Clinical Notes: Pressure Injury Prevention, Diabetes, LIV

Incidence density best measure of pressure-ulcer prevention program

According to the National Pressure Ulcer Advisory Panel (NPUAP), incidence density is the best quality measure of pressure-ulcer prevention programs. Pressure-ulcer incidence density is calculated by dividing the number of inpatients who develop a new pressure ulcer by 1,000 patient days. Using the larger denominator of patient days allows fair comparisons between institutions of all sizes. (more…)

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I’m going to conference!

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

Years ago, when I first started out in the wound care specialty, the only way to learn about new products and what was going on in the field was to “go to conference” (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasn’t an option; our facility, patients, and administrators needed us to attend. If we didn’t, we’d be way behind our competition in regard to cutting-edge, hot-off-the-press wound care treatments and techniques.

Besides being a forum for displaying new wound care products, conference is an opportunity to network, to see what others are doing—what’s working and what isn’t— and to hear firsthand from researchers. (more…)

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Understanding therapeutic support surfaces

By Rosalyn S. Jordan, BSN, RN, MSc, CWOCN, WCC, and Sandra Phipps, BSN, RN, MBA, WCC

Pressure-ulcer prevention and management guidelines recommend support-surface therapy to help prevent and treat pressure ulcers. Support surfaces include pads, mattresses, and cushions that redistribute pressure. Full cushions and cushion pads are considered therapeutic support surfaces if used to redistribute a patient’s pressure in a chair or wheelchair.

The National Pressure Ulcer Advisory Panel (NPUAP) defines support surfaces as “specialized devices for pressure redistribution designed for the management of tissue loads, microclimate, and/or other therapeutic functions.” These surfaces address the mechanical forces associated with skin and tissue injury, such as pressure, shear, friction, and excess moisture and heat. (See Clearing up the confusion.) (more…)

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Clinician Resources: Patient Safety, Ostomy, Wound Management

This issue’s resources include patient tools and new guidelines.

Improving patient safety

Research suggests that adverse events affect patients with limited English proficiency (LEP) more frequently, are commonly caused by communication problems, and are more likely to result in serious harm compared to adverse events affecting English-speaking patients. Your hospital can take steps to reduce risks of adverse events for patients with LEP with “Improving patient safety systems for patients with limited english proficiency: a guide for hospitals,” from The Disparities Solutions Center, Mongan Institute for Health Policy at Massachusetts General Hospital, Boston, and Abt Associates, Cambridge, Massachusetts. (more…)

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A Saudi rehabilitation facility fights pressure ulcers

Sultan Bin Abdulaziz Humanitarian City

By Joanne Aspiras Jovero, BSEd, BSN, RN; Hussam Al-Nusair, MSc Critical Care, ANP, RN; and Marilou Manarang, BSN, RN

A common problem in long-term care facilities, pressure ulcers are linked to prolonged hospitalization, pain, social isolation, sepsis, and death. This article explains how a Middle East rehabilitation facility battles pressure ulcers with the latest evidence-based practices, continual staff education, and policy and procedure updates. Sultan Bin Abdulaziz Humanitarian City (SBAHC) in Riyadh, Saudi Arabia, uses an interdisciplinary approach to address pressure-ulcer prevention and management. This article describes the programs, strategies, and preventive measures that have reduced pressure-ulcer incidence. (more…)

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NAWCO News

A letter from one of our own

I am writing this letter to share the sense of honor and privilege I felt in working with the National Alliance of Wound Care and Ostomy (NAWCO) to organize the first Eastern Region WCC Conference during the Fall of 2013. What an experience! In addition to representing a top-notch organization, I increased my knowledge of wound care and its products dramatically and met many amazing clinicians on the same journey.
Traveling from seven states and a wide variety of care settings, nearly 100 wound care clinicians came together with the common goal of enhancing their ability to make a difference in the lives of their patients. We launched the process of forming a vital clinician network that will allow us to share product and procedure information and experiences, leverage the information in our individual care settings, and strengthen the wound care knowledge of our peers.

