Clinician Resources: On the Road Again, Nutrition, Compression

A variety of resources to end the year and take you into 2014.

On the road again

Give your patients with an ostomy this information from the Transportation Security Administration to help them navigate airport screening:

• You can be screened without having to empty or expose your ostomy, but you need to let the officer conducting the screening know about the ostomy before the screening starts.
• You can be screened using imaging technology, a metal detector, or a thorough patdown.
• Your ostomy is subject to additional screening. In most cases, this means you will pat down your ostomy and then your hands will undergo explosive trace detection. (more…)

Read More

Making sure patients have the ostomy supplies they need

ostomy supplies they need

By Connie Johnson, BSN, RN, WCC, LLE, OMS, DAPWCA

No matter where you work or who your distributors are, ensuring the patient has sufficient ostomy supplies can be a challenge. Whether you’re the nurse, the physician, the patient, or the family, not having supplies for treatments can heighten frustration with an already challenging situation, such as a new ostomy. Here’s how to reduce the chance of experiencing frustrations related to ostomy supplies. (more…)

Read More

Making professional connections

Making professional connections

By Kathleen D. Pagana, PhD, RN

Are you making connections that benefit your career? Are you comfortable starting a conversation at a networking session? Do you know how to exit a conversation gracefully when it’s time to move on?

These are questions and concerns many clinicians share. Career success takes more than clinical expertise, management savvy, and leadership skills. Networking can be the critical link to success. This article helps you improve your networking skills by focusing on what to do before, during, and after a networking opportunity. (more…)

Read More

How do you prove a wound was unavoidable?

unavoidable pressure ulcers

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN

A pressure ulcer that a patient acquires in your facility or a patient’s existing pressure ulcer that worsens puts your organization at risk for regulatory citations as well as litigation. Unless you can prove the pressure ulcer was unavoidable, you could find yourself burdened with citations or fines, or could even end up in court. (more…)

Read More

What you need to know about hydrogel dressings

hydrogel dressings

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.


Hydrated polymer (hydrogel) dressings, originally developed in the 1950s, contain 90% water in a gel base, which helps regulate fluid exchange from the wound surface. Hydrogel dressing are usually clear or translucent and vary in viscosity or thickness. They’re available in three forms: (more…)

Read More

The long and short of it: Understanding compression bandaging

By Robyn Bjork, MPT, WCC, CWS, CLT-LANA

Margery Smith, age 82, arrives at your wound clinic for treatment of a shallow, painful ulcer on the lateral aspect of her right lower leg. On examination, you notice weeping and redness of both lower legs, 3+ pitting edema, several blisters, and considerable denude­ment of the periwound skin. She is wearing tennis shoes and her feet have relatively little edema, but her ankles are bulging over the edges of her shoes; both socks are wet. Stemmer’s sign is negative. The wound on the right leg is draining copious amounts of clear fluid; it’s dressed with an alginate, which is secured with conforming roll gauze. No signs or symptoms of infection are present. (more…)

Read More

Clinical Notes: Pressure-Ulcer Data, Diabetic Foot Ulcers, IFG & HbA1c

Hospital pressure-ulcer comparison data not accurate

Performance scores for rates of hospital-acquired pressure ulcers might not be appropriate for comparing hospitals, according to a study in the Annals of Internal Medicine.

Hospital report cards for hospital-acquired pressure ulcers: How good are the grades?,” funded by the Agency for Healthcare Research and Quality, analyzed 2 million all-payer administrative records from 448 California hospitals and quarterly hospital surveillance data from 213 hospitals from the Collaborative Alliance for Nursing Outcomes. (more…)

Read More

Protecting yourself from a job layoff

by Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

With uncertainty over how the Affordable Care Act (ACA) ultimately will affect operations, hospitals and other healthcare facilities are tightening up. In many areas, they’re laying off staff. In May, the healthcare industry lost 9,000 jobs—the worst month for the industry in a decade—and another 4,000 jobs were lost in July.

Medicare, Medicaid, and private insurance companies are reducing reimbursements to care providers, meaning less money is coming in and healthcare facilities have less money to pay out. In my experience, when job cuts are needed, the specialty and subspecialty positions go first. Wound and ostomy care is a subspecialty, so we need to be prepared to protect our jobs—not only for ourselves but for our patients. (more…)

Read More

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…)

Read More

How dietary protein intake promotes wound healing

dietary protein intake promotes wound healing

By Nancy Collins, PhD, RD, LD/N, FAPWCA, and Allison Schnitzer

Nutrition is a critical factor in the wound healing process, with adequate protein intake essential to the successful healing of a wound. Patients with both chronic and acute wounds, such as postsurgical wounds or pressure ulcers, require an increased amount of protein to ensure complete and timely healing of their wounds.

Elderly patients with wounds pose a special challenge because of their decreased lean body mass and the likelihood of chronic illnesses and insufficient dietary protein intake. To promote a full recovery, wound care clinicians must address the increased protein needs of wound patients, especially elderly patients. (more…)

Read More