Clinical Notes: diabetic foot osteomyelitis, BIA, footwear

January 30, 2014February 25, 2020 Wound Care Advisor

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…)

Quality-improvement initiative: Classifying and documenting surgical wounds

January 30, 2014February 25, 2020 Wound Care Advisor

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…)

How to apply a spiral wrap

January 30, 2014February 25, 2020 Wound Care Advisor

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…)

Have you made your New Year’s resolutions?

January 30, 2014February 25, 2020 Wound Care Advisor

Aresolution is a serious decision or determination to do, or not to do, something. Traditionally, most New Year’s resolutions focus on self-improvement: losing weight, giving up a bad habit, exercising more, being a better person. Because most of us spend about half of our waking lives at work, perhaps our work lives should be the subject

of some of our resolutions. Here are a few work-related resolutions I’ve come up with: (more…)

When and how to culture a chronic wound

January 30, 2014February 25, 2020 Wound Care Advisor

By Marcia Spear, DNP, ACNP-BC, CWS, CPSN

Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise.

Most chronic wounds are colonized by polymicrobial aerobic-anaerobic microflora. However, practitioners continue to debate whether wound cultures are relevant. Typically, chronic wounds aren’t cultured unless the patient has signs and symptoms of infection, which vary depending on whether the wound is acute or chronic. (See Differentiating acute and chronic wounds.) (more…)

A case of missed care

January 30, 2014February 25, 2020 Wound Care Advisor

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…)

Clinician Resources: On the Road Again, Nutrition, Compression

November 21, 2013February 25, 2020 Wound Care Advisor

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 about the ostomy before the screening starts.
• You can be screened using imaging technology, a metal detector, or a thorough patdown.
• Your ostomy is subject to additional screening. In most cases, this means you will pat down your ostomy and then your hands will undergo explosive trace detection. (more…)

Making sure patients have the ostomy supplies they need

November 21, 2013February 25, 2020 Wound Care Advisor

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…)

Making professional connections

November 21, 2013February 25, 2020 Wound Care Advisor

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…)

How do you prove a wound was unavoidable?

November 21, 2013February 25, 2020 Wound Care Advisor

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 up in court. (more…)

What you need to know about hydrogel dressings

November 21, 2013February 25, 2020 Wound Care Advisor

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 in viscosity or thickness. They’re available in three forms: (more…)

The long and short of it: Understanding compression bandaging

November 21, 2013February 25, 2020 Wound Care Advisor

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 and her feet have relatively little edema, but her ankles are bulging over the edges of her shoes; both socks are wet. Stemmer’s sign is negative. The wound on the right leg is draining copious amounts of clear fluid; it’s dressed with an alginate, which is secured with conforming roll gauze. No signs or symptoms of infection are present. (more…)

« 1 … 24 25 26 27 28 … 34 »