Posts Tagged ‘“Cindy Broadus RN”’

WHY ABI?

Monday, October 20th, 2014

What exactly is an ABI?  ABI stands for Ankle Brachial Index. This is a non-invasive bedside tool that compares the systolic blood pressure of the ankle to that of Doppler_BloodPressureCuffthe arm. It is done to rule out Peripheral Arterial Disease in the lower extremities. The ABI is considered the “bedside” gold standard diagnostic test and can be done by any trained clinician in a clinic, hospital, nursing home and/or even the home care setting. All you need is a blood pressure cuff and a hand held Doppler.

Why do we do the Ankle Brachial Index or ABI?  Well, there are several reasons why we include the ABI as part of our assessment for the patient with lower extremity wounds. First of all, in order to heal a wound we have to be sure that our patient has adequate blood flow. The ABI will tell us if the patient has impaired arterial blood flow, and how significant that impairment is.  We also need to know the amount of compression that we can safely apply to the venous patient, in general the lower the patients ABI reading, the lower the amount of compression that can be safely applied.

When do I need to do the ABI? Standards of care and Guidelines dictate when we should be doing the Ankle Brachial Index. Our current standard of practice states to do the ABI: Anytime a patient has a lower extremity ulcer, when foot pulses are not clearly palpable, prior to applying compression wraps / garments or when the lower extremity ulcer is no longer healing.

What does the ABI “number” mean? First we need to be aware that not everyone’s ABI is reliable, in fact patients with diabetes or end-stage renal disease may have incompressible vessels rendering a falsely high ABI score. For these patients we use another diagnostic test called the Toe Brachial toe_cuf_wound_care_education_institutePressure Index (TBPI) instead of the ABI.  For those with ABI readings, in general as the patients ABI score decreases, this signifies that the patient has arterial disease of the lower extremity, and poor blood flow. Any patient with an abnormal reading needs a referral to a vascular specialist. Bedside interpretations of the ABI that we use as wound clinicians are: 1.0 considered a normal reading, an ABI of 0.9 indicate more venous, 0.6-0.8 indicate a mixed etiology (venous and arterial) and less than or equal to 0.5 is indicative of arterial disease of the lower extremity.

We as wound care clinicians are held to certain standards of care and must follow those guidelines established by the experts.  Performing the ABI on patients before applying compression and on patients with lower extremity ulcers is one of them.  As wound clinicians we use the ABI and our clinical assessment to help guide us into determining what type of ulcer we are dealing with so we can make appropriate referrals and develop the best treatment plan for our patients. It’s a step we can’t afford to leave out; our patient’s limb may depend on it.

 

Lower Extremity Wounds: The Basics (Parts 1, 2 & 3)

Monday, August 8th, 2011
Cindy Broadus

Lower Extremity Wounds: The Basics (Parts 1, 2 & 3) will be presented by Cindy Broadus RN, BSHA, LNHA, CLNC, CLNI, CHCRM, WCC, 3C Healthcare Consulting, LLC, WCEI Instructor at this year’s Wild on Wound’s National Conference in Las Vegas September 7-10,2011.

Lower extremity wounds can be hard to tell apart. In this 3-part session we will focus on venous, arterial, and neuropathic wounds. We’ll discuss the causative factors, pathophysiology, appearance and the principles of management. During this session, we will also discuss the different types of compression and selecting the appropriate compression therapy based on the lower extremity assessment.

For more information about the Wound Care Education Institute, please visit http://www.wcei.net.

Click Here To Register for the Wild on Wounds National Conference

Keeping Yourself Out of Hot Water: Legal Implications In Wound Care

Monday, June 20th, 2011

Legal Implications in Wound Care

Keeping Yourself Out of Hot Water: Legal Implications In Wound Care will be presented by Cindy Broadus RN, BSHA, LNHA, CLNC, CLNI, CHCRM, WCC, 3C Healthcare Consulting LLC, and WCEI Instructor at this year’s Wild on Wounds National Conference in Las Vegas NV at Caesars Palace.

We know what gets us into trouble legally in wound care. So how do we avoid these complications? With litigation on the rise, it is better to be safe then sorry. In this session, we’ll discuss some of the ways you can keep yourself out of hot water and implement discussed precautions in your everyday practice.

Cindy’s sessions are usually jammed packed with attendees who want to learn about the Legal Implications in Wound Care. So don’t miss out on this session, its a great one!

