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Diabetic Wound Certified Nurses Paying It Forward in Philadelphia

May 14th, 2013

Diabetic Wound Care certified nurses had a dream to create a free diabetic foot screening clinic and open it up to the city of Philadelphia, PA. Their dream came true.

Philadelphia Nursing Team, WCC's and DWC's getting ready to open up the clinic.

Philadelphia Nursing Team, WCC’s and DWC’s and Dr. Fanelly getting ready to open up the clinic.

Wound Care Education Institute’s (WCEI®) clinical team presented a session last year called “Paying It Forward” at our annual “Wild on Wounds” convention. This session was all about developing and coordinating free community diabetic foot screening clinics. We walked attendees through every step necessary to conduct such a clinic, from choosing a location to marketing and funding, and including logistics such as station supplies and staffing.

As a result, Stanley A. Rynkiewicz III RN MSN WCC® DWC® CCS and Administrator at Deer Meadows Home Health was inspired to coordinate a one day clinic in his home town of Philadelphia. He asked if WCEI could help him coordinate the event making it available to the whole city. We were thrilled at the invitation!

The event took place on Saturday May 11th with staff that included volunteer nurses, Wound Care Certified (WCC®) and Diabetic Wound Certified (DWC®) clinicians and a local podiatrist and co-sponsor, Dr. John M. Fanelly DPM.

The clinic was a huge success!  Close to 100 Philadelphians came from all over the community, ranging in age from 35-85 years.  We were a welcome sight to them and you could see the appreciation in their faces.  They came to us with conditions that ranged from calluses to fungus and included hammer toes, Onychogryphosis (also known as “ram’s horn nails”), diabetic ulcers and Charcot foot .

Polymem Silver Toe dressing to combat bioburden

Polymem Silver Toe dressing to combat bioburden

We will never forget Willie, an older man who walked with a slow shuffle and a big smile. Because he had not seen a doctor in many years, he was thrilled to have his feet checked. When he took off his slipper we saw the “ram’s horn toe nails” shown in this photo. They had not been cut in years and were excessively thick and curled under and over.

Ram Horn Nails

Ram Horn Nails

Our post clinic meeting discussions made it clear that our outreach work has just touched the surface of a great need. Much more needs to be done and our knowledge and expertise has the potential to have enormous impact. There are many more Willies out there that need our help.

We plan to share our experience in detail at this year’s Wild on Wounds annual convention in Las Vegas on September 11-14, 2013. Our hope is to inspire more clinicians to do this in their own communities across the country.

Thanks again to all the wonderful nurses who donated their time on a very long Saturday and to the wonderful sponsors:  Deer Meadows Home Health Select DataFerris Manufacturing (Polymem Dressings) / Dr. John M. Fanelly DPM and Wound Care Education Institute.

 

Who Says Wound Care Can’t Be Fun!

April 9th, 2013

The Wild on Wounds annual conference is dedicated to spreading the knowledge needed to be a successful wound care practitioner. wow_boxing_ad

It is a multidisciplinary event providing exciting learning opportunities and a whole lot of fun!

To deliver a knock-out blow to chronic wounds, you need the passion and desire to achieve your goal and the know-how to turn that desire into results. This event will inspire you and give you the “moves and fancy footwork” needed to deliver positive results for your wound patients.  It is designed for the hands-on practitioner looking for evidence-based knowledge and tools to make a difference right away.

Conference Highlights:

  • 49 sessions covering the latest in evidence-based wound care
  • 21 “HOW-TO”  series of sessions to choose from
  • 7 “HANDS-ON” series of sessions to choose from
  • 4 Days of networking opportunities
  • Invitation to our 10th Anniversary Black & White Gala open to all main attendees
  • And More!

For complete details visit www.woundseminar.com

Trimming Those Tricky Diabetic Toenails

March 7th, 2013

diabetic blog pic

You are getting ready to trim your diabetic patients toenails.  What exactly does that all involve?  Well, first you need the proper tools.  A set of toenail nippers, nail file, and orange stick are typically used.   Always follow your facility or healthcare’s settings policy for infection control.  Single use disposable equipment is favorable.

