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Assessment

Assessment

Patient assessment is critical to ensure good wound healing outcomes. A ‘unified patient centred approach’ should be adopted which takes into account the systemic, regional and local factors which may affect wound healing

  1. How to assess wound exudate

    how to assess wound exudateBy Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS Each issue, Apple Bites brings you a tool you can apply in your daily practice. Exudate (drainage), a liquid produced by the body in response to tissue damage, is present… Read more…

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  2. What you need to know about transparent film dressings

    transparent film 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. Transparent film dressings are thin sheets of transparent polyurethane (polymer) coated with an adhesive. These… Read more…

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  3. When and how to culture a chronic wound

    how to culture a chronic woundBy 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… Read more…

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  4. Hidden complications: A case study in peripheral arterial disease

    By Pamela Anderson, MS, RN, APN-BC, CCRN, and Terri Townsend, MA, RN, CCRN-CMC, CVRN-BC Jan Smith, age 59, is admitted to the coronary intensive care unit with an acute inferior myocardial infarction (MI). Recently diagnosed with hypertension and hyperlipidemia, she… Read more…

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  5. Tool Kits

    Click each title to download the tool kit PDF. Alginate Dressing Ankle Brachial Index Diabetes foot examination Debridement Tool Job Task Analysis Lanarkshire Oximetry Index Plan-Do-Study-Act (PDSA) – Cycle Planning Sheet PDSA Cycle Progress Sheet PDSA Reporting Form SBAR wound and…

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  6. What’s causing your patient’s lower-extremity redness?

    patient lower extremity rednessBy Robyn Bjork, MPT, CWS, WCC, CLT-LANA The ability to understand or “read” lower-extremity redness in your patient is essential to determining its cause and providing effective treatment. Redness can occur in multiple conditions—hemosiderin staining, lipodermatosclerosis, venous dermatitis, chronic inflammation,… Read more…

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  7. Clinical Notes: Revascularization, Amputation Risk Score

    Amputation Risk ScoreLeg revascularization fails to improve outcomes in nursing home patients Lower-extremity revascularization often fails to improve outcomes in nursing home patients, according to an article in JAMA Internal Medicine. “Functional outcomes after lower extremity revascularization in nursing home residents: A… Read more…

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  8. Comprehensive skin assessment

    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. Here’s an overview of performing a comprehensive skin assessment. In the healthcare setting, a comprehensive… Read more…

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  9. Immobility as the root cause of pressure ulcers

    By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN Many factors can contribute to the formation of a pressure ulcer, but it’s rare that one develops in an active, mobile patient. As the National Pressure Ulcer Advisory Panel 2014 guidelines state,… Read more…

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  10. Clinician Resources: Nutrition, Treatment Algorithms, Pressure Ulcer Prevention

    Check out these resources for your practice. Be a nutrition champion One in three patients enters a hospital malnourished. Fight malnutrition by viewing six short videos from the Alliance to Advance Patient Nutrition, including “Rapidly Implement Nutrition Interventions” and “Recognize… Read more…

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  11. You want to touch me where?

    By Debra Clair, PhD, APRN, WOCN, WCC, DWC Providing wound care requires a great deal of knowledge and skill. To become a wound care nurse entails taking classes, gaining and maintaining certifications, and acquiring on-the-job experience. But despite your education, knowledge,… Read more…

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  12. 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… Read more…

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  13. Knowing when to ask for help

    As a wound care expert, you’re probably consulted for every eruption, scrape, and opening in a patient’s skin. Occasionally during a patient assessment, you may scratch your head and ask yourself, “What is this? I’ve never seen anything like it.”… Read more…

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  14. Clinician Resources: MRSA, Dosing Calculator, CDC Resources

    Special edition: Resources from the Buzz Report This issue, we highlight some resources from “The Buzz Report,” the popular presentation given by editor-in-chief Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS, at the Wild On Wounds (WOW) conference, held each September… Read more…

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  15. Providing skin care for bariatric patients

