Lower Extremity Ulcers and the Toe Brachial Pressure Index

January 19th, 2018

When treating patients with lower extremity ulcers, you need to find out if there’s impaired arterial blood flow. But for some patients, the standard Ankle Brachial Index (ABI) yields  misleading results. Fortunately, there’s an easy alternative: the Toe Brachial Pressure Index (TBPI).  Here’s when and how to perform this simple test.

 

Lower Extremity Ulcers and the Toe Brachial Pressure Index

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Diabetes: Eight Reasons to Get It Under Control Now!

January 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Patients with diabetes are more likely to suffer many serious health issues besides foot wounds and amputations. This makes it imperative that they resolve to get their blood glucose levels under control.

Diabetes: 8 Reasons to Get It Under Control Now!

 

All of the lawsuits I review have a common theme. The plaintiff suffers from a chronic wound and some degree of malnutrition and/or dehydration. I have started to notice that in addition to these problems, the plaintiff also quite often has diabetes. This trifecta of problems leads to pain, suffering, disability, and discontent.

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

People with diabetes are 10 to 20 times more likely to have a lower extremity amputation than those without diabetes.1 This is a scary statistic compounded by the fact that people with diabetes may not even notice a foot wound developing because they cannot feel it because of neuropathy. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes.2 Knowing this should provide enough motivation for patients to get their diabetes under control, but some people need even more reasons. Here are eight more consequences you can discuss with your patients. Hopefully, one will hit home.

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Ostomy Minute: End Stoma vs. Loop Stoma

January 5th, 2018

In this short video, WCEI Clinical Instructor Joy Hooper, RN, BSN, CWOCN, OMS, WCC uses a simple but powerful visual aid to explain the difference between two stoma configurations: the end stoma and the loop stoma.

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Top WCEI Blogs of 2017

December 29th, 2017

We’re excited to launch a new year of wound care topics. But first, we’re looking back at the WCEI blogs you liked best in 2017. Here are the year’s most read (and often most shared and discussed) posts. 

[Click on the title or image to read the full post.]

1. Wet-to-Dry Dressings: Why Not?

What should wound care professionals do when a physician orders wet-to-dry dressings? Be prepared and know the facts.

Wet-to-Dry Dressings: Why Not?

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Acetic Acid or Dakin’s Solution in Wound Care: Am I Doing This Right?

December 21st, 2017

How and when do you use two common topical antiseptics, acetic acid and Dakin’s solution? We help clear up the confusion. 

Acetic Acid or Dakin’s Solution in Wound Care: Am I Doing This Right?

 

In wound care, we now recognize that antibiotics – and their overuse –  contribute to bacterial resistance. With so many antibiotics losing their effectiveness, clinicians have turned to antiseptics that are bactericidal (kill bacteria) or bacteriostatic (inhibit bacteria growth) to cleanse and treat infected wounds.

At WCEI®, we receive a lot of questions about two popular antiseptics:  acetic acid and Dakin’s solution (sodium hypochlorite).  Both boast a broad range of effectiveness. Neither is new or cutting-edge. The early Egyptians treated wounds with acetic acid.  World War I clinicians successfully used sodium hypochlorite to avoid amputations due to infection. Yet, despite these long histories, we find that today’s clinicians are confused about how to use them. When should we choose these treatments and how do we use them to prepare and dress the wound?

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The Case of the Dirty Wound Care Clinic

December 15th, 2017

Nancy Collins, PhD, RDN, LD, NWCC, FAND

We have made progress in reducing healthcare-associated infections, but still have a long way to go, especially when patients complain of dirty, dingy hospitals and clinics.

Dirty Wound Care Clinics and Infections

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

I feel a little like girl detective Nancy Drew as I ask you to consider the Case of the Dirty Wound Care Clinic. Let me explain. In a recent lawsuit, the plaintiff alleged that her mother’s wound did not heal and became infected because of the lack of cleanliness in the hospital-based clinic where she was receiving treatment. It would not surprise me if your initial reaction to this claim is that it is nonsense, so let’s take a closer look.

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Advanced VAC Therapy: When is the Right Time to Step Up Your Game?

November 20th, 2017

Kimberly Hall, DNP, RN, GCNS-BC, CW­CN-AP

When V.A.C. VERAFLO™ Therapy has made a difference in my clinical practice

Advanced VAC Therapy

 

Kimberly Hall

Kimberly Hall, DNP, RN, GCNS-BC, CWCN-AP

For some of us, V.A.C.® Therapy has been a mainstay for decades. But even as some of the most experienced clinicians, we know that sometimes we just need something else–something—more? What do we do when patients who have been on V.A.CTherapy for a week and that granulation tissue isn’t quite as beefy red as we would have expected or hoped for? Or maybe the wound that seems to have stalled and just won’t budge even though you’ve seen V.A.C.® Therapy heal a similar wound in the same amount or less time? How about the wound that you’re using V.A.C Therapy on but every time you do a dressing change, that layer of wet yellow slough in the base of the wound keeps returning like a bad habit, despite using all the tricks up your sleeve for additional chemical and mechanical debridement? Then what?

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World Wide Pressure Injury Prevention Day: Resources, Resources, Resources!

November 15th, 2017

World Wide Pressure Injury Day - WCEI Resources

 

Join Wound Care Education Institute (WCEI), the National Pressure Ulcer Advisory Panel (NPUAP), and healthcare organizations across the globe in promoting awareness about pressure injury prevention!

To celebrate, we’ve brought together WCEI resources– webinars, blogs, journal articles, slideshows and downloads— to help keep you on top of the current pressure injury guidelines and definitions.

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Can You Use Job Burnout as a Legal Defense?

November 10th, 2017

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Wound care is a stressful profession, and sometimes your empathy bucket becomes empty, but job burnout is not a proper professional or legal defense.

Can You Use Job Burnout as a Legal Defense?

 

A group of my professional friends were having lunch together and catching up when one friend disclosed that she was taking a month off of work. We all looked at her agape and at the same time exclaimed “a month?” We had a dozen questions for her. Was she ill? How did she arrange this? What did her supervisor say? Would she still have her job at the end of the month? And most importantly, why was she taking a month off?

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Medicare Spending on Wound Care: The First Comprehensive Study

October 13th, 2017

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Chronic wounds impact 15% of Medicare beneficiaries at an estimated annual cost of $28 billion to $32 billion, making nutrition a seemingly cost-effective purchase.

Medicare Spending on Wound Care: The First Comprehensive Study

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Did you ever wonder how much it really costs to treat and heal various wounds? Patients, family members, and healthcare team members often complain to me that $5/day for nutrition therapy is “too expensive.” Cost is relative, because according to the first comprehensive study of Medicare spending on wound care, it appears that an investment in medical nutrition therapy is a wise investment indeed.

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