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Eating better to help manage chronic stress
By Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, and Dana Marie Dillard, MS, HSMI
Like many clinicians, you may experience stress frequently, both on and off the job. Chronic stress can alter your equilibrium (homeostasis), activating physiologic reactive pathways that cause your body to shift its priorities. Physiologic effects of stress may include:
- slowed digestion
- delay in reproductive and repair processes
- priming of survival mechanisms (respiratory, cardiovascular, and muscular) for immediate use
- depletion of the body’s nutrients.
Understanding the crusting procedure
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.
The crusting procedure produces a dry surface and absorbs moisture from
broken skin through an artificial scab that’s created by using skin barrier powder (stoma powder) and liquid polymer skin barrier. The crusting procedure is most frequently used on denuded peristomal skin to create a dry surface for adherence of an ostomy pouching system while protecting the peristomal skin from effluent and adhesives. Crusting can increase pouching-system wear time, resulting in fewer pouch changes and less disruption to irritated peristomal skin. The crusting procedure can also be used for other denuded partial-thickness weeping wounds caused by moisture. (more…)
Hidden complications: A case study in peripheral arterial disease
By Pamela Anderson, MS, RN, APN-BC, CCRN, and Terri Townsend, MA, RN, CCRN-CMC, CVRN-BC
Jan Smith, age 59, is admitted to the coronary intensive care unit with an acute inferior myocardial infarction (MI). Recently diagnosed with hypertension and hyperlipidemia, she smokes a pack and a half of cigarettes daily. She reports she has always been healthy and can’t believe she has had a heart attack. (Note: Name is fictitious.)
On physical exam, the cardiologist finds decreased femoral pulses bilaterally and recommends immediate cardiac catheterization. Fortunately, primary percutaneous coronary intervention (PCI) is readily available at this hospital. PCI is the preferred reperfusion method when it can be provided by skilled cardiologists in a timely manner. (more…)
Read MoreWhat is a comprehensive risk assessment?
By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN
Prevention of pressure ulcers and skin breakdown begins with a comprehensive risk assessment. Most providers use a skin risk assessment tool, such as the Braden or Norton scale. While these tools have been validated to predict pressure ulcer development, their use alone isn’t considered a comprehensive assessment, and frequently the individual risk factors they identify aren’t carried through to the plan of care. (more…)
Read MoreClinical Notes: Pressure Injury Prevention, Diabetes, LIV
Incidence density best measure of pressure-ulcer prevention program
According to the National Pressure Ulcer Advisory Panel (NPUAP), incidence density is the best quality measure of pressure-ulcer prevention programs. Pressure-ulcer incidence density is calculated by dividing the number of inpatients who develop a new pressure ulcer by 1,000 patient days. Using the larger denominator of patient days allows fair comparisons between institutions of all sizes. (more…)
Read MoreI’m going to conference!
By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Years ago, when I first started out in the wound care specialty, the only way to learn about new products and what was going on in the field was to “go to conference” (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasn’t an option; our facility, patients, and administrators needed us to attend. If we didn’t, we’d be way behind our competition in regard to cutting-edge, hot-off-the-press wound care treatments and techniques.
Besides being a forum for displaying new wound care products, conference is an opportunity to network, to see what others are doing—what’s working and what isn’t— and to hear firsthand from researchers. (more…)
Read MoreUnderstanding therapeutic support surfaces
By Rosalyn S. Jordan, BSN, RN, MSc, CWOCN, WCC, and Sandra Phipps, BSN, RN, MBA, WCC
Pressure-ulcer prevention and management guidelines recommend support-surface therapy to help prevent and treat pressure ulcers. Support surfaces include pads, mattresses, and cushions that redistribute pressure. Full cushions and cushion pads are considered therapeutic support surfaces if used to redistribute a patient’s pressure in a chair or wheelchair.
The National Pressure Ulcer Advisory Panel (NPUAP) defines support surfaces as “specialized devices for pressure redistribution designed for the management of tissue loads, microclimate, and/or other therapeutic functions.” These surfaces address the mechanical forces associated with skin and tissue injury, such as pressure, shear, friction, and excess moisture and heat. (See Clearing up the confusion.) (more…)
Read MoreBacteria living on skin may affect how wounds heal
2014 Journal: March April Vol. 3 No. 2
“This is how we’ve always done it” isn’t good enough
Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Have you ever faced responsibility for a patient-care situation you learned about in school but had yet to encounter in the real world? With so many different health conditions and constant advancements in medical care, it’s not surprising that this happens frequently to many clinicians. The first and easiest way for most…
A Saudi rehabilitation facility fights pressure ulcers
By Joanne Aspiras Jovero, BSEd, BSN, RN; Hussam Al-Nusair, MSc Critical Care, ANP, RN; and Marilou Manarang, BSN, RN A common problem in long-term care facilities, pressure ulcers are linked to prolonged hospitalization, pain, social isolation, sepsis, and death. This article explains how a Middle East rehabilitation facility battles pressure ulcers with the latest evidence-based practices, continual staff education, and…
Achieving a work-life balance
By Julie Boertje, MS, RN, LMFT, QMRP, and Liz Ferron, MSW, LICSW Almost everyone agrees that achieving a work-life balance is a good thing. Without it, we risk long-term negative effects on our physical and mental health, our relationships, and our work performance. But many clinicians have a hard time achieving this balance due to job demands, erratic work schedules,…
Becoming a wound care diplomat
By Bill Richlen, PT, WCC, CWS, DWC, and Denise Stetter, PT, WCC, DCCT The Rolling Stones may have said it best when they sang, “You can’t always get what you want,” a sentiment that also applies to wound care. A common frustration among certified wound care clinicians is working with other clinicians who have limited current wound care education and…
Clinical Notes: Low BMD, CKD, hypoglycemia, HBOT
Low BMD common after ostomy Low bone mineral density (BMD) is common in patients with inflammatory bowel disease who have a stoma placed, according to “Frequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases,” published in Inflammatory Bowel Diseases.
