Archive for the ‘Nutrition’ Category

Medicare Spending on Wound Care: The First Comprehensive Study

Friday, 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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Malpractice or Obesity: Can a 276-Pound Patient Heal a Pressure Injury?

Friday, September 8th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Obesity presents challenges to wound healing, but with knowledge and appropriate care interventions, we can provide optimal conditions to support the best possible outcome for every patient, no matter what size.

Malpractice or Obesity?

 

The US obesity epidemic reached a new all-time high in 2016, according to newly released Centers for Disease Control and Prevention data.1 Every single state has an obesity rate greater than 20%, and in five states it’s even greater than 35%. Topping the chart is West Virginia, at 37.7%.

Many of these people end up in the healthcare system because of obesity-related diseases and sometimes develop a wound, such as a pressure injury. As we know, wounds that do not heal after 12 weeks are termed chronic, and lawsuits because of chronic wounds and their consequences are rampant

The Obese Plaintiff

The discovery process surely will reveal whether a patient was overweight or obese because nutritional status and body weight are factors in the healing process. The tricky part is deciding how much, if any, of the chronicity of the wound was because of obesity.

In a recent case, the patient was 5′3″ and weighed 276 pounds. Can a person of this size heal? The defendants claimed they did everything according to the standard of care, but despite excellent care, the patient did not heal. They recounted some difficulty repositioning the patient because of her size and problems with moisture management in her skin folds. The plaintiff thought those were excuses and that there was size bias in the care given to the patient. So what are the facts when dealing with a larger patient with a wound?

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Nutrition and Wounds: The View From Both Sides

Friday, July 14th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Nutrition is frequently conjoined to wound care lawsuits because patients often lose weight, so it is important to thoroughly document nutrition interventions and education.

 Nutrition and Wounds

 

Most pressure injury lawsuits begin as just that—a lawsuit initiated because of an acquired pressure injury. Usually the wound in question never healed to closure, became infected, led to an amputation, or otherwise caused the patient suffering. During the legal discovery process, all sorts of other care issues come to light, and the scope of the lawsuit grows. One of the most common additional issues is the patient’s nutritional status. Let’s look at it from both sides.

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