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 âgo to conferenceâ (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasnât an option; our facility, patients, and administrators needed us to attend. If we didnât, weâd 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 doingâwhatâs working and what isnâtâ and to hear firsthand from researchers. (more…)
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 patientâs pressure in a chair or wheelchair.
The National Pressure Ulcer Advisory Panel (NPUAP) defines support surfaces as âspecialized devices for pressure redistribution designed for the management of tissue loads, microclimate, and/or other therapeutic functions.â 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…)
This issueâs resources include patient tools and new guidelines.
Improving patient safety
Research suggests that adverse events affect patients with limited English proficiency (LEP) more frequently, are commonly caused by communication problems, and are more likely to result in serious harm compared to adverse events affecting English-speaking patients. Your hospital can take steps to reduce risks of adverse events for patients with LEP with âImproving patient safety systems for patients with limited english proficiency: a guide for hospitals,â from The Disparities Solutions Center, Mongan Institute for Health Policy at Massachusetts General Hospital, Boston, and Abt Associates, Cambridge, Massachusetts. (more…)
The Rolling Stones may have said it best when they sang, âYou canât always get what you want,â 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 knowledge. This situation worsens when these clinicians are making treatment recommendations or writing treatment orders not based on current wound-healing principles or standards of care.
Frequently, these same clinicians seem uninterested in listening to what you say and arenât receptive to treatment suggestions. This is where your skills of diplomacy will make all the difference. Rarely is it a simple matter of sharing your expertise to change a personâs mind. Lack of training and knowledge of current best practices may be part of the reason for resistance. âWeâve always done it that wayâ or âThe rep told meâ are common statements you might hear.
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, itâs not surprising that this happens frequently to many clinicians. The first and easiest way for most…
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…
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,…
By Bill Richlen, PT, WCC, CWS, DWC, and Denise Stetter, PT, WCC, DCCT The Rolling Stones may have said it best when they sang, âYou canât always get what you want,â 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…
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 âFrequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases,â published in Inflammatory Bowel Diseases.
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 associationâs website include: a variety of discussion groups information for patients list of helpful links. The site also provides contact information for the…
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…
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…
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 knowledgeâand my new WCC credentialâback to the long-term care facility where I worked. I was ready to change the world. It didnât take me long to…
By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA In an atmosphere of changing reimbursement, itâs important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities wonât 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
By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN Weâve all experienced how a bad nightâs sleep can affect our mood and ability to function the next day. Now imagine youâre a patient who has a pressure ulcer, most likely secondary to a declining disease state, and youâre being awakened and manipulated every 2 hours or in some cases hourly. How…
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…)
By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA
In an atmosphere of changing reimbursement, itâs important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities wonât receive appropriate reimbursement for provided services. This article focuses on Medicare reimbursement for hyperbaric oxygen therapy (HBOT). (See What is hyperbaric oxygen therapy?)
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 plasma. Exudate can result also from conditions that cause edema, such as inflammation, immobility, limb dependence, and venous and lymphatic insufficiency. (more…)
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, itâs not surprising that this happens frequently to many clinicians.
The first and easiest way for most of us to handle this situation is to ask our coworkers what to do. While this isnât necessarily a bad thing, we as clinicians should reach a little further and get corroboration of what coworkers tell us. What we learn on the job may soundâand even seemâcredible but it also needs validity so it can stand up in a legal situation. Recently, I was teaching a class to clinicians on ostomy care when one student shrieked, âOur entire hospital system has been doing this wrong for years.â (more…)
Meetings are a powerful communication tool. They bring together people who can look at an issue from their own unique perspective and contribute to a solution acceptable to many disciplines. Generally, meetings are held to:
⢠discuss common issues
⢠brainstorm ideas for solving specific concerns
⢠make collaborative decisions about a shared concern or problem. (more…)
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 patientâs caregiving supportersânot 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…)
Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. Whatâs 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 arenât 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…)
⢠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…)