You have gathered your equipment to trim the patients toenails, now what?  Nails are easiest to trim after a bath or soak for 10min to soften nails.  The soaking of diabetics feet should only be done by a healthcare professional. You can clean under the patients toenail with an orange stick (wearing gloves), wiping on a clean washcloth in between each toe during soaking. .

After soaking and washing of the feet are completed, dry the patients feet completely.  Wash your hands and put on gloves to trim the toenails.  Use your dominant hand to hold the nipper.  Start with the small toe and work your way medial toward the great toe.  Squeeze the nipper to make small nips to cut along the curve of the toenail.  Be careful not to cut the skin.  Use your index finger to block any flying nail fragments.  Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail.  Never use two hands on the nipper.  The nail is trimmed in small clips in a systematic manner.  The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed.  The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges.  When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.

When all toes have been trimmed and filed, remove gloves and wash hands.  Apply clean gloves and apply lotion to the top of the foot and to the soles of the feet, rubbing lotion in well, wipe excess lotion off with a towel.  Put patients socks and shoes back on as needed.  Wash hands and smile, you are done!

For your patients who are trimming their own toenails at home teach them the following simple instructions:  Be sure you have good lighting. Trim toenails after bathing, dry feet well, especially in between the toes.  Start with the little toe and work your way into the great toe.  Use small cuts, never cut the toenail across all at once.   Cut straight across and use a nail file to smooth edges.  Apply lotion to the bottom and tops of the feet, never in between the toes.  For patients with thickened toenails or yellowed toenails, recommend a foot care specialist like a podiatrist cut their toenails.

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Successful Care Continuum Educational Event held in Florida

February 8th, 2013

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Hill-Rom® and Wound Care Education Institute® (WCEI®) held the first educational care continuum event in Ft Lauderdale, Florida with great success!

Nancy Morgan RN, BSN, MBA, WOC, WCC, DWC, OMS

Nancy Morgan RN, BSN, MBA, WOC, WCC, DWC, OMS

Hill-Rom is a leading worldwide manufacturer and provider of medical technologies and related services for the health care industry.  Representatives from Hill-Rom were  invited by the CNO of Westside Regional Memorial in Plantation, FL to provide clinical education to their staff.  Taking advantage of a strong working relationship with WCEI, Hill-Rom  got them involved in this effort.

This week our event educated 60+ clinicians from all care settings within the community along with staff members.  Speaker Nancy Morgan focused on wound assessments, documentation and surface selection while the Hill-Rom team provided Clinitron® education and competency training.  This type of education is critical in creating a continuum of care collaborative team amongst healthcare providers. Clinicians who attended the event were energized by Nancy’s practical, dynamic, interesting and fun approach to education.

Hill-Rom hopes to continue this effort where the care continuum goal is to provide quality care and to minimize readmissions. WCEI will also continue to support these efforts wherever possible.

Clinitron® Air Fluidized Therapy bed

Clinitron® Air Fluidized Therapy bed

 

FBTWYT

“Footnotes on Selecting Diabetic Footwear”

January 28th, 2013

There are a lot of shoes out there, but not all of them would be appropriate selections for our diabetic patients.  In fact, selecting improper footwear could actually harm our diabetic patients and lead to diabetic foot ulcers and possible amputations.  Statistics show that 50% of amputations of our diabetic patients are directly related to improper footwear!amputation

Diabetic Wound Certified clinicians need to know how to check the footwear of our patients as well as the staff caring for our patients.  What are we looking for in a shoe for our diabetic patient?  The shoe should offer a firm snug fit.  The heel should be less than 1 inch, the greater the heel the greater the pressure on the ball of the foot and this could lead to callus formation and ulcerations.  The shoe should have laces, buckles or elastic to hold it in place.  When the diabetic is wearing slip on shoes the toes must curl to hold the shoe on and this can lead to calluses on the top of the toes and potential ulceration.  The shoe should have 1cm between the longest toe and the end of the shoe when the patient stands, we don’t want added pressure to the tips of the toes or on the toenails.  The sole of the shoe should be smooth without seams and cushioned to absorb shock and reduce pressure on the feet.  The shoe should be made from a material that “breathes”, avoid plastic and vinyl as they can encourage fungal infections.  The shoe should have a protective function; a closed toe shoe is imperative for our diabetic patient.  Look closely at the patients foot and the shoe – they should be the same shape, pointed toe shoes cause corns, calluses and ulcerations! Be sure the shoe width is appropriate, has a wide toe box that allow toes to move and accommodates any foot deformity.  The heel of the shoe should also be firm, you can check this by holding the sides of the heel of the shoe between your thumb and forefinger, try to push them together, if the heel compresses, its to soft and won’t give the patient good enough support when walking.

