By Erin Fazzari, MPT, CLT, CWS, DWC Have you seen legs like those shown in the images below in your practice? These images show lymphedema and venous stasis ulcers, illustrating the importance of collaboration between clinicians in two disciplines: lymphedema and wound care.

Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS 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…

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.

Learn about resources useful to your practice. Nutrition and pressure ulcers Advances in Skin & Wound Care has published “The role of nutrition for pressure ulcer management: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance White Paper.” The white paper includes evidence-based nutrition strategies for preventing and managing pressure ulcers.

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…

By Cindy Barefield, BSN, RN-BC, CWOCN Like many hospitals, Houston Methodist San Jacinto Hospital uses national benchmarks such as the National Database of Nursing Quality Indicators (NDNQI®) to measure quality outcomes. Based on benchmark reports that showed an increased trend of pressure ulcers in critically ill patients in our hospital, the clinical nurses in our Critical Care Shared Governance Unit-Based…

By Beth Hoffmire Heideman, MSN, RN No one wants an ostomy, but sometimes it’s required to save a patient’s life. As ostomy specialists, our role is to assess and intervene for patients with a stoma or an ostomy to enhance their quality of life. We play an active role in helping patients perform self-care for their ostomy and adjust to…

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN 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.

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. Here’s a brief overview on moldable, bendable, and stretchable adhesive rings and strips used to improve the seal around a stoma. Benefits Adhesive rings and strips can be an alternative to stoma paste for filling…

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…

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…