Clinical Notes: Moldable Skin Barrier, hypoglycemia, diabetic food ulcers

Moldable skin barrier effective for elderly patients with ostomy

A study in Gastroenterology Nursing reports that compared to a conventional skin barrier, a moldable skin barrier significantly improves self-care satisfaction scores in elderly patients who have a stoma. The moldable skin barrier also caused less irritant dermatitis and the costs for leakage-proof cream were lower.

“The application of a moldable skin barrier in the self-care of elderly ostomy patients” included 104 patients ages 65 to 79 who had a colostomy because of colorectal cancer.

Risk factors for severe hypoglycemia in older adults with diabetes identified

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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 guide that can be saved and easily accessed from a mobile device to assist providers with essential information in the healthcare setting. (more…)

Self-management ostomy program improves HRQOL

A five-session ostomy self-care program with a curriculum based on the Chronic Care Model can improve health-related quality of life (HRQOL), according to a study in Psycho-Oncology.

“A chronic care ostomy self-management program for cancer survivors” describes results from a longitudinal pilot study of 38 people. Participants reported sustained improvements in patient activation, self-efficacy, total HRQOL, and physical and social well-being. Most patients had a history of rectal cancer (60.5%) or bladder cancer (28.9%). (more…)

Being positive in a negative situation is not naïve. It’s leadership.

— Ralph S. Marston, Jr., author and

publisher of The Daily Motivator website

Clinicians may encounter many challenges and stressors in the workplace—long hours, rotating shifts, inadequate staffing, poor teamwork, and pressure to achieve higher performance levels in an emotionally and physically demanding field.

But hope exists. Positive psychology uses scientific understanding and interventions to help people achieve a more satisfactory life. Positive psychologists have shown that building positive emotions can change the way we approach and view our environment, helping us become healthier, happier, and more resilient and helping employees and teams become more productive and engaged. (more…)

At the 2015 Wild on Wounds conference, the interactive workshop “Are You Ready for an Outpatient Reimbursement Challenge?” featured a lively discussion among participants about 25 real-life reimbursement scenarios. Here are the top 10 questions the attendees asked, with the answers I provided.

Q Why is it necessary for qualified healthcare professionals (QHPs) such as physicians, podiatrists, nurse practitioners, physician assistants, and clinical nurse specialists to identify the place of service where they provide wound care services and to correctly state the place of service on their claim forms? (more…)

We all lead busy lives, with demanding work schedules and home responsibilities that can thwart our best intentions. Although we know it’s our responsibility to stay abreast of changes in our field, we may feel overwhelmed when we try to make that happen.

Keeping clinicians up-to-date on clinical knowledge is one of the main goals of the Wild On Wounds (WOW) conference, held each September in Las Vegas. Each year, I present the opening session of this conference, called “The Buzz Report,” which focuses on the latest-breaking wound care news—what’s new, what’s now, what’s coming up. I discuss innovative new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management. This article highlights the hottest topics from my 2015 Buzz Report. (more…)

Value of systematic reviews and meta-analyses in wound care

“Systematic reviews and meta-analyses—literature-based recommendations for evaluating strengths, weaknesses, and clinical value,” in Ostomy Wound Management, discusses evidence-based practice and how systematic reviews (SRs) and meta-analyses (MAs) can help improve management of wound care patients.

The authors of the article explain evidence-based practice and provide useful definitions for key terms. They then provide a list of eight questions to use when evaluating SRs and practical tips such as how to search for SR and MA studies. The article finishes with a list of eight interventions supported by the most evidence: hydrocolloidal dressings, honey, biosynthetic dressings, iodine complexes, silver compounds, hydrogels, foam dressings, and negative pressure wound therapy. (more…)

Immobility affects all our body systems, including our skin. According to the National Pressure Ulcer Advisory Panel, many contributing factors are associated with the formation of a pressure ulcer, with impaired mobility leading the list.

So what can clinicians do to prevent harm caused by immobility? One often-overlooked strategy is a restorative nursing program. (See About restorative nursing.)

Moving up the time line

Most patients who score poorly for mobility and/or activity impairments on the Braden Scale for Predicting Pressure Ulcer Risk are referred to physical therapy, but too often a restorative nursing program (more…)

Start the New Year off right by checking out these resources.

Pressure ulcer prevention education

Access the following education resources from Wounds International:

The webinar “Real-world solutions for pressure ulcer prevention: Optimising the role of support surfaces” includes:

• an overview of the issue of pressure ulcers

• what to consider when choosing a support surface

• how to operationalize support surfaces in the clinical setting. (more…)

Modified Braden risk score proposed

A study in Ostomy Wound Management states the risk classification of patients using Braden Scale scores should comprise three (rather than five) levels: high risk, with a total score ≤11; moderate risk, with a total score of 12 to 16; and mild risk, with a total score ≥17.

The retrospective analysis of consecutively admitted patients at risk for pressure ulcer to an acute-care facility included 2,625 patients, with an age range from 1 month to 98 years; 3.1% developed a pressure ulcer. (more…)

Providing skin care for bariatric patients

By Gail R. Hebert, MS, RN CWCN, DWC, WCC, OMS

How would you react if you heard a 600-lb patient was being admitted to your unit? Some healthcare professionals would feel anxious—perhaps because they’ve heard bariatric patients are challenging to care for, or they feel unprepared to provide their care. (more…)

Role of the ostomy specialist clinician in ileal pouch anal anastomosis surgery

By Leanne Richbourg, MSN, RN, APRN-BC, CWON-AP, CCCN, GCNS-BC

Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is the gold standard for surgical treatment of ulcerative colitis (UC) or familial adenomatous polyposis (FAP). It’s also done to treat colon and rectal cancers, such as those caused by Lynch syndrome (LS). IPAA allows the patient to maintain fecal continence and evacuate stool from the anus after colon and rectum removal. A temporary ileostomy may be part of the overall process, but there’s no need for a permanent stoma. (See Understanding ulcerative colitis, FAP, and Lynch syndrome.) (more…)

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Category: Ostomy

Clinical Notes: Moldable Skin Barrier, hypoglycemia, diabetic food ulcers

Moldable skin barrier effective for elderly patients with ostomy

Risk factors for severe hypoglycemia in older adults with diabetes identified

Clinician Resources: human trafficking, npuap, caregiver, ostomy, HIV

Clinical Notes: ostomy, pressure ulcer, burn treatment

Self-management ostomy program improves HRQOL

The power of the positive

Top 10 outpatient reimbursement questions

Buzz Report: Latest trends, Part 1

Clincal Notes: Analysis, Osteomyelitis, sickle cell, maggot

Restorative nursing programs help prevent pressure ulcers

Clinician Resources: Ulcer Prevention, CAUTI, Negative Bacteria

Clinical Notes: Modified Braden Risk Score, dialysis patients, plantar

Modified Braden risk score proposed

Providing skin care for bariatric patients

Role of the ostomy specialist clinician in ileal pouch anal anastomosis surgery