Clinician Resources

Greet the new year by tapping into some new resources.

Free app for patients with Crohn’s Disease

GI Buddy is a free tool from the Crohn’s & Colitis Foundation of America that patients can use to stay on top of managing their Crohn’s Disease or ulcerative colitis symptoms. Patients can record what they eat, track their treatment and well-being, and access detailed reports. Patients also can access a video of tips for using GI Buddy, which is available online and as an iPhone app. (more…)

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Clinical Notes: diabetic foot osteomyelitis, BIA, footwear

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.

Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis. A randomized comparative trial” compared two groups: an antibiotics group and a surgery group. Patients in the antibiotics group received antibiotics for 90 days, and patients in the surgery group received conservative surgery with postoperative antibiotics for 10 days. (more…)

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Quality-improvement initiative: Classifying and documenting surgical wounds

By Jennifer Zinn, MSN, RN, CNS-BC, CNOR, and Vangela Swofford, BSN, RN, ASQ-CSSBB

For surgical patients, operative wound classification is crucial in predicting postoperative surgical site infections (SSIs) and associated risks. Information about a patient’s wound typically is collected by circulating registered nurses (RNs) and documented at the end of every surgical procedure. (more…)

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How to apply a spiral wrap

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

The spiral wrap is a technique used for applying compression bandaging.

Procedure

Here’s how to apply a spiral wrap to the lower leg. Please note that commercial compression wraps come with specific instructions for proper bandaging technique. Be sure to follow these instructions to provide safe and effective compression. (more…)

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A case of missed care

By Lydia A. Meyers RN, MSN, CWCN

Missed care, a relatively new concept in the medical community, refers to any part ofrequired patient care that is omitted of delayed. It’s not the same as a mistake or error, but like them, missed care can negatively affect patient outcomes.

I want to share the case of a patient admitted into home health care for wound care. The case includes several areas of missed care from many different different sources. (more…)

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Making sure patients have the ostomy supplies they need

ostomy supplies they need

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 how to reduce the chance of experiencing frustrations related to ostomy supplies. (more…)

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Making professional connections

Making professional connections

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 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…)

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Clinical Notes: Pressure-Ulcer Data, Diabetic Foot Ulcers, IFG & HbA1c

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 California hospitals and quarterly hospital surveillance data from 213 hospitals from the Collaborative Alliance for Nursing Outcomes. (more…)

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2013 Journal: November – December Vol. 2 No. 6

Wound Care Advisor Journal 2013 Vol2 No6

How do you prove a wound was unavoidable?

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.

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Clinical Notes: Pressure-Ulcer Data, Diabetic Foot Ulcers, IFG & HbA1c

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…

Clinician Resources: On the Road Again, Nutrition, Compression

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…

dietary protein intake promotes wound healing

How dietary protein intake promotes wound healing

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…

unavoidable pressure ulcers

How do you prove a wound was unavoidable?

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…

Making professional connections

Making professional connections

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…

ostomy supplies they need

Making sure patients have the ostomy supplies they need

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…

Protecting yourself from a job layoff

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.…

Skin problems with chronic venous insufficiency and phlebolymphedema

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…

The long and short of it: Understanding compression bandaging

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…

hydrogel dressings

What you need to know about hydrogel dressings

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…

2013 Journal: November – December Vol. 2 No. 6

Click here to access the digital edition

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Skin problems with chronic venous insufficiency and phlebolymphedema

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 be unrelenting. If not properly identified and treated, these skin problems can impede the prompt treatment of lymphedema and reduce a patient’s quality of life.

This article reviews skin problems that occur in patients with CVI and phlebo­lymphedema and discusses the importance of using a multidisciplinary team approach to manage these patients. (more…)

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Developing a cost-effective pressure-ulcer prevention program in an acute-care setting

By Tamera L. Brown, MS, RN, ACNS-BC, CWON, and Jessica Kitterman, BSN, RN, CWOCN

Pressure ulcers take a hefty toll in both human and economic terms. They can lengthen patient stays, cause pain and suffering, and increase care costs. The average estimated cost of treating a pressure ulcer is $50,000; this amount may include specialty beds, wound care supplies, nutritional support, and increased staff time to care for wounds. What’s more, national patient safety organizations and insurance payers have deemed pressure ulcers avoidable medical errors and no longer reimburse the cost of caring for pressure ulcers that develop during hospitalization. (more…)

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Compassionate care: The crucial difference for ostomy patients

Compassionate care

By Gail Hebert, RN, MS, CWCN, WCC, DWC, LNHA, OMS; and Rosalyn Jordan, BSN, RN, MSc, CWOCN, WCC, OMS

Imagine your physician has just told you that your rectal pain and bleeding are caused by invasive colon cancer and you need prompt surgery. She then informs you that surgery will reroute your feces to an opening on your abdominal wall. You will be taught how to manage your new stoma by using specially made ostomy pouches, but will be able to lead a normal life.

Like most people, you’d probably be in shock after hearing this. More than 700,000 people in the United States are living with ostomies. Every year, at least 100,000 ostomy surgeries are done, preceded by a conversation much like the one above. So how do patients recover from the shock of learning about their pending surgery—and then return to a full life? (more…)

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