Device–related pressure ulcers: Avoidable or not?

July 21, 2014February 25, 2020 Wound Care Advisor

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

A medical device–related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace; splint; cast; respiratory mask or tubing; tracheostomy tube, collar, or strap; feeding tube; or a negative-pressure wound therapy device. The golden rule of pressure ulcer treatment is to identify the cause of pressure and remove it. Unfortunately, many of the medical devices are needed to sustain the patient’s life, so they can’t be removed. (more…)

Clinical Notes: Aspirin, Skin Infections, NPWT surgical incisions

July 21, 2014February 25, 2020 Wound Care Advisor

Aspirin inhibits wound healing

A study in the Journal of Experimental Medicine describes how aspirin inhibits wound healing and paves the way for the development of new drugs to promote healing.

The authors of “12-hydroxyheptadecatrienoic (12-HHT) acid promotes epidermal wound healing by accelerating keratinocyte migration via the BLT2 receptor” report that aspirin reduced 12-HHT production, which resulted in delayed wound closure in mice. However, a synthetic leukotriene B4 receptor 2 (BLT2) agonist increased the speed of wound closure in cultured cells and in diabetic mice. (more…)

Confronting conflict with higher-ups

July 21, 2014February 25, 2020 Wound Care Advisor

By Pam Bowers, RN, and Liz Ferron, MSW, LICSW

Conflict in the workplace is a fact of life, and dealing with it is never easy. Sometimes it seems easier to ignore it and hope it will take care of itself. But in healthcare organizations, that’s not a good strategy. Unresolved conflict almost always leads to poor communications, avoidance behavior, and poor working relationships—which can easily affect patient safety and quality of care. (more…)

You want to touch me where?

July 21, 2014February 25, 2020 Wound Care Advisor

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, skills, and certifications, you may encounter problems when wound care requires you to touch the patient in a sensitive or embarrassing area. Touching the patient in these areas is called intimate touch. (more…)

Wound Care Advisor Journal 2014 vol3 no4

Using maggots in wound care: Part 1

Maggot therapy is the controlled, therapeutic application of maggots to a wound. Simple to use, it provides rapid, precise, safe, and powerful debridement. Many wound care professionals don’t provide maggot therapy (also called wound myiasis) because they lack training. But having maggot therapy technology available for patients adds to your capabilities as a wound care provider.

Knowledge of maggot biology and life history helps wound care practitioners optimize therapy and anticipate or prevent problems. Educating patients and colleagues about maggot therapy can reduce stress and simplify your life as a wound care professional, whether you’re a novice or an experienced maggot therapist.

Clinical Notes: Aspirin, Skin Infections, NPWT surgical incisions

Posted: July 21, 2014

Aspirin inhibits wound healing A study in the Journal of Experimental Medicine describes how aspirin inhibits wound healing and paves the way for the development of new drugs to promote healing. The authors of “12-hydroxyheptadecatrienoic (12-HHT) acid promotes epidermal wound healing by accelerating keratinocyte migration via the BLT2 receptor” report that aspirin reduced 12-HHT production, which resulted in delayed wound…

Clinician Resources: Colorectal, ADA, Carbapenem-resistant

Posted: July 21, 2014

Be sure you’re familiar with these valuable resources for you and your patients. Colorectal cancer resources Fight Colorectal Cancer has a comprehensive resource library for patients, including: a link to “My Colon Cancer Coach,” which provides a personalized report to help guide patients in making treatment decisions archives of webinars (past topics include healthy changes that may reduce recurrence, highlights…

Confronting conflict with higher-ups

Posted: July 21, 2014

By Pam Bowers, RN, and Liz Ferron, MSW, LICSW Conflict in the workplace is a fact of life, and dealing with it is never easy. Sometimes it seems easier to ignore it and hope it will take care of itself. But in healthcare organizations, that’s not a good strategy. Unresolved conflict almost always leads to poor communications, avoidance behavior, and…

Creating an effective care plan

Posted: July 21, 2014

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.

