Archive for the ‘Nutrition’ Category

The Head to Toe Search for Wounds

Tuesday, June 12th, 2018

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

 

A comprehensive skin assessment should look for more than just wounds because many medical problems have telltale signs that are easy to see if you know what to look for.

comprehensive skin assessment

 

Dr Nancy Collins

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

 

POA. These three little letters have become very important in wound care because we must document any wounds present on admission (POA). By doing so, we are saying that these wounds began somewhere else—maybe at home, maybe in another care setting, but definitely not while under the present facility’s care. This distinction of origin has great implications both financially and legally.

 

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Nutrition Tips for Wound Patients With Cancer

Friday, May 11th, 2018

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

Patients with wounds usually have multiple medical problems, and often the other diagnoses make meeting the nutritional plan difficult, such as when the wound patient also has cancer.

Nutrition Tips for Wound Patients With Cancer

 

Dr Nancy Collins

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

I often discuss the increased nutritional requirements to fuel wound healing. Patients need extra calories and protein each day, plus an adequate amount of fluids, the right mix of vitamins and minerals, and any adjuvant treatments, such as targeted amino acids. A question that I often am asked is how you accomplish this when the patient has an additional diagnosis that impedes or supersedes the recommended nutritional plan. It is rare that a patient presents with only a single medical problem, and sometimes the other problems pose challenges to the nutritional plan.

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Helping Wounds Heal With Amino Acids

Friday, April 6th, 2018

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

The use of targeted amino acids is becoming more common as a strategy to help heal a variety of conditions, including wounds, because of the role key amino acids have in rebuilding tissue.

Helping Wounds Heal With Amino Acids

 

Chronic wounds, meaning those that have not healed in 12 weeks, affect approximately 6.5 million patients in the United States annually at a cost of $25 billion.1 The term chronic wound refers to various types of skin integrity problems, such as pressure injuries, diabetic foot ulcers, venous ulcers, arterial ulcers, burns, and traumatic wounds to name a few.

The Role of Nutrition

Dr Nancy Collins

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

Nutrition often is not the first thing you think of when talking about wounds, but it is important to understand the link between poor nutrition and wound healing. Essentially, when a body has a wound, it has competition for the nutrients it needs. Wound healing is very energy dependent; energy is another word for calories. If your patient is not eating well and not meeting his or her caloric and protein goals every day, weight loss typically occurs.

When nutritional substrate is in short supply, the body decides whether to use the available substrate to build new tissue for the wound or to use it to keep its vital organs functioning. If weight loss continues unchecked, wound healing is impaired and eventually it will cease altogether in favor of the body’s vital organs.2

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Discover the Benefits of Wound Care Nutrition Certification

Friday, February 9th, 2018

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

Whether you are looking to increase your wound care nutrition knowledge or advance your career, a new wound care certification course for Registered Dietitians (RD) and Registered Dietitian Nutritionists (RDN) will help you meet your goals, while improving outcomes for your wound care patients.

Discover the Benefits of Wound Care Nutrition Certification

 

I often get funny reactions when I tell people I specialize in wounds. Lay people always assume I mean bullet wounds. I notice them nodding with confusion when I go on to explain that I do not see many bullet wounds, but treat plenty of pressure injuries and diabetic foot ulcers.

Dr Nancy Collins

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

When I have the same conversation with nurses, patient care assistants, and other healthcare providers who do not specialize in wounds, they seem to nod with a similar amount of confusion. They immediately think of topical care and turning and repositioning—all important to wound healing—but they overlook the fact that in order to build new tissue it is necessary to have adequate nutritional substrate onboard.

Clearing up this confusion is one of the reasons I am so excited to share the new nutrition certification available from the National Alliance of Wound Care and Ostomy® (NAWCO®). Hopefully every skin and wound care team will soon have a certified nutrition member to help heal wounds from the inside out!

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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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