Compression Sock for Excessive Sitting or Standing

Helping Patients with Lymphedema

Success as an HME compression provider takes commitment, education and an understanding that there is more to compression beyond the feet.

The compression sock is an integral product to carry for any HME provider committed to using compression technology to help patients. Compression doesn’t even need to be required due a medical condition – it’s an almost universal need. Sitting or standing for excessive amounts of time can be terrible for your health, especially the feet. For example, sitting with your legs crossed beneath your chair can cause pressure that results in swollen ankles or varicose veins. And standing all day at work can cause issues from your neck all the way to your feet. (more…)

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Instill instead: Negative pressure wound therapy with instillation for complex wounds

Negative pressure wound therapy (NPWT) uses negative pressure to draw wound edges together, remove edema and infectious material, and promote perfusion and granulation tissue development. The tissue stretch and compression created by negative pressure during NPWT promotes tissue perfusion and granulation tissue development through angiogenesis, cellular proliferation, fibroblast migration, increased production of wound healing proteins, and reduction of wound area. NPWT has been used to improve healing in a variety of wounds, including traumatic injuries, surgical wounds, pressure ulcers, diabetic foot ulcers, and venous stasis ulcers. (more…)

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Comprehensive turning programs can avoid a pain in the back

Turning programs are essential to prevent and promote healing of pressure ulcers and to prevent the many negative effects of immobility, ranging from constipation to respiratory infections. However, turning a patient often puts a caregiver’s body in an awkward position, which can lead to musculoskeletal damage, especially back injuries.

According to the U.S. Bureau of Labor Statistics, healthcare workers suffer the highest rate of musculoskeletal disorders for all occupational groups and more than seven times the average rate for all occupations. Direct caregivers are the group most likely to experience musculoskeletal injuries. During turning tasks, excessive forces are imposed on the caregiver’s musculoskeletal structure due to the external load of the patient and the caregiver’s form and position during the task. Fragala and Fragala found that turning patients in bed is one of the highest-risk activities that lead to low back pain. (more…)

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Comprehensive skin assessment

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. Here’s an overview of performing a comprehensive skin assessment.

In the healthcare setting, a comprehensive skin assessment is a process in which the entire skin of a patient is examined for abnormalities. It requires looking at and touching the skin from head to toe, with a particular emphasis on bony prominences and skin folds. Comprehensive skin assessment is repeated on a regular basis to determine whether changes in the skin’s condition have occurred. The goal of a skin assessment is to identify problem areas promptly for treatment and prevention. (more…)

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Case study: Bariatric patient with serious wounds and multiple complications

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 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. (more…)

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Hidden complications: A case study in peripheral arterial disease

By Pamela Anderson, MS, RN, APN-BC, CCRN, and Terri Townsend, MA, RN, CCRN-CMC, CVRN-BC

Jan Smith, age 59, is admitted to the coronary intensive care unit with an acute inferior myocardial infarction (MI). Recently diagnosed with hypertension and hyperlipidemia, she smokes a pack and a half of cigarettes daily. She reports she has always been healthy and can’t believe she has had a heart attack. (Note: Name is fictitious.)

On physical exam, the cardiologist finds decreased femoral pulses bilaterally and recommends immediate cardiac catheterization. Fortunately, primary percutaneous coronary intervention (PCI) is readily available at this hospital. PCI is the preferred reperfusion method when it can be provided by skilled cardiologists in a timely manner. (more…)

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What is a comprehensive risk assessment?

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

Prevention of pressure ulcers and skin breakdown begins with a comprehensive risk assessment. Most providers use a skin risk assessment tool, such as the Braden or Norton scale. While these tools have been validated to predict pressure ulcer development, their use alone isn’t considered a comprehensive assessment, and frequently the individual risk factors they identify aren’t carried through to the plan of care. (more…)

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Clinician Resources: On the Road Again, Nutrition, Compression

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…)

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