We also need to teach our patients and their family members instructions on checking for proper fit of their shoes and how to shop for new shoes.  They should be re-measured each time, shop late in the day, try on both shoes and walk around in them to ensure they are comfortable, be sure there is a thumbs width of space at the end of the longest toe, try the shoe on with the socks they will be wearing, be sure the heel is less than an inch, and be sure the shoe has laces or velcro closures.  If the patient has serious foot problems or deformities they should be referred for specially molded inserts and or shoes.

Following the above recommendations may just prevent a patient from developing a diabetic foot ulcer and an amputation!  Patient and caregiver education is a key factor in preventing diabetic foot ulcers!

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Wound Care Education Institute 2013 Class Schedule Posted

January 18th, 2013

The Wound Care Education Institute® (WCEI®) is the official certification course for Wound Care Certified® (WCC®), Diabetic Wound Certified (DWC®) and the new Ostomy Management Specialist™ (OMS).

Wound Care Education Institute

Wound Care Education Institute

WCEI is a dedicated center of education designed to provide students with comprehensive training programs taught by top-notch, up-beat instructors. Our training is practical, valuable, interesting, fun, high energy and interactive. On-site courses are located at multiple locations throughout the U.S.  and most are offered as a self-paced computer based module.

Upon successful completion of our programs, eligible medical professionals can then complete an on-site exam offered by the National Alliance of Wound Care® to achieve their National Certification in Wound Care (WCC®), Diabetic Wound Management (DWC®) or Ostomy Management Specialist℠ (OMS). Eligible medical professionals include: RNs, LPN/LVNs, PTs, PTAs, OTs, NPs, PAs, and MD/DOs.

Visit our website for individual class schedules at www.wcei.net

 

Foot Ulcers Gone Bad!

January 11th, 2013

To all our Diabetic Wound Management Certified clinicians out there or anyone interested in diabetic wound management, here are some tips to remember.

When it comes to diabetic foot ulcers, patient education plays a vital role in positive outcomes for our patient.  Patients need to understand the importance of proper foot care and importance of good blood glucose control.  The American Diabetes Association states that comprehensive foot care programs that include risk assessment, foot care education, preventative therapeutic treatment and referrals to a specialist can reduce the amputation rates bDiabetic Wound Certificationy 45-85%.  A reduction of the patients A1c blood test by 1% can reduce the risk of microvascular complications by 40%.

So what do our patients need to know?  They need to work closely with their physician and the dietician to be sure their blood glucose levels are properly controlled. The ADA recommends an A1c below 7%.   They need to know how important it is to check their feet daily to catch any problems early.  We as clinicians need to teach them how to do this and what to look for.  Teach your diabetic patients to inspect their feet everyday.  They can do this by having family members or caregivers check their feet, or they can use a mirror and do it themselves.   I have heard some patients buy the mirrored tiles and put one on the floor and the other one up against the wall for a good view of their foot.  Explain to your patients what exactly they are looking for; cuts, sores, red spots, swelling, infected toenails, blisters, calluses, cracks, excessive dryness or any other abnormality.  They should check all surfaces of the feet and toes carefully, at the same time each and every day.  Explain to your patients to call their physician right away if they notice any abnormalities or any open areas.  Other problems the diabetic patient should be aware of with their feet and report to their physician include tingling or burning sensation, pain in the feet, cracks in the skin, a change in the shape of their foot, or lack of sensation – they might not feel warm, cold, or touch.  The patient should be aware that any of the above could potentially lead to diabetic foot ulcers.

Instruct your patients to wash their feet every day, but not soak their feet.  Use warm, NOT hot water – be sure they check the water temperature with a thermometer or their elbow.  Dry feet well, especially between toes.  Apply lotion on the tops and bottoms of their feet but not between toes.  Trim toenails each week and as needed after bath / shower, trim nails straight across with clippers, smooth edges with emery board.