Creating effective education programs on a shoestring budget

Posted: July 21, 2014

By Jennifer Oakley, BS, RN, WCC, DWC, OMS It’s time again for annual staff education, and you, the certified wound clinician, need to teach the staff at your organization. You dream of staff entering a state-of-the-art classroom with computers at each station, mannequins, wound anatomy models, and enough products for each student to do hands-on demonstrations. But when you open…

Device–related pressure ulcers: Avoidable or not?

Posted: July 21, 2014

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS A medical device–related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace; splint; cast; respiratory mask or tubing; tracheostomy tube, collar, or strap; feeding tube; or a negative-pressure wound therapy device. The golden rule…

Education vital for successful wound management in the home

Posted: July 21, 2014

By Judy Bearden, MSN/ED, RN Changes in healthcare policy and reimbursement are pushing treatment from the hospital to the community. This shift is likely to result in a higher number of complex wounds being treated in the home, which can create stress for patients and families. Education plays a key role in reducing this stress. This article focuses on education…

How to love and care for yourself unconditionally

Posted: July 21, 2014

By Yolanda G. Smith, MSN, RN, CCRN Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you: have trouble falling or staying asleep? smoke, drink, or eat to reduce tension? have headaches, back pain, or stomach problems? get irritated or upset over insignificant things? have too much to do and too little time…

Using maggots in wound care: Part 1

Posted: July 21, 2014

By: Ronald A. Sherman, MD; Sharon Mendez, RN, CWS; and Catherine McMillan, BA Maggot therapy is the controlled, therapeutic application of maggots to a wound. Simple to use, it provides rapid, precise, safe, and powerful debridement. Many wound care professionals don’t provide maggot therapy (also called wound myiasis) because they lack training. But having maggot therapy technology available for patients…

What you need to know about transparent film dressings

Posted: July 21, 2014

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. Transparent film dressings are thin sheets of transparent polyurethane (polymer) coated with an adhesive. These dressings are available in a variety of sizes and shapes.

You want to touch me where?

Posted: July 21, 2014

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, skills, and certifications, you may encounter problems when wound care requires you to touch the patient in a sensitive or…

2014 Journal: July August Vol. 3 No. 4

Click here to access the digital edition

The DIME approach to peristomal skin care

May 22, 2014February 25, 2020 Wound Care Advisor

By Catherine R. Ratliff, PhD, APRN-BC, CWOCN, CFCN

It’s estimated that about 70% of the 1 million ostomates in the United States and Canada will experience or have experienced stomal or peristomal complications. Peristomal complications are more common, although stomal complications (for example, retraction, stenosis, and mucocutaneous separation) can often contribute to peristomal problems by making it difficult to obtain a secure pouch seal. This article will help you differentiate types of peristomal complications, including how to prevent and manage them. (more…)

Clinical Notes: Pressure Injury Prevention, Diabetes, LIV

May 22, 2014February 25, 2020 Wound Care Advisor

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…)

Understanding therapeutic support surfaces

May 22, 2014February 25, 2020 Wound Care Advisor

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…)

Achieving a work-life balance

March 25, 2014February 25, 2020 Wound Care Advisor

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…)

Clinical Notes: Low BMD, CKD, hypoglycemia, HBOT

March 25, 2014February 25, 2020 Wound Care Advisor

Low BMD common after ostomy

Low bone mineral density (BMD) is common in patients with inflammatory bowel disease who have a stoma placed, according to “Frequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases,” published in Inflammatory Bowel Diseases. (more…)

Managing venous stasis ulcers

January 30, 2014February 25, 2020 Wound Care Advisor

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 and impact. Chronic venous insufficiency (CVI) causes hypertension in the venous system of the legs, leading to various pathologies that involve pain, swelling, edema, skin changes, stasis dermatitis, and ulcers. An estimated 1% of the U.S. population suffers from venous stasis ulcers (VSUs). Causes of VSUs include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. Preventing VSUs is the most important aspect of CVI management. (more…)

Have you made your New Year’s resolutions?

January 30, 2014February 25, 2020 Wound Care Advisor

Aresolution is a serious decision or determination to do, or not to do, something. Traditionally, most New Year’s resolutions focus on self-improvement: losing weight, giving up a bad habit, exercising more, being a better person. Because most of us spend about half of our waking lives at work, perhaps our work lives should be the subject

of some of our resolutions. Here are a few work-related resolutions I’ve come up with: (more…)

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