Throughout this experience, I talked with dozens of local wound care product representatives. Like the clinicians, they provided a wealth of wound care insights. I encourage clinicians to reach out to these “best friends” of wound care and take advantage of their depth of knowledge.

I am passionate about advocating proper wound care, and if I can help disseminate wound treatment knowledge to other clinicians in support of their patients, I need no better reward.

Finally, the opportunity to represent NAWCO filled me with pride because of the respect I have for its vision. I believe in the importance of continuing education, furthering knowledge, and ensuring expertise through a certification process that is based on solid, research-based wound care. My hope is to represent NAWCO in the future.
Thank you for this exciting opportunity!

Sincerely,
Janie Hollenbach, RN, WCC, OMS,
DAPWCA, FACCWS

NAWCO names new executive director

The National Alliance of Wound Care and Ostomy (NAWCO), the largest wound care and ostomy certification organization in the United States, is pleased to announce that Cynthia (Cindy) Broadus, RN, BSHA, LNHA, CLNC, CHRM, WCC, DWC, OMS, was named executive director effective February 1, 2014.

Ms. Broadus brings a wealth of experience and knowledge to the organization. She has excelled for over 2 decades in specialty nursing care, litigation, corporate management, and company development. She joins the organization at a time of exciting change and will be instrumental in achieving accreditation that will provide national and international recognition for NAWCO.

“I am excited to be a part of such a great organization and supporting the efforts of the close-knit community that makes up the NAWCO certificants,” Ms. Broadus says.

Read the full press release.

DISCLAIMER: 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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Guidelines for safe negative-pressure wound therapy

safe negative-pressure wound therapy

By Ron Rock MSN, RN, ACNS-BC

Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT) has become a leading technology in the care and management of acute, chronic, dehisced, traumatic wounds; pressure ulcers; diabetic ulcers; orthopedic trauma; skin flaps; and grafts. NPWT applies controlled suction to a wound using a suction pump that delivers intermittent, continuous, or variable negative pressure evenly through a wound filler (foam or gauze). Drainage tubing adheres to an occlusive transparent dressing; drainage is removed through the tubing into a collection canister. NWPT increases local vascularity and oxygenation of the wound bed and reduces edema by removing wound fluid, exudate, and bacteria. (more…)

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Clinician Resources: Intl Ostomy Assoc., Substance Use Disorder

Take a few minutes to check out this potpourri of resources.

International Ostomy Association

The International Ostomy Association is an association of regional ostomy associations that is committed to improving the lives of ostomates. Resources on the association’s website include:

  • a variety of discussion groups
  • information for patients
  • list of helpful links.

The site also provides contact information for the regional associations. (more…)

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Medicare reimbursement for hyperbaric oxygen therapy

hyperbaric oxygen therapy

By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA

In an atmosphere of changing reimbursement, it’s important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities won’t receive appropriate reimbursement for provided services. This article focuses on Medicare reimbursement for hyperbaric oxygen therapy (HBOT). (See What is hyperbaric oxygen therapy?)

Indications and documentation requirements

(more…)

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Achieving a work-life balance

Nurse Work Life Balance

By Julie Boertje, MS, RN, LMFT, QMRP, and Liz Ferron, MSW, LICSW

Almost everyone agrees that achieving a work-life balance is a good thing. Without it, we risk long-term negative effects on our physical and mental health, our relationships, and our work performance. But many clinicians have a hard time achieving this balance due to job demands, erratic work schedules, or the inability to say no when someone asks for help.

The challenges of stress and burnout

Stress and job burnout can cause, contribute to, or result from a poor work-life balance. They disrupt our normal patterns, behaviors, and feelings.

Of course, no one can escape stress altogether. Sometimes stress is a good thing, but we need to be able to identify when it’s a problem. For many clinicians, stress springs from the desire to provide good service and care in all parts of their lives. This desire can create stress, especially when barriers exist to achieving it. (more…)

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