    Providing skin care for bariatric patientsBy 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… Read more…

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  16. Seeing healthcare from a new perspective

    By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS As healthcare clinicians, our world is full of tasks to be completed. Some are new, but many are tasks we repeat every day and thus have become routine—things we could almost… Read more…

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  17. Caution: Checklists may lead to inaccurate documentation

    Using a checklist form to document wound care can make the task easier and faster—and help ensure that you’ve captured all pertinent data needed for assessment, reimbursement, and legal support. But the form itself may not be comprehensive; some important fields may be missing. Recently, we at… Read more…

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  18. Cutaneous candidiasis

    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. Here’s an overview of cutaneous candi­diasis. Cutaneous candidiasis is an infection of the skin caused… Read more…

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  19. Time to select a support surface

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Having the proper support surface for beds and wheelchairs is imperative in preventing pressure ulcers. “Pressure” ulcers are named that for a reason—pressure is the primary cause of interruption of blood… Read more…

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  20. Clinician Resources: OSHA, Education Program, Civil Workplace

    This issue we focus on resources to help clinicians protect themselves from injuries and engage in a healthier lifestyle. OSHA safety website A hospital is one of the most hazardous places to work, according to the Occupational Safety and Health Administration (OSHA). The agency provides… Read more…

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  21. Clinical Notes: ostomy, pressure ulcer, burn treatment

    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… Read more…

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  22. Prove the Value Program

    Click here to download the PDF.

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  23. Is your therapy department on board with your wound care team?

    therapy department wound careBy Cheryl Robillard, PT, WCC, CLT, DWC Patients in your clinical practice who develop wounds should prompt a call for “all hands on deck” to manage the situation, but some personnel may be missing the boat. Physical therapists (PTs), occupational… Read more…

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  24. No more skin tears

    Imagine watching your skin tear, bleed, and turn purple. Imagine, too, the pain and disfigurement you’d feel. What if you had to live through this experience repeatedly? That’s what many elderly people go through, suffering with skin tears through no fault of their own. Some go on… Read more…

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  25. Linear wound measurement basics

    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. Measurement of wounds is an important component of wound assessment and provides baseline measurements, enables… Read more…

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  26. Assessing footwear in patients with diabetes

    Inappropriate footwear is the most common source of trauma in patients with diabetes. Frequent and proper assessment of appropriate footwear is essential for protecting the diabetic foot from ulceration. Here is a step-by-step process for evaluating footwear. Be sure to evaluate footwear with the patient walking, standing, and… Read more…

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  27. Helping patients overcome ostomy challenges

    By Beth Hoffmire Heideman, MSN, RN No one wants an ostomy, but sometimes it’s required to save a patient’s life. As ostomy specialists, our role is to assess and intervene for patients with a stoma or an ostomy to enhance… Read more…

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  28. Clinical Notes: biofilm, bariatric surgery, statins and more

    Management of biofilm recommendations The Journal of Wound Care has published “Recommendations for the management of biofilm: a consensus document,” developed through the Italian Nursing Wound Healing Society. The panel that created the document identified 10 interventions strongly recommended for clinical practice; however, panel members noted that, “there… Read more…

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  29. Providing evidence-based care for patients with lower-extremity cellulitis

    By Darlene Hanson, PhD, RN; Diane Langemo, PhD, RN, FAAN; Patricia Thompson, MS, RN; Julie Anderson, PhD, RN; and Keith Swanson, MD Cellulitis is an acute, painful, and potentially serious spreading bacterial skin infection that affects mainly the subcutaneous and… Read more…

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  30. Balancing the wheels of life

    Have you ever ridden a bicycle with a wobbly wheel? The ride isn’t smooth, and you notice every bump in the road. As you focus on your discomfort, you may be distracted from the beautiful vistas you’re riding past. Think of the bicycle as your… Read more…

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  31. Wound Photography – How it Benefits Clinical Documentation

    wound photographyAccurate assessment and documentation of wounds is essential for developing a comprehensive plan of care. Photography now plays a key role in wound care. The use of digital photography has enhanced the reliability and accuracy of wound documentation. Though a wound assessment… Read more…

