By Beth Hoffmire Heideman, MSN, BSN, RN, WCC, DWC, OMS
Fifty shades of wound care at home refers to treating the whole patient and the patient’s caregiving supporters—not just the wound. Only by understanding the nuances, or shades, of a patient and his or her environment can clinicians best achieve desired outcomes.
Wound healing in home care depends on teamwork. Members of the team must understand the unique situation of delivering care in the home and how to help patients adhere to the plan of care. (more…)
Venous disease, which encompasses all conditions caused by or related to diseased or abnormal veins, affects about 15% of adults. When mild, it rarely poses a problem, but as it worsens, it can become crippling and chronic.
Chronic venous disease often is overlooked by primary and cardiovascular care providers, who underestimate its magnitude and impact. Chronic venous insufficiency (CVI) causes hypertension in the venous system of the legs, leading to various pathologies that involve pain, swelling, edema, skin changes, stasis dermatitis, and ulcers. An estimated 1% of the U.S. population suffers from venous stasis ulcers (VSUs). Causes of VSUs include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. Preventing VSUs is the most important aspect of CVI management. (more…)
Antibiotics and conservative surgery yield similar outcomes in patients with diabetic foot osteomyelitis
A study in Diabetes Care finds that antibiotics and surgery have similar outcomes related to rate of healing, time of healing, and short-term complications in patients who have neuropathic forefoot ulcers and osteomyelitis, but no ischemia or necrotizing soft-tissue infections.
Are you making connections that benefit your career? Are you comfortable starting a conversation at a networking session? Do you know how to exit a conversation gracefully when it’s time to move on?
These are questions and concerns many clinicians share. Career success takes more than clinical expertise, management savvy, and leadership skills. Networking can be the critical link to success. This article helps you improve your networking skills by focusing on what to do before, during, and after a networking opportunity. (more…)
A pressure ulcer that a patient acquires in your facility or a patient’s existing pressure ulcer that worsens puts your organization at risk for regulatory citations as well as litigation. Unless you can prove the pressure ulcer was unavoidable, you could find yourself burdened with citations or fines, or could even end up in court. (more…)
Each issue, Apple Bites brings you a tool you can apply in your daily practice.
Description
Hydrated polymer (hydrogel) dressings, originally developed in the 1950s, contain 90% water in a gel base, which helps regulate fluid exchange from the wound surface. Hydrogel dressing are usually clear or translucent and vary in viscosity or thickness. They’re available in three forms: (more…)
With uncertainty over how the Affordable Care Act (ACA) ultimately will affect operations, hospitals and other healthcare facilities are tightening up. In many areas, they’re laying off staff. In May, the healthcare industry lost 9,000 jobs—the worst month for the industry in a decade—and another 4,000 jobs were lost in July.
Medicare, Medicaid, and private insurance companies are reducing reimbursements to care providers, meaning less money is coming in and healthcare facilities have less money to pay out. In my experience, when job cuts are needed, the specialty and subspecialty positions go first. Wound and ostomy care is a subspecialty, so we need to be prepared to protect our jobs—not only for ourselves but for our patients. (more…)
A pressure ulcer that a patient acquires in your facility or a patient’s existing pressure ulcer that worsens puts your organization at risk for regulatory citations as well as litigation. Unless you can prove the pressure ulcer was unavoidable, you could find yourself burdened with citations or fines, or could even end up in court.
In 2010, the National Pressure Ulcer Advisory Panel (NPUAP) hosted a multidisciplinary conference to establish a consensus on whether all pressure ulcers are avoidable.