Wear socks and shoes at all times, the diabetic patient should never be barefoot, even indoors.  Wearing white socks are helpful to detect any drainage from the foot.  Have them check their shoes prior to wearing,be sure there are no objects inside and the lining is smooth.   Instruct them to wear shoes that protect their feet; athletic shoes or walking shoes that are leather are best, be sure they fit their feet appropriately and accommodate the foot width and any foot deformities.

For our diabetic patients, glucose control is a key factor in keeping them healthy, but patient education and understanding of proper foot inspection and what findings to report to their physician are just as important for the well being of our diabetic patient.

For information on the Diabetic Wound Management Certification Course, click here.

Diabetic Skin and Wound Management Certification 2013 Course Schedule

December 21st, 2012

 

 

 

The Diabetic Wound Management course is offered as an On-Site classroom or self paced, Computer-Based program and both focus on overall diabetic wound care and promotion of an optimal wound healing environment including prevention, therapeutic and rehabilitative interventions.  [Video]

Eligibility for the DWC® Exam
1.  Hold a current, unrestricted license as an LPN/ LVN, RN, NP, PT, PTA, OT, MD, DPM, DO or PA
2.  Complete an NAWC® approved “Diabetic Skin and Wound Management Course.”
3.  Can meet ONE of the following requirements:
a) Currently holds an accredited certification in wound care
(WCC®, CWS®, CWCN®, CWON®, CWOCN®)
OR…
b) Show documented active involvement in the care of diabetic patients, or in management, education or research directly related to diabetes while actively licensed for at least two (2) years full-time or four (4) years part-time within the past five (5) years.
2013 Class Schedule
MARCH
Monday, March 11, 2013 – Friday, March 15, 2013
Location: Lake Geneva, WI

Monday, March 18, 2013 – Friday, March 22, 2013
Location: Philadelphia, PA

APRIL
Monday, April 15, 2013 – Friday, April 19, 2013
Location: Glenview, IL – at the Oakton Community College

JUNE
Monday, June 03, 2013 – Friday, June 07, 2013
Location: Orlando, FL

NOVEMBER
Monday, November 04, 2013 – Friday, November 08, 2013
Location: Philadelphia, PA

DECEMBER
Monday, December 02, 2013 – Friday, December 06, 2013
Location: Des Plaines, IL at the Oakton Community College

Click Here for Registration Details.

Wound Management Seminars

December 13th, 2012

In plain, simple language explore the mysteries of wound care and learn how to crack the code for faster wound healing. Learn to “Dress for Success” with this comprehensive review of topical wound management products. This session will focus on the advanced wound dressing categories and review what, why, when, who, including “how-to-apply” videos. Hands-on fun with actual product stations where you can practice application of various products.  Cost: $99 per person.

Download details  -  Class Locations and Registration

This session will cover:
•  Up-to-date tips and techniques to overcome obstacles in wound healing.
•  Separating the “myths” from “reality”, we will explore some of the most common myths in wound care.
•  Learn the 5 most valuable concepts required to heal a wound.
•  TOP 10 MUST HAVE topical wound treatments.
•  Twelve common barriers to wound healing and how to remove them

Seminar Objectives: Upon conclusion participants will be able to:
•  Identify five concepts required to heal a wound.
•  Discuss barriers to wound healing.
•  Choose appropriate topical wound treatment based upon individual needs.

WHO SHOULD ATTEND:
Clinicians that are interested in wound care or work directly in wound care—LPN, RN, NP, PT, PTA, OT, OTA, MD/DO, Nurse Managers, Treatment Nurses, Wound Care Team, Clinic Directors, MDS Coordinators, Consultants.

www.wcei.net/one-day

Diabetic Wound Management – What Now? Series

November 5th, 2012

You have been dealing with a non-healing diabetic foot ulcer for what seems to be forever.

Diabetic Wound Certification

Diabetic Wound Management

You still can’t figure out what piece of the puzzle you are missing.  Well lets make sure we have covered each possibility in this chronic ulcer that could potentially impede healing.

Lets look at the wound and figure out if we can heal it.  What is the blood flow of the extremity?  Have you done a TBPI or toe brachial pressure index to be sure there is adequate blood flow to heal the wound?  If not, lets refer the patient out for further vascular studies.  If the TBPI is normal then lets look at other factors that may be impeding our wound from healing. Read the rest of this entry »