A Saudi rehabilitation facility fights pressure ulcers

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 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…)

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 association’s website include:

a variety of discussion groups
information for patients
list of helpful links.

The site also provides contact information for the regional associations. (more…)

By Carrie Carls, BSN, RN, CWOCN, CHRN, and Sherry Clayton, RHIA

In an atmosphere of changing reimbursement, it’s important to understand indications and utilization guidelines for healthcare services. Otherwise, facilities won’t 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

(more…)

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, or the inability to say no when someone asks for help.

The challenges of stress and burnout

Stress and job burnout can cause, contribute to, or result from a poor work-life balance. They disrupt our normal patterns, behaviors, and feelings.

Of course, no one can escape stress altogether. Sometimes stress is a good thing, but we need to be able to identify when it’s a problem. For many clinicians, stress springs from the desire to provide good service and care in all parts of their lives. This desire can create stress, especially when barriers exist to achieving it. (more…)

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 “Frequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases,” published in Inflammatory Bowel Diseases. (more…)

By Bill Richlen, PT, WCC, CWS, DWC, and Denise Stetter, PT, WCC, DCCT

The Rolling Stones may have said it best when they sang, “You can’t always get what you want,” 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. (more…)

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 plasma. Exudate can result also from conditions that cause edema, such as inflammation, immobility, limb dependence, and venous and lymphatic insufficiency.
(more…)

Turning programs hinder a good night’s sleep

By Jeri Lundgren, BSN, RN, PHN, CWS, CWCN

We’ve all experienced how a bad night’s sleep can affect our mood and ability to function the next day. Now imagine you’re a patient who has a pressure ulcer, most likely secondary to a declining disease state, and you’re being awakened and manipulated every 2 hours or in some cases hourly. How is your body supposed to recover without adequate sleep? (more…)

“This is how we’ve always done it” isn’t good enough

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, it’s 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 isn’t 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 sound—and even seem—credible 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, “Our entire hospital system has been doing this wrong for years.” (more…)

It takes a village: Leading a wound team

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 knowledge—and my new WCC credential—back to the long-term care facility where I worked. I was ready to change the world.

It didn’t take me long to figure out that I couldn’t change the complex world of wound care alone. I needed a team of specialists who could manage my patient’s troubles with nutrition, swallowing, activities of daily living, positioning, body image issues, and many other areas that required expertise I didn’t have. (more…)

Tag: 2014 Journal Vol3 No2

A Saudi rehabilitation facility fights pressure ulcers

Guidelines for safe negative-pressure wound therapy

Clinician Resources: Intl Ostomy Assoc., Substance Use Disorder

International Ostomy Association

Medicare reimbursement for hyperbaric oxygen therapy

Achieving a work-life balance

The challenges of stress and burnout

Clinical Notes: Low BMD, CKD, hypoglycemia, HBOT

Low BMD common after ostomy

Becoming a wound care diplomat

How to assess wound exudate

Turning programs hinder a good night’s sleep

“This is how we’ve always done it” isn’t good enough

It takes a village: Leading a wound team