a shared…

Quality-improvement initiative: Classifying and documenting surgical wounds

By Jennifer Zinn, MSN, RN, CNS-BC, CNOR, and Vangela Swofford, BSN, RN, ASQ-CSSBB For surgical patients, operative wound classification is crucial in predicting postoperative surgical site infections (SSIs) and associated risks. Information about a patient’s wound typically is collected by circulating registered nurses (RNs) and documented at the end of every surgical procedure.

how to culture a chronic wound

When and how to culture a chronic wound

By Marcia Spear, DNP, ACNP-BC, CWS, CPSN Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise. Most chronic wounds are colonized by…

2014 Journal: January February Vol. 3 No. 1

Click here to access the digital edition

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Skin problems with chronic venous insufficiency and phlebolymphedema

Dermatologic difficulties: Skin problems in patients with chronic venous insufficiency and phlebolymphedema By Nancy Chatham, RN, MSN, ANP-BC, CWOCN, CWS; Lori Thomas, MS, OTR/L, CLT-LANA; and Michael Molyneaux, MD

Skin problems associated with chronic venous insufficiency (CVI) and phlebolymphedema are common and often difficult to treat. The CVI cycle of skin and soft tissue injury from chronic disease processes can be unrelenting. If not properly identified and treated, these skin problems can impede the prompt treatment of lymphedema and reduce a patient’s quality of life.

This article reviews skin problems that occur in patients with CVI and phlebo­lymphedema and discusses the importance of using a multidisciplinary team approach to manage these patients. (more…)

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Clinical Notes: Debridement, Optimal Wound Healing, Diabetes, Sacral Wounds

Frequent debridement improves wound healing

A study in JAMA Dermatology reports that fre­quent debridements speed wound healing.

“The more frequent the debridement, the better the healing outcome,” concludes “Frequency of debridements and time to heal: A retrospective cohort study of 312 744 wounds.” The median number of debridements was two.

Most of the wounds in the 154,644 patients were diabetic foot ulcers, venous leg ulcers, and pressure ulcers. The study authors note that debridement is a “key process” in wound bed preparation and starting the healing process.

The findings are congruent with previous studies and are based on an analysis of the largest wound data set to date. (more…)

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