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  32. Accuracy of the Ankle-brachial Index in the Assessment of Arterial Perfusion of Heel Pressure Injuries

    Abstract: Background. The evaluation and treatment of heel pressure injuries are a significant and expensive sequela of the aging population. Although the workup of patients with lower extremity tissue loss usually involves an assessment of the arterial blood flow by means… Read more…

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  33. Understanding NPUAP’s updates to pressure ulcer terminology and staging

    On April 13, 2016, the National Pressure Ulcer Advisory Panel (NPUAP) announced changes in pressure ulcer terminology and staging definitions. Providers can adapt NPUAP’s changes for their clinical practice and documentation, but it’s important to note that, as of press time, the Centers for Medicare & Medicaid… Read more…

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  34. Pressure Injury Prevention: Managing Shear and Friction

    pressure injury interventionLet us start off this post with a typical scenario. You walk into any facility or institution and you see a patient slouched in their wheelchair, with no wheelchair cushion. You notice part of their brief hanging out of the… Read more…

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  35. Lymphedema and lipedema: What every wound care clinician should know

    Imagine you have a health condition that affects your life every day. Then imagine being told nothing can be done about it; you’ll just have to live with it. Or worse yet, your physician tells you the problem is “you’re just fat.” Many people with… Read more…

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  36. Buzz Report: Latest trends, Part 1

    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… Read more…

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  37. Pros and cons of hydrocolloid dressings for diabetic foot ulcers

    Pros Cons Hydrocolloid Foot UlcersDiabetic foot ulcers stem from multiple factors, including peripheral neuropathy, high plantar pressures, decreased vascularity, and impaired wound healing. Contributing significantly to morbidity, they may cause limb loss and death. (See Foot ulcers and diabetes.) Initially, hydrocolloid dressings were developed… Read more…

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  38. Medications and wound healing

    Each issue, Apple Bites brings you a tool you can apply in your daily practice. Here are examples of medications that can affect wound healing. Assessment and care planning for wound healing should include a thorough review of the individual’s… Read more…

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  39. Case study: Peristomal pyoderma gangrenosum

    As a wound care specialist, you have learned about many skin conditions, some so unusual and rare that you probably thought you would never observe them. I’ve been a nurse for 38 years, with the last 10 years in wound… Read more…

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  40. 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… Read more…

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  41. More from The Buzz Report: A wound care clinician’s best friend

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS 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… Read more…

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  42. Finding common ground: Surviving wound care communication

    By Jennifer Oakley, BS, RN, WCC, DWC, OMS The author describes how to overcome challenges to effective communication in the healthcare setting. Accurate communication among healthcare professionals can spell the difference between patient safety and patient harm. Communication can be… Read more…

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  43. Palliative wound care: Part 2

    This approach brings patient-centered care to life.  By Gail Rogers Hebert, MS, RN, CWCN, WCC, DWC, OMS, LNHA Editor’s note: This article is the second in a two-part series on palliative wound care. For the first part, click here. By… Read more…

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  44. Preventing pressure ulcers in pediatric patients

    By Roxana Reyna, BSN, RNC-NIC, WCC, CWOCN As wound care clinicians, we are trained—and expected—to help heal wounds in patients of any age and to achieve positive outcomes. Basic wound-healing principles apply to all patients, whatever their age or size.… Read more…

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  45. A collaborative approach to wound care and lymphedema therapy: Part 2

    By Erin Fazzari, MPT, CLT, CWS, DWC Have you seen legs like these in your practice? These legs show lymphedema and chronic wounds before treatment (left image) and after treatment (right image) with complex decongestive therapy (CDT)—the gold standard of… Read more…

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  46. What exactly are “the rules”?

    By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Editor-in-Chief During a recent wound care presentation, an audience member jumped up to contradict the speaker. “That is incorrect,” she asserted. “The rules state….” When someone asked her what rules she… Read more…

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