Archive for the ‘pressure injuries’ Category

The Great (Legal) Debate About Turn and Reposition Documentation

Friday, April 7th, 2017

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

Documentation of turning and repositioning often leads to legal problems as some healthcare providers chart by exception and others chart at the point of care.

The Great (Legal) Debate About Turn and Reposition Documentation

 

“The hospital never turned the patient, and therefore the patient suffered a serious pressure injury,” declared the plaintiff attorney. The defense team shot back, “Whoa. Slow down. Never is long time, and of course we turned the patient.” How can a basic care intervention such as turning and repositioning have two totally opposing views?

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When Your Patient Refuses to Be Turned and Repositioned—And Then Sues!

Friday, February 3rd, 2017

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

The battle between optimal medical care and patient rights is one to fight with empathy and finesse to keep it out of the courtroom.

When Your Patient Refuses to Be Turned and Repositioned—And Then Sues!

 

I recently reviewed a lawsuit filed by the family of a patient* with a spinal cord injury. The patient was involved in a car accident and sustained multiple traumatic injuries. The medical team worked tirelessly over the course of many weeks to stabilize him. Because of this catastrophic accident, the patient was understandably quite devastated and depressed. He refused all physical therapy and spent most days lying in bed on his back, despite encouragement from his medical team and pleading from his family. He frequently stated that he wished he was dead and that he wanted everyone to leave him alone, often escalating things to the point of screaming.

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Wound Care Myths: 5 More Debunked

Friday, November 25th, 2016

Whether it involves heel protectors, anti-embolism stockings, or letting wounds “breathe,” there are still plenty of wound-care myths circulating out there. Ready for the truth? You can handle it.

Wound Care Myths: 5 More Debunked

 

Do you use wet-to-dry dressings in order to save money? Have you administered oral antibiotics to treat infected wounds? And do you follow physicians’ orders for wound treatments even though you know they’re inappropriate?

If you answered yes to any of these questions, then you are not alone. You are among a host of other professionals who have believed or participated in some of the most common wound care myths. In an earlier post, we revealed why these and other wound care myths simply need to go away. But we’re not finished. Here are five more myths that run counter to the evidence and wound care standards that guide our clinical practice.

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Pressure Injuries with Cartilage? Stage Away

Wednesday, September 14th, 2016

When it comes to wound care, staging pressure injuries with visible or palpable cartilage doesn’t have to be complicated. Here’s what to do.  

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(Photo: NPUAP copyright & used with permisson)

 

If you’ve ever treated wounds around the ear or in the area just below the bridge of the nose, you know how very little subcutaneous tissue there is. As a result, pressure injuries in these areas tend to be quite shallow, and they typically reveal cartilage.

So when encountering a pressure injury with visible or palpable cartilage, how should you stage it? We’ve got the answer.

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Pressure Injury Prevention: Nutrition Matters

Friday, July 15th, 2016

(Adapted from  Nutrition and Wound Care by Amy Carrera, MD, RD, CNSC)

Proper nutrition is key when it comes to pressure injury prevention and effective wound care, no matter if it’s at home or in a health care facility.


Nutrition and Pressure Injury Prevention


Pressure injuries can occur in health care settings or at home, and affect more than 2.5 million Americans annually. The cost of treating just one Stage III or IV pressure injury may range anywhere from $5,000 to $50,000. Adequate nutrition status is paramount to wound prevention and helps to facilitate wound healing.

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Pressure Injuries? (Don’t) Say It Ain’t So!

Tuesday, April 19th, 2016

Mounting pressure to call pressure injuries (aka pressure ulcers) something else has caused a stir – and clinicians in wound care are feeling the heat. Find out why.

Pressury Injuries - Don't Say It Ain't So

One of the most basic principles of healing a wound is to determine the cause – and then remove it. It sounds so simple, doesn’t it? But this is easier said than done, as many wounds have similar characteristics, and we don’t always have all the facts at our disposal in order to pinpoint the cause.

Unfortunately, this process has become further – and unnecessarily – complicated, thanks to increasing pressure (no pun intended) on wound clinicians to name a pressure injury something else. See? We told you it was complicated. Here’s what you need to know.

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Pressure Injury (Ulcer) Staging: More Real-World Answers

Friday, April 15th, 2016

More real-world wound care questions and answers relating to pressure injury staging, including slough, debridement and skin breakdown.

More Real-World Pressure Injuries

 

Can’t get enough of pressure injury staging? Neither can we. That’s why we’re excited to present even more questions and answers about this topic, based on what wound clinicians experience out in the field (versus what we might learn from textbooks or in a classroom).

In our first such post – packed with some awesome pressure injury staging questions from the field – we discussed slough, levels of destruction and debridement. Here, you’ll find out more about pressure injury staging as it relates to abrasions, surgical flaps, skin breakdown due to clothing, and more. So here they are – five more tips for staging pressure injuries, based on real questions from clinicians.

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Wound Care News: National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology

Wednesday, April 13th, 2016

Breaking Wound Care News

The term “pressure injury” replaces “pressure ulcer” in the National Pressure Ulcer Advisory Panel Pressure Injury Staging System, according to the NPUAP. The change in terminology more accurately describes pressure injuries to both intact and ulcerated skin. In the previous staging system Stage 1 and Deep Tissue Injury described injured intact skin, while the other stages described open ulcers. This led to confusion because the definitions for each of the stages referred to the injuries as “pressure ulcers”.

In addition to the change in terminology, Arabic numbers are now used in the names of the stages instead of Roman numerals. The term “suspected” has been removed from the Deep Tissue Injury diagnostic label. Additional pressure injury definitions agreed upon at the meeting included Medical Device Related Pressure Injury and Mucosal Membrane Pressure Injury.

CLICK HERE to read the National Pressure Ulcer Advisory Panel’s full press release.

 

 

 

Real World Pressure Ulcers: Staging Can Be Tricky

Tuesday, March 29th, 2016

This wound care Q&A answers five of the most common questions about pressure injury staging dilemmas (that you probably didn’t learn from textbooks).

Real World Pressure Injuries

 

In the world of wound care, just as in real life, the phrase, “Expect the unexpected” couldn’t be more appropriate. Clinicians can do everything exactly by the book, only to find that a wound just won’t heal, or the source of the problem appears to be one thing but then ends up being another. This is especially true with pressure injuries.

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