Nurses and therapists often wonder if their license permits them to perform sharp wound debridement. Scope of practice varies significantly from state to state, so it’s imperative to check your state for specific guidance, but we can address some of the challenges clinicians face in deciding whether they can perform this valuable service for patients.
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Instill instead: Negative pressure wound therapy with instillation for complex wounds
Negative pressure wound therapy (NPWT) uses negative pressure to draw wound edges together, remove edema and infectious material, and promote perfusion and granulation tissue development. The tissue stretch and compression created by negative pressure during NPWT promotes tissue perfusion and granulation tissue development through angiogenesis, cellular proliferation, fibroblast migration, increased production of wound healing proteins, and reduction of wound area. NPWT has been used to improve healing in a variety of wounds, including traumatic injuries, surgical wounds, pressure ulcers, diabetic foot ulcers, and venous stasis ulcers. (more…)
Read MoreAssessing 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 sitting. (more…)
Read MoreDoing it cheaply vs. doing what’s best for patients
Sad but true: Much of what we do as healthcare professionals is based on reimbursement. For nearly all the services and products we use in wound care and ostomy management, Medicare, Medicaid, and insurance companies control reimbursement. For many years, these payers have been deciding which interventions, medications, products, and equipment are the best, and then reimbursing only for those items. If we want to use something not on the list, we—or our patients—will have to pay for it out of pocket. (more…)
Read MoreClinical 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 is a paucity of reliable, well-conducted clinical trials which have produced clear evidence related to the effects of biofilm presence.” (more…)
Read More2015 Journal: November – December Vol. 4 No. 6
2016 Journal: March – April Vol. 5 No. 2
2016 Journal: January – February Vol. 5 No. 1
Note from Executive Director—May/June 2016
In the first article of this series, I shared how the NAWCO Certification Committee works. Although it was only a brief overview, I hope it gave you an idea of the work this talented group of individuals does. In this article, I will continue to introduce you to the 15 members of the committee. (more…)
Read MoreClinician 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 a wealth of information on how to protect hospital workers as part of its website Worker Safety in Hospitals: Caring for Our Caregivers. PDF resources include:
• A fact sheet that helps dispel myths, barriers, and concerns related to safe patient handling
• Information on making the case for safe patient handling programs (more…)
Read More10 tips for a successful professional conference
Attending a professional conference can yield many benefits if you follow these 10 tips.
1 Obtain new knowledge. Conferences provide opportunities for clinicians to gain new knowledge about procedures, technology, and research. Take notes and keep handouts for reference. After you return, share what you have learned with colleagues so multiple people benefit from the conference. Remember to complete the necessary information to obtain professional continuing education (CE) credit.
2 Become certified. Conferences typically provide opportunities for attendees to take certification exams or attend sessions to prepare for exams. If you’re planning to take a certification test, obtain test blue prints at the conference or attend a pre- or post-conference session that focuses on the certification exam. If you’re ready to test, sign up before the conference so you can become certified while you’re away. (more…)
Read MoreUnderstanding radiation dermatitis
According to the National Cancer Institute, an estimated 1.6 million new cases of cancer will have been diagnosed in the United States in 2015. During the course of their disease, most cancer patients receive radiation therapy.
Delivering high energy in the form of waves or particles, radiation therapy alters the DNA of cancer cells, causing their death. Radiation can be administered either externally or internally (through materials placed into the body). It’s given in fraction doses, with the total recommended dose divided into daily amounts. Treatment, including the total dose, is determined on an individual basis.
Although improvements have been made in delivery of radiation therapy, approximately 95% of patients who receive it experience a skin reaction. What’s more, radiation therapy commonly is given concurrently with chemotherapy or targeted therapy to improve survival, which increases the toxicity risk. (more…)
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