Clinician Resources: Intl Ostomy Assoc., Substance Use Disorder
Take a few minutes to check out this potpourri of resources. International Ostomy Association The International Ostomy Association is an association of regional ostomy associations that is committed to improving the lives of ostomates. Resources on the association’s website include: a variety of discussion groups information for patients list of helpful links. The site also provides contact information for the…
Guidelines for safe negative-pressure wound therapy
By Ron Rock MSN, RN, ACNS-BC Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT) has become a leading technology in the care and management of acute, chronic, dehisced, traumatic wounds; pressure ulcers; diabetic ulcers; orthopedic trauma; skin flaps; and grafts. NPWT applies controlled suction to a wound using a suction pump that delivers intermittent, continuous, or variable…
How to assess wound exudate
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. Exudate (drainage), a liquid produced by the body in response to tissue damage, is present in wounds as they heal. It consists of fluid that has leaked out of blood vessels and closely resembles blood…
It takes a village: Leading a wound team
By Jennifer Oakley, BS, RN, WCC, DWC, OMS I used to think I could do it alone. I took the wound care certification course, passed the certification exam, and took all of my new knowledge—and my new WCC credential—back to the long-term care facility where I worked. I was ready to change the world. It didn’t take me long to…
Medicare reimbursement for hyperbaric oxygen therapy
By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA In an atmosphere of changing reimbursement, it’s important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities won’t receive appropriate reimbursement for provided services. This article focuses on Medicare reimbursement for hyperbaric oxygen therapy (HBOT). (See What is hyperbaric oxygen therapy?) Indications and documentation requirements
Turning programs hinder a good night’s sleep
By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN We’ve all experienced how a bad night’s sleep can affect our mood and ability to function the next day. Now imagine you’re a patient who has a pressure ulcer, most likely secondary to a declining disease state, and you’re being awakened and manipulated every 2 hours or in some cases hourly. How…
A Saudi rehabilitation facility fights pressure ulcers
By Joanne Aspiras Jovero, BSEd, BSN, RN; Hussam Al-Nusair, MSc Critical Care, ANP, RN; and Marilou Manarang, BSN, RN
A common problem in long-term care facilities, pressure ulcers are linked to prolonged hospitalization, pain, social isolation, sepsis, and death. This article explains how a Middle East rehabilitation facility battles pressure ulcers with the latest evidence-based practices, continual staff education, and policy and procedure updates. Sultan Bin Abdulaziz Humanitarian City (SBAHC) in Riyadh, Saudi Arabia, uses an interdisciplinary approach to address pressure-ulcer prevention and management. This article describes the programs, strategies, and preventive measures that have reduced pressure-ulcer incidence. (more…)
Read MoreNAWCO News
A letter from one of our own
I am writing this letter to share the sense of honor and privilege I felt in working with the National Alliance of Wound Care and Ostomy (NAWCO) to organize the first Eastern Region WCC Conference during the Fall of 2013. What an experience! In addition to representing a top-notch organization, I increased my knowledge of wound care and its products dramatically and met many amazing clinicians on the same journey.
Traveling from seven states and a wide variety of care settings, nearly 100 wound care clinicians came together with the common goal of enhancing their ability to make a difference in the lives of their patients. We launched the process of forming a vital clinician network that will allow us to share product and procedure information and experiences, leverage the information in our individual care settings, and strengthen the wound care knowledge of our peers.
Throughout this experience, I talked with dozens of local wound care product representatives. Like the clinicians, they provided a wealth of wound care insights. I encourage clinicians to reach out to these “best friends” of wound care and take advantage of their depth of knowledge.
I am passionate about advocating proper wound care, and if I can help disseminate wound treatment knowledge to other clinicians in support of their patients, I need no better reward.
Finally, the opportunity to represent NAWCO filled me with pride because of the respect I have for its vision. I believe in the importance of continuing education, furthering knowledge, and ensuring expertise through a certification process that is based on solid, research-based wound care. My hope is to represent NAWCO in the future.
Thank you for this exciting opportunity!
Sincerely,
Janie Hollenbach, RN, WCC, OMS,
DAPWCA, FACCWS
NAWCO names new executive director
The National Alliance of Wound Care and Ostomy (NAWCO), the largest wound care and ostomy certification organization in the United States, is pleased to announce that Cynthia (Cindy) Broadus, RN, BSHA, LNHA, CLNC, CHRM, WCC, DWC, OMS, was named executive director effective February 1, 2014.
Ms. Broadus brings a wealth of experience and knowledge to the organization. She has excelled for over 2 decades in specialty nursing care, litigation, corporate management, and company development. She joins the organization at a time of exciting change and will be instrumental in achieving accreditation that will provide national and international recognition for NAWCO.
“I am excited to be a part of such a great organization and supporting the efforts of the close-knit community that makes up the NAWCO certificants,” Ms. Broadus says.
Read the full press release.
DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.
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