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Practical Issues in Wound, Skin and Ostomy Management
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…)
Read MoreBy Yolanda G. Smith, MSN, RN, CCRN
Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you:
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…)
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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…
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…
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…
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.
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…
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…
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…
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…
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…
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.
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…
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By Cheryl Ericson, MS, RN, CCDS, CDIP
Providers are often surprised at how pages upon pages of documentation in a patient’s health record can result in few reportable diagnosis and/or procedure codes, which often fail to capture the complexity of the patient’s condition. However, providers need to be aware of the implications of coding. As healthcare data become increasingly digital through initiatives such as meaningful use, coded data not only impact reimbursement but also are increasingly used to represent the quality of care provided. Here’s a closer look at how documentation and coding work in the context of wound care. (more…)
Read MoreBy Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, and Dana Marie Dillard, MS, HSMI
Like many clinicians, you may experience stress frequently, both on and off the job. Chronic stress can alter your equilibrium (homeostasis), activating physiologic reactive pathways that cause your body to shift its priorities. Physiologic effects of stress may include:
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.
The crusting procedure produces a dry surface and absorbs moisture from
broken skin through an artificial scab that’s created by using skin barrier powder (stoma powder) and liquid polymer skin barrier. The crusting procedure is most frequently used on denuded peristomal skin to create a dry surface for adherence of an ostomy pouching system while protecting the peristomal skin from effluent and adhesives. Crusting can increase pouching-system wear time, resulting in fewer pouch changes and less disruption to irritated peristomal skin. The crusting procedure can also be used for other denuded partial-thickness weeping wounds caused by moisture. (more…)
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 smokes a pack and a half of cigarettes daily. She reports she has always been healthy and can’t believe she has had a heart attack. (Note: Name is fictitious.)
On physical exam, the cardiologist finds decreased femoral pulses bilaterally and recommends immediate cardiac catheterization. Fortunately, primary percutaneous coronary intervention (PCI) is readily available at this hospital. PCI is the preferred reperfusion method when it can be provided by skilled cardiologists in a timely manner. (more…)
Read MoreBy 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…)
Read MoreBy: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Years ago, when I first started out in the wound care specialty, the only way to learn about new products and what was going on in the field was to “go to conference” (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasn’t an option; our facility, patients, and administrators needed us to attend. If we didn’t, we’d be way behind our competition in regard to cutting-edge, hot-off-the-press wound care treatments and techniques.
Besides being a forum for displaying new wound care products, conference is an opportunity to network, to see what others are doing—what’s working and what isn’t— and to hear firsthand from researchers. (more…)
Read MoreBy 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…)
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