Clinician Resources: Nutrition, Treatment Algorithms, Pressure Ulcer Prevention

Check out these resources for your practice.

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Be a nutrition champion

One in three patients enters a hospital malnourished. Fight malnutrition by viewing six short videos from the Alliance to Advance Patient Nutrition, including “Rapidly Implement Nutrition Interventions” and “Recognize and Diagnose All Patients at Risk of Malnutrition.” The videos show how to collaborate with the care team to become champions of nutrition and help improve patient outcomes. Watch the videos online or download them for later viewing. (more…)

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Preventing pressure ulcers in pediatric patients

By Roxana Reyna, BSN, RNC-NIC, WCC, CWOCN

As wound care clinicians, we are trained—and expected—to help heal wounds in patients of any age and to achieve positive outcomes. Basic wound-healing principles apply to all patients, whatever their age or size. The specific anatomy and physiology of vulnerable pediatric patients, however, requires detailed wound care. Unfortunately, little evidence-based research exists to support and direct the care of pediatric patients with pressure ulcers. This article describes efforts to reduce pressure ulcers in pediatric patients at Driscoll Children’s Hospital (DCH) in Corpus Christi, Texas. (more…)

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Case study: Early detection and treatment resolves a deep tissue injury

deep tissue injury

By Todd Zortman, RN, WCC, and James Malec, PhD

Pressure ulcers are a chronic healthcare burden for both patients and pro­viders. Over 2.5 million patients in the United States are affected annually by pressure ulcers, with nearly 60,000 of those cases directly resulting in death. From a provider’s perspective, the cost of individual care ranges anywhere from $500 to $70,000 per pressure ulcer, which translates to annual costs in the U.S. approaching $11 billion. (more…)

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Clinical Notes: Revascularization, Amputation Risk Score

Amputation Risk Score

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Leg revascularization fails to improve outcomes in nursing home patients

Lower-extremity revascularization often fails to improve outcomes in nursing home patients, according to an article in JAMA Internal Medicine.

Functional outcomes after lower extremity revascularization in nursing home residents: A national cohort study” found that few patients are alive and ambulatory a year after surgery, and those who are alive have little, if any, gain in function. The study, which included 10,784 patients, was based on data from nursing homes participating in Medicare or Medicaid. (more…)

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Motivational interviewing: A collaborative path to change

By Sharon Morrison, MAT, RN

Michael had diabetes and a history of elevated blood glucose levels. A long-time drinker, he seemed to have no interest in giving up the habit. I met him while working as a diabetes nurse educator for the Boston Health Care for the Homeless Program, traveling from shelter to shelter to help persons with diabetes set goals to improve their health.

If our meeting had taken place a decade earlier, I might have given Michael information about diabetes and talked with him about his alcohol use. I would have encouraged him to stop drinking by explaining the problems alcohol can cause for people with diabetes. (more…)

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Case study: Working under a time crunch in a short-stay facility

short stay facility

By Janet Wolfson, PT, CWS, CLT-LANA

After landing my dream job as the wound care coordinator at an inpatient rehabilitation facility (IRF), I found myself trying to determine how much healing could be achieved for our more challenging patients, given the constraints of reimbursement and what can be done in the typical 10 to 14 days of a patient stay.

Here’s an example of how I worked with our team to help one of these challenging patients. (more…)

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Helping patients overcome ostomy challenges

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 it psychologically, starting even before surgery. (more…)

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Providing evidence-based care for patients with lower-extremity cellulitis

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 are characteristically irregular. Although cellulitis may occur in many body areas, this article discusses the most common location—the lower limb. (more…)

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Finding common ground: Surviving wound care communication

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 see the body language, so it’s easy to misinterpret the words. (more…)

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Role of rehab in wound care

 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 themselves are confused about reimbursement or what their role on the wound care team can be. (more…)

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Clinician Resources: March-April 2015

Below are resources you may find helpful to your practice.

AHRQ’s Safety Program for Nursing Homes: On-Time Prevention

The Agency for Healthcare Research and Quality (AHRQ) has established “AHRQ’s Safety Program for Nursing Homes: On-Time Prevention,” designed to improve long-term care by turning daily documentation into useful information that enhances clinical care planning.

On-Time uses electronic medical records to develop weekly reports that identify residents at risk for common adverse events in nursing homes to help clinical staff intervene early. Facilitators help the team integrate these reports into clinical decision making to improve care planning.

For each adverse event, the website provides a description of the reports and suggested meetings and huddles where the reports may be used, the functional specifications for programming the reports, description of implementation tools, and a 2-day training curriculum for facilitators.

Sleep times guidelines

The National Sleep Foundation has issued new recommendations for appropriate sleep durations. Check below to see if your patients—and you—are getting enough sleep:

• newborns (0-3 months): 14-17 hours

• infants (4-11 months): 12-15 hours

• toddlers (1-2 years): 11-14 hours

• preschoolers (3-5 years): 10-13 hours

• school-age children (6-13 years): 9-11 hours

• teenagers (14-17 years): 8-10 hours

• younger adults (18-25 years): 7-9 hours

• adults (26-64 years): 7-9 hours

• older adults (65+ years): 7-8 hours.

Access “National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary” in Sleep Health.

Venous ulcer resources

The website for the Association for the Advancement of Wound Care (AAWC) has several resources related to venous ulcers:

• AAWC Venous Ulcer Guideline 3.12

• AAWC Venous Ulcer Guideline Evidence 6.13

• AAWC Venous Ulcer Guideline Algorithm Presentation 8.13

• AAWC Venous Ulcer Guideline Checklist 7.13.

The resources are available at no cost.

Wound care app

The Johnson & Johnson Wound Care Resource™ App helps patients identify, track, and provide recommendations on wound care treatment.

The free app includes treatment videos and coupons to help patients save on wound care treatment supplies. The app is available for download on iTunes.

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Healthcare reform and changes provide opportunities for wound care clinicians

By Kathleen D. Schaum, MS

Qualified healthcare professionals (QHPs), such as physicians, podiatrists, physician assistants, nurse practitioners, and clinical nurse specialists, are taught to diagnose the reasons that chronic wounds aren’t healing and to create plans of care for aggressively managing the wound until it heals. Wound care professionals—nurses and therapists—are taught to implement those plans of care. All of these highly skilled wound care professionals know how to manage chronic wounds from identification through healing. (more…)

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