For more information about the Wound care Education Institute and WOW 2011, Check Out Wild On Wounds National Convention.

Pressure Ulcer Etiology

Tuesday, February 2nd, 2010

WCEI Instructor Cindy Broadus RN reviews Pressure Ulcer Etiology with the WCC candidates in a recent class in Philadelphia PA. Below is a little video from a Skin and Wound Management Course in which Pressure Ulcer Etiology is discussed. Cindy demonstrates how if the skin and soft tissue is compressed or squeezed together by weight or tension, the blood vessels collapse and tissue necrosis follows.

[youtube]http://www.youtube.com/watch?v=crOCKBPx0oU[/youtube]

Additionally, the Clinical presentation and characteristics of Pressure Ulcers are discussed in part in this video. Some of the characteristics include:

  • Rounded, crater-like shapes (not always round)
  • regular edges
  • usually develop over a bony prominence (not always over a bone)
  • will take on the shape of the object that caused the pressure

Typical anatomical locations that pressure ulcers are found include: (Top 5)

  • Sacral/Coccyx
  • Greater Trochanter
  • Ischial Tuberosity
  • Heel
  • Lateral Malleolus

The progression of Breakdown is as follows:

  1. Hyperemia
  2. Tissue Ischemia
  3. Tissue Necrosis
  4. Ulceration

For more information on becoming wound care certified or our Skin and Wound Management Course, check out our registration page

If it Wasn’t Documented, It Wasn’t Done! Documentation Woes! Part 2

Wednesday, October 14th, 2009

http://www.wcei.net . Cindy Broadus RN discusses Defensive Documentation.

The medical record is considered to be the most reliable source for determining what happened. It is a legal document, yet not always treated as such. With litigation lurking around the corner for every healthcare professional, we, as Wound Care Certified professionals, need to make sure our documentation is complete, concise and correct. Come on it and let’s talk about correct terms, techniques, and steps it will take to keep you out of trouble.

For more information about becoming Wound Care Certified, please visit http://www.wcei.net

If it wasn’t Documented, It wasn’t done!

Sunday, October 11th, 2009

How many times have we all heard, “If it wasn’t documented, it wasn’t done”? Far too often, we’re sure. Seriously, we as clinicians should take note of our documentation practices. Below is a short clip (Part 1 of 4) in which WCEI’s own Cindy Broadus RN, presented to the attendees at the Wild On Wounds Conference in Las Vegas NV in September. Her session was titled “If It Wasn’t Documented, It Wasn’t Done! Documentation Woes”.

Here was the description of the session: The medical record is considered to be the most reliable source for determining what happened. It is a legal document, yet not always treated as such. With litigation lurking around the corner for every health care professional, we, as Wound Care Certified professionals, need to make sure our documentation is complete, concise and correct. Come on it and let’s talk about correct terms, techniques, and steps it will take to keep you out of trouble.

Cindy always knocks it out of the park! Great job Cindy!

Differentiating Arterial and Venous Ulcers

Sunday, August 2nd, 2009

http://www.wcei.net Wound Care Education Institute Co-founder Nancy Morgan RN and Instructor Cindy Broadus RN discuss a question that was emailed to WCEI about how to distinguish an Arterial Ulcer from a Venous Ulcer

For More Information about becoming Wound Care Certified and knowing how to differentiate between Arterial Ulcers and Venous Ulvers, check out http://www.wcei.net

Wound Care Certification: Defensive Documentation

Sunday, June 28th, 2009

Practicing as a Wound Care Certified nurse or professional has its challenges. Not only do we have the challenge of taking care of complex patients and the wounds they incur. We also have the challenge of protecting ourselves through proper and defensive documentation. We should always document the services we are providing accurately. We should always be taking credit for the services we provide and thus properly documenting is defensive documentation. Far too often we become complacent in our day to day jobs and say to ourselves “I’ll just document that later”. Sometimes that “later” becomes never! We should all practice good documentation habits, not only for reimbursement purposes, but for defensive purposes. Below is a short video in which Cindy Broadus RN and Nancy Morgan RN discuss the importance of defensive documentation.

How do we protect ourselves, legally?

Tuesday, May 19th, 2009

Cindy Broadus RN and Nancy Morgan RN briefly discuss how to protect yourself legally. As Wound Care Certified Nurses and Professionals , we want to practice with peace of mind. Knowing ahead of time how to protect ourselves is half the battle. Document, document document!

WCEI- How will CMS effect Acute Care?

Saturday, March 14th, 2009