As wound care clinicians, we are trained—and expected—to help heal wounds in patients of any age and to achieve positive outcomes. Basic wound-healing principles apply to all patients, whatever their age or size. The specific anatomy and physiology of vulnerable pediatric patients, however, requires detailed wound care. Unfortunately, little evidence-based research exists to support and direct the care of pediatric patients with pressure ulcers. This article describes efforts to reduce pressure ulcers in pediatric patients at Driscoll Children’s Hospital (DCH) in Corpus Christi, Texas. (more…)
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…)
Silence, roving eyes, fidgeting, excuses, a quick subject change—these are typical responses from healthcare clinicians when asked, “What’s the patient’s ankle-brachial index?” You’d think someone had just uttered a dirty word.
The ankle-brachial index (ABI) is a key component of the lower-extremity vascular exam, recommended and in some cases mandated by numerous clinical practice guidelines, including the most recent international guidelines on preventing and treating pressure ulcers. (more…)
Research has shown that exercise can help ease symptoms in patients with arterial insufficiency, venous insufficiency, neuropathic disease, or a combination of these conditions. Here’s what you need to know to ensure your patients reap the most benefits from exercise. (more…)
Factors affecting medication adherence in patients with diabetes identified
Factors associated with better adherence to antidiabetic medications taken by patients with diabetes include older age, male sex, higher education, higher income, use of mail-order vs. retail pharmacies, primary care vs. nonendocrinology specialist prescribers, higher daily total pill burden, and lower out-of-pocket costs. (more…)
By preventing and relieving suffering, palliative care improves the quality of life for patients facing problems associated with life-threatening illness. This care approach emphasizes early identification, impeccable assessment, and treatment of pain and other issues—physical, psychosocial, and spiritual.
When relieving distressing symptoms takes higher priority than healing the wound, the patient may choose palliative wound care after consulting with the medical team. Addressing such issues as pain, odor, exudate, bleeding, infection, and cosmetic appearance, this treatment approach couples the elements of traditional wound care with symptom management. When delivered correctly, it brings patient-centered care to life.
Guidelines for optimal off-loading to prevent diabetic foot ulcers “The management of diabetic foot ulcers through optimal off-loading,” published in the Journal of the American Podiatric Medical Association, presents consensus guidelines and states the “evidence is clear” that off-loading increases healing of diabetic foot ulcers. The article calls for increased use of off-loading and notes that “current evidence favors the use of nonremovable casts or fixed…
By Jennifer Oakley, BS, RN, WCC, DWC, OMS The author describes how to overcome challenges to effective communication in the healthcare setting. Accurate communication among healthcare professionals can spell the difference between patient safety and patient harm. Communication can be a challenge, especially when done electronically. With an e-mail or a text, you can’t hear the other person’s voice or…
By Karen Culp, RN, WCC I’m one of the nurses responsible for the pressure ulcer prevention education program at the 150-bed skilled nursing facility where I work. We try to keep education sessions simple, fun, and interactive. One day, our administrator asked us to develop a crossword puzzle and “minute to win it” education game that would be appropriate for…
By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Keeping clinicians up to date on clinical knowledge is one of the main goals of the Wild On Wounds (WOW) conference,held each September in Las Vegas. Each year, I present the opening session of this conference, called “The Buzz Report,”which focuses on the latest-breaking wound care news—what’s new, what’s now, and…
This approach brings patient-centered care to life. By Gail Rogers Hebert, MS, RN, CWCN, WCC, DWC, OMS, LNHA Editor’s note: This article is the second in a two-part series on palliative wound care. For the first part, click here. By preventing and relieving suffering, palliative care improves the quality of life for patients facing problems associated with life-threatening illness. This…
By Bill Richlen, PT, WCC, DWC, and Denise Richlen, PT, WCC, DCCT How many times have you heard someone say, “I didn’t know PTs did wound care”? Statements like this aren’t uncommon. The role of physical therapists (PTs), occupational therapists, and speech therapists in wound care is commonly misunderstood by and even a mystery to many clinicians. Sometimes the therapists…
By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Editor-in-Chief During a recent wound care presentation, an audience member jumped up to contradict the speaker. “That is incorrect,” she asserted. “The rules state….” When someone asked her what rules she was referring to, she replied, “The government’s rules.” On the surface, that might seem like a straightforward answer. But when…
The author describes how to overcome challenges to effective communication in the healthcare setting.
Accurate communication among healthcare professionals can spell the difference between patient safety and patient harm. Communication can be a challenge, especially when done electronically. With an e-mail or a text, you can’t hear the other person’s voice or see the body language, so it’s easy to misinterpret the words. (more…)
By Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Editor-in-Chief
During a recent wound care presentation, an audience member jumped up to contradict the speaker. “That is incorrect,” she asserted. “The rules state….” When someone asked her what rules she was referring to, she replied, “The government’s rules.”
On the surface, that might seem like a straightforward answer. But when you stop to think about it, what government did she mean? Federal? State? Local? (more…)
Guidelines for optimal off-loading to prevent diabetic foot ulcers
“The management of diabetic foot ulcers through optimal off-loading,” published in the Journal of the American Podiatric Medical Association, presents consensus guidelines and states the “evidence is clear” that off-loading increases healing of diabetic foot ulcers.
The article calls for increased use of off-loading and notes that “current evidence favors the use of nonremovable casts or fixed ankle walking braces as optimum off-loading modalities.” The authors reviewed about 90 studies. (more…)
Below are resources you may find helpful to your practice.
AHRQ’s Safety Program for Nursing Homes: On-Time Prevention
The Agency for Healthcare Research and Quality (AHRQ) has established “AHRQ’s Safety Program for Nursing Homes: On-Time Prevention,” designed to improve long-term care by turning daily documentation into useful information that enhances clinical care planning.
On-Time uses electronic medical records to develop weekly reports that identify residents at risk for common adverse events in nursing homes to help clinical staff intervene early. Facilitators help the team integrate these reports into clinical decision making to improve care planning.
For each adverse event, the website provides a description of the reports and suggested meetings and huddles where the reports may be used, the functional specifications for programming the reports, description of implementation tools, and a 2-day training curriculum for facilitators.
Sleep times guidelines
The National Sleep Foundation has issued new recommendations for appropriate sleep durations. Check below to see if your patients—and you—are getting enough sleep:
The free app includes treatment videos and coupons to help patients save on wound care treatment supplies. The app is available for download on iTunes.
Keeping clinicians up to date on clinical knowledge is one of the main goals of the Wild On Wounds (WOW) conference,held each September in Las Vegas. Each year, I present the opening session of this conference, called “The Buzz Report,”which focuses on the latest-breaking wound care news—what’s new, what’s now, and what’s coming up. I discuss innovative new products, practice guidelines, resources, and tools from the last 12 months in skin, wound, and ostomy management. (more…)
