Clinician Resources: OSHA, Education Program, Civil Workplace

July 1, 2016February 25, 2020 Wound Care Advisor

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…)

Wise use of antibiotics in patients with wound infections

July 1, 2016February 25, 2020 Wound Care Advisor

Antibiotic resistance is a pressing public health threat not only in the United States, but worldwide. According to the World Health Organization (WHO), it is one of the major threats to human health.

Despite these concerns, antibiotics continue to be widely used—and overused. In long-term care, for instance, antibiotics are the most frequently prescribed medications, with as many as 70% of residents receiving one or more courses per year. And antibiotics are consistently ordered for suspected pressure ulcer infections.

Here is what clinicians who care for patients with wounds can do to help reduce antibiotic resistance. (more…)

Understanding radiation dermatitis

July 1, 2016February 25, 2020 Wound Care Advisor

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…)

Pros and cons of hydrocolloid dressings for diabetic foot ulcers

January 28, 2016February 25, 2020 Wound Care Advisor

Diabetic 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 to function as part of the stomal flange. Based on their success in protecting peristomal skin, they were introduced gradually into other areas of wound care. They contain wafers of gel-forming polymers, such as gelatin, pectin, and cellulose agents, within a flexible water-resistant outer layer. The wafers absorb wound exudate, forming a gel and creating a moist healing environment. (more…)

Empowering patients to play an active role in pressure ulcer prevention

January 28, 2016February 25, 2020 Wound Care Advisor

Developing a pressure ulcer can cause the patient pain, lead to social isolation, result in reduced mobility, and can even be fatal. According to the Agency for Healthcare Research and Quality, estimated costs for each pressure ulcer range from $37,800 to $70,000, and the total annual cost of pressure ulcers in the United States is an estimated $11 billion.

Nurses understand their role in preventing pressure ulcers, but what role do patients play in the prevention plan? Nurses need to empower the patient to be an active member in health promotion activities and participate in prevention measures. In this article, I highlight the importance of incorporating pressure ulcer prevention into patient education for high-risk patients as a way to empower patients. Empowered patients can help improve outcomes and reduce overall costs of this hospital-acquired complication. (more…)

Case study: Peristomal pyoderma gangrenosum

January 28, 2016February 25, 2020 Wound Care Advisor

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 care, and that’s certainly what I thought. But I was wrong. Let me tell you about my challenging patient with an unusual skin condition.

A perplexing patient (more…)

The power of the positive

January 28, 2016February 25, 2020 Wound Care Advisor

Being positive in a negative situation is not naïve. It’s leadership.

— Ralph S. Marston, Jr., author and

publisher of The Daily Motivator website

Clinicians may encounter many challenges and stressors in the workplace—long hours, rotating shifts, inadequate staffing, poor teamwork, and pressure to achieve higher performance levels in an emotionally and physically demanding field.

But hope exists. Positive psychology uses scientific understanding and interventions to help people achieve a more satisfactory life. Positive psychologists have shown that building positive emotions can change the way we approach and view our environment, helping us become healthier, happier, and more resilient and helping employees and teams become more productive and engaged. (more…)

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

May 21, 2015February 25, 2020 Wound Care Advisor

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 dermal layers. Usually of an acute onset, it’s marked by redness, warmth, swelling, and tenderness. Borders of the affected skin are characteristically irregular. Although cellulitis may occur in many body areas, this article discusses the most common location—the lower limb. (more…)

Creating high-performance interprofessional teams

May 19, 2015February 25, 2020 Wound Care Advisor

By Terry Eggenberger, PhD, RN, CNE, CNL; Rose O. Sherman, EdD, RN, NEA-BC, FAAN; and Kathryn Keller, PhD, RN

Kate Summer, a wound care clinician in a urban hospital, is leading an initiative to reduce pressure ulcers. She knows from experience that more effective communication and collaborative planning by the interdisciplinary team managing these patients is crucial for reducing pressure ulcers. But doing this has been challenging for Kate. (more…)

Translating the language of health care

February 9, 2015February 25, 2020 Wound Care Advisor

By Catherine E. Chung, PhD, RN, CNE, WCC

As a wound care clinician, you teach patients about medications, wound treatments, the plan of care, symptoms of complications, wound physiology—you teach a lot. And most patients probably smile and nod when you ask, “Do you understand?” However, health literacy research has shown that only 12% of the U.S. population is fluent in the language of health care. As health care has become increasingly complex, it has become increasingly difficult for patients to understand. Fortunately for your patient, you can translate. (more…)

Case study: Bariatric patient with serious wounds and multiple complications

November 20, 2014February 25, 2020 Wound Care Advisor

By Hedy Badolato, RD, CSR, CNSC; Denise Dacey, RD, CDE; Kim Stevens, BSN, RN, CCRN; Jen Fox, BSN, RN, CCRN; Connie Johnson, MSN, RN, WCC, LLE, OMS, DAPWCA; Hatim Youssef, DO, FCCP; and Scott Sinner, MD, FACP

Despite the healthcare team’s best efforts, not all hospitalizations go smoothly. This article describes the case of an obese patient who underwent bariatric surgery. After a 62-day hospital stay, during which a multidisciplinary team collaborated to deliver the best care possible, he died. Although the outcome certainly wasn’t what we wanted, we’d like to share his story to raise awareness of the challenges of caring for bariatric patients. (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…)

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