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2014 Journal: November – December Vol. 3 No. 6

Case study: Bariatric patient with serious wounds and multiple complications

Despite the healthcare team’s best efforts, not all hospitalizations go smoothly. This article describes the case of an obese patient who underwent bariatric surgery. After a 62-day hospital stay, during which a multidisciplinary team collaborated to deliver the best care possible, he died. Although the outcome certainly wasn’t what we wanted, we’d like to share his story to raise awareness of the challenges of caring for bariatric patients.

An easy tool for tracking pressure ulcer data

Posted: November 20, 2014

By David L. Johnson, NHA, RAC-CT As a senior quality improvement specialist with IPRO, the Quality Improvement Organization for New York State over the past 11 years, I’ve been tasked with helping skilled nursing facilities (SNFs) embrace the process of continuous quality improvement. A necessary component of this effort has been to collect, understand, and analyze timely and accurate data.…

Building an effective pressure ulcer prevention program

Posted: November 20, 2014

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN As a wound care nurse, do you feel the weight of the world on your shoulders when trying to implement a pressure ulcer prevention program? Many staff members think it’s up to the wound care nurse alone to implement the program. However, a successful program requires involvement from all staff and is…

Case study: Bariatric patient with serious wounds and multiple complications

Posted: November 20, 2014

By Hedy Badolato, RD, CSR, CNSC; Denise Dacey, RD, CDE; Kim Stevens, BSN, RN, CCRN; Jen Fox, BSN, RN, CCRN; Connie Johnson, MSN, RN, WCC, LLE, OMS, DAPWCA; Hatim Youssef, DO, FCCP; and Scott Sinner, MD, FACP Despite the healthcare team’s best efforts, not all hospitalizations go smoothly. This article describes the case of an obese patient who underwent bariatric…

Clinical Notes: Radiation & Lymphedema, Decline in Diabetic Foot Ulcers

Posted: November 20, 2014

Radiation and lymphedema Radiation therapy doesn’t increase the incidence of lymphedema in patients with node-negative breast cancer, according to research presented at the American Society for Radiation Oncology’s 56th Annual Meeting held this fall.

Clinician Resources: United Ostomy Association, NGC, NCCN, Experts

Posted: November 20, 2014

Here is a list of valuable ostomy resources, some suggested by our colleagues who follow Wound Care Advisor on Twitter. United Ostomy Association of America The United Ostomy Association of America provides comprehensive resources for patients, including information about the types of ostomies and issues related to nutrition, sexuality, and travel. Much of the information is also available in Spanish…

Developing a successful program for wound care in the home

Posted: November 20, 2014

By Stanley A. Rynkiewicz III, MSN, RN, WCC, DWC, CCS Developing a successful wound care program requires a strong commitment and a willingness to learn. Our experience with creating such a program at Deer Meadows Home Health and Support Services, LLC (DMHHSS), a nonprofit home-care facility in Philadelphia, Pennsylvania, may help others build a similar wound care program and reap…

Linear wound measurement basics

Posted: November 20, 2014

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. Measurement of wounds is an important component of wound assessment and provides baseline measurements, enables monitoring of healing rates, and helps distinguish among wounds that are static, deteriorating, or improving. All alterations in skin integrity,…

Make your patient-teaching idea a patented reality

Posted: November 20, 2014

By Joy Hooper, BSN, RN, CWOCN, OMS Have you ever had an idea for improving patient care that you wanted to market? You may have lacked confidence or know-how, as I once did. But one patient, a crafty idea, and a trip to Walmart put me on the path to becoming a successful nurse entrepreneur.

Using maggots in wound care: Part 2

Posted: November 20, 2014

By Ronald A. Sherman, MD; Sharon Mendez, RN, CWS; and Catherine McMillan, BA Note From the Editor: This is the second of two articles on maggot therapy. The first article appeared in our July/August 2014 issue, Read part 1 here. Whether your practice is an acute-care setting, a clinic, home care, or elsewhere, maggot debridement therapy (MDT) can prove to…

What to do when someone pushes your buttons

Posted: November 20, 2014

By Laura L. Barry, MBA, MMsc, and Maureen Sirois, MSN, RN, CEN, ANP Why is it that some things don’t bother us, while other things catapult us from an emotional 0 to 60 mph in a heartbeat? We all know what it feels like when someone says or does something that gets our juices flowing. We feel it in our…

When should we take “No” for an answer?

Posted: November 20, 2014

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS Have you ever had a patient yell “Get out of my room!” or “Don’t touch me! I don’t want to be turned”? How about “No! Don’t put those compression stockings on my legs!” or “No, I’m not going to wear those ugly orthopedic shoes!” or “No way. I can’t stay in bed.…

2014 Journal: November – December Vol. 3 No. 6

Click here to access the digital edition

Confronting conflict with higher-ups

July 21, 2014February 25, 2020 Wound Care Advisor

By Pam Bowers, RN, and Liz Ferron, MSW, LICSW

Conflict in the workplace is a fact of life, and dealing with it is never easy. Sometimes it seems easier to ignore it and hope it will take care of itself. But in healthcare organizations, that’s not a good strategy. Unresolved conflict almost always leads to poor communications, avoidance behavior, and poor working relationships—which can easily affect patient safety and quality of care. (more…)

How to love and care for yourself unconditionally

July 21, 2014February 25, 2020 Wound Care Advisor

By Yolanda G. Smith, MSN, RN, CCRN

Are you able to relax, have fun, and enjoy the simple pleasures of life? Or do you:

have trouble falling or staying asleep?
smoke, drink, or eat to reduce tension?
have headaches, back pain, or stomach problems?
get irritated or upset over insignificant things?
have too much to do and too little time to do it?

(more…)

You want to touch me where?

July 21, 2014February 25, 2020 Wound Care Advisor

By Debra Clair, PhD, APRN, WOCN, WCC, DWC

Providing wound care requires a great deal of knowledge and skill. To become a wound care nurse entails taking classes, gaining and maintaining certifications, and acquiring on-the-job experience. But despite your education, knowledge, skills, and certifications, you may encounter problems when wound care requires you to touch the patient in a sensitive or embarrassing area. Touching the patient in these areas is called intimate touch. (more…)

Eating better to help manage chronic stress

May 22, 2014February 25, 2020 Wound Care Advisor

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.

(more…)

Guidelines for safe negative-pressure wound therapy

March 25, 2014February 25, 2020 Wound Care Advisor

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 negative pressure evenly through a wound filler (foam or gauze). Drainage tubing adheres to an occlusive transparent dressing; drainage is removed through the tubing into a collection canister. NWPT increases local vascularity and oxygenation of the wound bed and reduces edema by removing wound fluid, exudate, and bacteria. (more…)

Mastering the art of meetings

January 30, 2014February 25, 2020 Wound Care Advisor

By Toni Ann Loftus, MBA, RN, MHA

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…)

Fifty shades of wound care at home

January 30, 2014February 25, 2020 Wound Care Advisor

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 patient’s caregiving supporters—not 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…)

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…)

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…)

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 to fit in fast at your new job

September 25, 2013February 25, 2020 Wound Care Advisor

By Gregory S. Kopp, RN, MN, MHA

A new job can be stimulating, but it can also be stressful. Not only will you have new responsibilities, but you’ll also have a new setting, new leaders, and new colleagues. And the quicker you can figure out who’s who and what’s what—without stepping on anyone’s toes—the better off you’ll be.

But establishing positive relationships while performing your new job well can be tricky. And early missteps can have a lasting effect on your working relationships and your effectiveness. That’s why I recommend using the four tactics below, starting on day one. (more…)

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