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Practical Issues in Wound, Skin and Ostomy Management
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A new study shows a clear association between the prophylactic use of five-layer foam sacral dressings and reductions in pressure injury rates. Specifically, the study looked at the prophylactic use of Mölnlycke’s Mepilex® Border Sacrum dressing in the acute care setting over a six-year period (2010-2015). (more…)
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Antibiotic overuse contributes to the problems of antibiotic resistance and healthcare acquired infections, such as Clostridium difficile. Antibiotic stewardship programs improve patient outcomes, reduce antimicrobial resistance, and save money. These programs are designed to ensure patients receive the right antibiotic, at the right dose, at the right time, and for the right duration. (more…)
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Although it is described as “one of society’s greatest achievements,” with the aging population, cancer incidence is expected to accelerate rapidly, as 50% of cancer occurs within this age group.(1)
Nutrition therapy is a crucial component of cancer care. Early and continuous nutrition management is necessary to avoid malnutrition, as this is associated with poor clinical outcomes.(2) Often, the elderly already face chronic comorbid conditions, such as high blood pressure, heart disease, lung disease, diabetes, kidney disease, bone disease and arthritis, further complicating their care.(3) (more…)
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This 30-minute presentation features learning opportunities that will provide in-depth instruction and demonstration in wound care treatments. After this webinar, the learner will be able to:
This 30-minute presentation features learning opportunities that will provide in-depth instruction and demonstration in wound care treatments. After this webinar, the learner will be able to:
Tips for how to differentiate and goals for protection and management. At the end of the webinar you will be able to:
"Skin tears" may sound like a relatively minor event, but in reality, these injuries can have a significant impact on the quality of patients' lives in the form of pain, infection, and limited mobility.
The incidence of skin tears has been reported to be as high as 1.5 million annually, and with an aging population, this number is likely to go higher.
In this webinar, experts will explain how nurses can use an evidence-based approach -- including following practice guidelines to assess the wound and select the proper dressing -- for managing skin tears and minimizing their negative effects.
One of many dreaded tags from a Centers for Medicare & Medicaid Survey is F-Tag 314 — Pressure ulcers.
CMS writes, “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.” (more…)
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by Dr. Michael Miller
For those of you not as familiar with the Hoosier State as you should be, I used to think it was essentially paradise. Jim Nabors of Gomer Pyle fame is our ubiquitous, tuneful icon with his always well-received “Back Home in Indiana” as a mantra to that source of pride. Our former Governor “My Man” Mitch Daniels was a genius who, using a combination of intelligence, common sense and the persuasive powers of a midwest Svengali, created an economic model that our neighbors can only lust after. Our medicolegal climate is among the best in the US and well it should be. However, while there are some extraordinary caregivers and facilities here, a recent US News and World Report curiously showed that almost none of our hospitals made their “Best of” lists in any category. That is not to say there is bad care but to not have a single facility in an entire state even achieve an honorable mention gives one pause to reflect. The State newspapers were notoriously quiet on this concerning fact despite their trumpeting of who does what well, when and where. (more…)
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Around 6.5 million patients in the U.S. suffer from chronic wounds, such as pressure injuries or ulcers. Treatment costs $25 billion each year, representing a sizable and growing problem. Despite the wide impact of chronic wounds, it’s rare to see specialized, effective wound care delivered across the care continuum.
A chronic non-healing wound is a surrogate marker for illness. These patients require holistic management of their co-morbidities and continuity across care settings.
Despite this, a great deal of emphasis has been placed on treating wounds as singular events, managed topically with expensive dressings and support surfaces. This is only a small part of wound healing.
As a physician focused solely on wound care, I have learned that we must shift the focus from simply treating the wound to treating the wounded patient. The impact in the post-acute care setting in particular is worthy of evaluation and discussion, as up to 29% of patients in long-term care facilities will experience a pressure ulcer, posing serious legal, financial, and staffing implications.
For those providers working outside long-term care, there is little understanding of challenges facing LTC providers. Acute providers do not often ask, for example, how are my LTC partners reimbursed? How are they staffed? What are the requirements and regulatory pressures they face? Asking these questions would facilitate a more productive dialogue with a focus on collaborative prevention, rather than waiting until a chronic wound occurs in the LTC setting.
Creating an integrated wound care community
To address the needs of the present and growing population of patients with chronic wounds, Healogics developed an integrated wound care community model, to coordinate the wound healing process across all care settings. The program utilizes Healogics Specialty Physicians, a subspecialty group of physicians and providers with extensive training solely focused on wound care.
HSPs provide expert inpatient consultation and ensure safe transition of patients out of the hospital into the appropriate care setting. Because HSPs see the patient regardless of post-discharge venue, patients receive the same quality of care whether they are going home, to a skilled-nursing, assisted living, or LTC setting. Because chronic wounds are surrogate markers for illness, we have realized it’s essential to have an integrated, multi-setting, and multi-disciplinary process to treat the patient and their co-morbidities.
Data collected at a pilot IWCC site in the Midwestern U.S. from 2014 to 2016 revealed very positive trends for chronic wound patients. In the acute care setting, the average length of stay decreased from 9.41 days to 5.64 days, and total cost of care per patient was reduced from $10,670 to $7,248.
We’re excited by these promising results, which were revealed at the American College of Wound Healing and Tissue Repair Conference last December. We look forward to refining and expanding the model by helping our partners in acute and LTC settings standardize their practices, use evidence-based clinical guidelines, mobilize technologies and processes, and pay critical attention to patient safety and value-based outcomes.
When it comes to wound healing, no venue of care should operate alone—an integrated solution that creates continuity for the patient is critical. There are four things LTC facilities can do to break down the silos:
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Washington, D.C. – The National Pressure Ulcer Advisory Panel (NPUAP) announced the convening of its subcommittee, the Support Surface Standards Initiative (S3I), this spring to approve new standards tests that may help prevent pressure injuries in bed-bound individuals. 