Hospital pressure-ulcer comparison data not accurate Performance scores for rates of hospital-acquired pressure ulcers might not be appropriate for comparing hospitals, according to a study in the Annals of Internal Medicine. “Hospital report cards for hospital-acquired pressure ulcers: How good are the grades?,” funded by the Agency for Healthcare Research and Quality, analyzed 2 million all-payer administrative records from 448…
A variety of resources to end the year and take you into 2014. On the road again Give your patients with an ostomy this information from the Transportation Security Administration to help them navigate airport screening: • You can be screened without having to empty or expose your ostomy, but you need to let the officer conducting the screening know…
By Nancy Collins, PhD, RD, LD/N, FAPWCA, and Allison Schnitzer Nutrition is a critical factor in the wound healing process, with adequate protein intake essential to the successful healing of a wound. Patients with both chronic and acute wounds, such as postsurgical wounds or pressure ulcers, require an increased amount of protein to ensure complete and timely healing of their…
By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN A pressure ulcer that a patient acquires in your facility or a patient’s existing pressure ulcer that worsens puts your organization at risk for regulatory citations as well as litigation. Unless you can prove the pressure ulcer was unavoidable, you could find yourself burdened with citations or fines, or could even end…
By Kathleen D. Pagana, PhD, RN Are you making connections that benefit your career? Are you comfortable starting a conversation at a networking session? Do you know how to exit a conversation gracefully when it’s time to move on? These are questions and concerns many clinicians share. Career success takes more than clinical expertise, management savvy, and leadership skills. Networking…
By Connie Johnson, BSN, RN, WCC, LLE, OMS, DAPWCA No matter where you work or who your distributors are, ensuring the patient has sufficient ostomy supplies can be a challenge. Whether you’re the nurse, the physician, the patient, or the family, not having supplies for treatments can heighten frustration with an already challenging situation, such as a new ostomy. Here’s…
by Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS With uncertainty over how the Affordable Care Act (ACA) ultimately will affect operations, hospitals and other healthcare facilities are tightening up. In many areas, they’re laying off staff. In May, the healthcare industry lost 9,000 jobs—the worst month for the industry in a decade—and another 4,000 jobs were lost in July.…
Dermatologic difficulties: Skin problems in patients with chronic venous insufficiency and phlebolymphedema By Nancy Chatham, RN, MSN, ANP-BC, CWOCN, CWS; Lori Thomas, MS, OTR/L, CLT-LANA; and Michael Molyneaux, MD Skin problems associated with chronic venous insufficiency (CVI) and phlebolymphedema are common and often difficult to treat. The CVI cycle of skin and soft tissue injury from chronic disease processes can…
By Robyn Bjork, MPT, WCC, CWS, CLT-LANA Margery Smith, age 82, arrives at your wound clinic for treatment of a shallow, painful ulcer on the lateral aspect of her right lower leg. On examination, you notice weeping and redness of both lower legs, 3+ pitting edema, several blisters, and considerable denudement of the periwound skin. She is wearing tennis shoes…
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. Description Hydrated polymer (hydrogel) dressings, originally developed in the 1950s, contain 90% water in a gel base, which helps regulate fluid exchange from the wound surface. Hydrogel dressing are usually clear or translucent and vary…
Collagen, the protein that gives the skin its tensile strength, plays a key role
in each phase of wound healing. It attracts cells, such as fibroblasts and keratinocytes, to the wound, which encourages debridement, angiogenesis, and reepithelialization. In addition, collagen provides a natural scaffold or substrate for new tissue growth. (more…)
Achieving excellent wound care outcomes can be challenging, given the growing number of high-risk patients admitted to healthcare facilities today. Many of these patients have comorbidities, such as obesity, diabetes, renal disease, smoking, chronic obstructive pulmonary disease, and poor nutritional status. These conditions reduce wound-healing ability. (more…)
The first 24 hours after a patient’s admission are critical in preventing pressure ulcer development or preventing an existing ulcer from worsening. A skin inspection, risk assessment, and temporary care plan should all be implemented during this time frame. Essentially, it’s the burden of the care setting to prove to insurers, regulators, and attorneys the pressure ulcer was present on admission and interventions were put into place to avoid worsening of the condition. Of course, patients also benefit from having their condition identified and treated promptly. (more…)
Critical limb ischemia may not increase mortality risk in patients with diabetes
Diabetic patients with critical limb ischemia (CLI) who are assessed quickly and treated aggressively do not have an increased risk of long-term cardiac mortality, according to a study in Diabetes Care.(more…)
