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Best Practices Posts

  • “Ouch! That hurts!” 

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Wound pain can have a profound effect on a person’s life and is one of the most devastating aspects of living with a wound. In addition to pharmaceutical options, wound care clinicians should consider other key aspects of care that can alleviate pain. Here is a checklist to ensure you are… Read more… 

    Comments: 32 Comments

  • FAQs for pressure ulcer staging 

    pressure ulcer stagingBy Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Staging pressure ulcers can be challenging. Below are some common questions—and answers—about staging. Q. If a pressure ulcer heals (completely epithelialized over), but later reopens at the same site, how should it be staged? A. According to the National Pressure Ulcer Advisory Panel, if a pressureulcer reopens in the same site, the ulcer… Read more… 

    Comments: 29 Comments

  • Is your wound-cleansing practice up to date? 

    wound cleansing practiceBy Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS With so much focus on dressing choices, it’s easy to forget the importance of wound cleansing. Cleaning a wound removes loose debris and planktonic (free-floating) bacteria, provides protection to promote an optimal environment for healing, and facilitates wound assessment by optimizing visualization of the wound. You should clean a wound every… Read more… 

    Comments: 24 Comments

  • What you need to know about hydrogel dressings 

    hydrogel dressingsBy 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 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… Read more… 

    Comments: 10 Comments

  • Managing venous stasis ulcers 

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

    Comments: 9 Comments

  • 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… Read more… 

    Comments: 6 Comments

  • Mission possible: Getting Medicare reimbursement for wound care in acute-care settings 

    By Susan Reinach-Lannan, BSOM In the current healthcare environment, wound care practitioners need to capitalize on all available reimbursement avenues for care delivery and wound care supplies and dressings. And when it comes to reimbursement, there’s one constant: The rules change constantly. Whether these changes always benefit the patient is questionable. Nowhere is this more evident than in acute-care settings.… Read more… 

    Comments: 5 Comments

  • It takes a village: Leading a wound team 

    By Jennifer Oakley, BS, RN, WCC, DWC, OMS I used to think I could do it alone. I took the wound care certification course, passed the certification exam, and took all of my new knowledge—and my new WCC credential—back to the long-term care facility where I worked. I was ready to change the world. It didn’t take me long to… Read more… 

    Comments: 4 Comments

  • Positive Stemmer’s sign yields a definitive lymphedema diagnosis in 10 seconds or less 

    By Robyn Bjork, MPT, CWS, WCC, CLT-LANA In a busy wound clinic, quick and accurate differential diagnosis of edema is essential to appropriate treatment or referral for comprehensive care. According to a 2010 article in American Family Physician, 80% of lower extremity ulcers result from chronic venous insufficiency (CVI). In 2007, the German Bonn Vein Study found 100% of participants… Read more… 

    Comments: 4 Comments

  • Creating an effective care plan 

    By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN The development of a care plan related to skin integrity can be challenging for any clinician. It takes a strong understanding of skin integrity risk factors and knowledge of how to modify, stabilize, and eliminate those risk factors. This article provides tips for the care-planning process. Establish goals A skin integrity care plan… Read more… 

    Comments: 4 Comments

  • A guide to diabetic foot ulcers 

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC This chart (please click the PDF icon to download) explains the differences among ischemic, neuropathic, and neuroischemic diabetic foot ulcers, making it easier for you to select the best treatment for your patient.  View: Diabetic foot exam

    Comments: 3 Comments

  • How to write effective wound care orders 

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Writing effective orders for wound care is vital to ensure patients receive the right care at the right time, to protect yourself from possible litigation, and to facilitate appropriate reimbursement for clinicians and organizations. Below are some overall strategies you can use: • Avoid “blanket” orders, for example, “continue previous treatment”… Read more… 

    Comments: 3 Comments

  • Differentiating lower extremity ulcers 

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Use this handy reference tool to help you assess lower extremity ulcers. You can download a PDF of the tool. Donna Sardina is Editor-in-Chief of Wound Care Advisor and cofounder of the Wound Care Education Institute in Plainfield, Illinois.

    Comments: 3 Comments

  • Turning programs hinder a good night’s sleep 

    By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN We’ve all experienced how a bad night’s sleep can affect our mood and ability to function the next day. Now imagine you’re a patient who has a pressure ulcer, most likely secondary to a declining disease state, and you’re being awakened and manipulated every 2 hours or in some cases hourly. How… Read more… 

    Comments: 2 Comments

  • Preventing pressure ulcers starts on admission 

    By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN The first 24 hours after a patient’s admission are critical in preventing pressure ulcer development or preventing an existing ulcer from worsening. A skin inspection, risk assessment, and temporary care plan should all be implemented during this time frame. Essentially, it’s the burden of the care setting to prove to insurers, regulators,… Read more… 

    Comments: 2 Comments

  • Improving outcomes with noncontact low-frequency ultrasound 

    By Ronnel Alumia, BSN, RN, WCC, CWCN, OMS Achieving excellent wound care outcomes can be challenging, given the growing number of high-risk patients admitted to healthcare facilities today. Many of these patients have comorbidities, such as obesity, diabetes, renal disease, smoking, chronic obstructive pulmonary disease, and poor nutritional status. These conditions reduce wound-healing ability. At the same time patient acuity… Read more… 

    Comments: 2 Comments

  • Debridement options: BEAMS made easy 

    By Cindy Broadus, RN, BSHA, LNHA, CHCRM, CLNC, CLNI, WCC, DWC, OMS At one time or another, all wound care professionals encounter a chronic wound, defined as a wound that fails to heal in an orderly and timely manner. Globally, about 67 million people (1% to 5% of the world’s population) suffer chronic wounds. In the United States, chronic wounds… Read more… 

    Comments: 2 Comments

  • Evolution of the deep tissue injury or a declining pressure ulcer? 

     By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN A declining pressure ulcer decreases the quality of life for patients and places providers at risk for regulatory citations and litigation. But it’s important for clinicians to determine whether the first appearance of skin injury is truly a stage I or II pressure ulcer or if it’s a deep tissue injury (DTI),… Read more… 

    Comments: 2 Comments

  • Bedside ankle-brachial index testing: Time-saving tips 

    By Robyn Bjork, MPT, CWS, WCC, CLT-LANA A hot flush of embarrassment creates a bead of sweat on my forehead. “I’ve got to get this measurement,” I plead to myself. One glance at the clock tells me this bedside ankle-brachial index (ABI) procedure has already taken more than 30 minutes. My stomach sinks as I realize I’ll have to abandon… Read more… 

    Comments: 1 Comment

  • How to choose a digital camera for wound documentation 

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Digital cameras have many helpful features, but the most important considerations for choosing a camera are hardware features. Focus on the following when choosing a camera: Resolution. The resolution determines picture quality. The National Pressure Ulcer Advisory Panel recommends using a digital camera with a minimum of 3 megapixels for wound… Read more… 

    Comments: 1 Comment

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