Posts Tagged ‘Donna Sardina 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.

 

Diabetic Foot Ulcer Assessment and Hands On Lab

Wednesday, October 1st, 2014
Donna Sardina RN, MHA, WCC, DWC, OMS

Donna Sardina RN, MHA, WCC, DWC, OMS

Do you know the components of a Diabetic Foot Exam? It is so important that all of us in wound care know the steps to preventing foot ulcers on our diabetic patients.  And that starts with a routinely scheduled comprehensive foot exam.

Donna Sardina took us through all the aspects of a comprehensive exam during the pre-conference session “Diabetic Foot Assessment.”

The key word here is comprehensive. A proper exam involves much more than just a test of sensation using a Semmes Weinstein monofilament or a tuning fork. What about skin color, texture, temperature, foot deformities, nail deformities, glucose control, and critically important perfusion status. Did you know that it is estimated that 50% of amputations in diabetics are a direct result of improper footwear? That statement gets my attention every time I hear it.

In this session we learned how to examine our patient’s footwear for signs of trouble. Included in the handouts was a document “Diabetes: Shoe Fitting Tips” that will be extremely helpful when putting our knowledge into practice. In recognition of the fact that we are not all specialists in the diabetic foot, Donna shared a “Simplified Sixty Second Foot Screen” published by Dr. Sibbald in 2012. It is a validated tool that has just 10 items on it that can be completed in less than 60 seconds. This seminar was empowering to all who attended and gave us the tools we need to make a difference in this at risk population.

DFU_exam

I’m going to conference! Are you?

Thursday, August 7th, 2014

Donna_headshotBy: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

Years ago, when I first started out in the wound care specialty, the only way to learn about new products and what was going on in the field was to “go to conference” (wound care conference). All year long, planning and excitement continued to build for our big trip. Not going wasn’t an option; our facility, patients, and administrators needed us to attend. If we didn’t, we’d be way behind our competition in regard to cutting-edge, hot-off-the-press wound care treatments and techniques.

Besides being a forum for displaying new wound care products, conference is an opportunity to network, to see what others are doing—what’s working and what isn’t— and to hear firsthand from researchers.

Living in the digital age has changed things for us. We’re blessed to have innovative information at our fingertips whenever we connect to the Web via computer, smartphone, or tablet. Manufacturers’ websites, government guidelines, and social media sites can keep us informed of what’s hot and happening if we just take the time to check them.

But as glorious as the Web is, I still believe in the power of attending conference. Some things are just meant to be seen, touched, and experienced—live and in person. Being in a convention hall with hundreds or even thousands of clinicians who love the same icky, yucky, stinky, and sometimes-nauseating challenge of wound management is something you just can’t experience on the Web. The power of passion, excitement, and inspiration from others is so contagious.

It’s understandable that money and time constraints play a big part in decisions to attend conference. Nonetheless, I believe all wound and ostomy experts should figure out a way to go to conference every year, or at least every other year. Here are some creative ideas for funding your conference expenses:

Educational grants from suppliers
State or local educational grants
Employer’s tuition-reimbursement program
Combining your annual family vacation with the conference trip
Holiday or birthday gift from your family
Simple negotiation with your employer.

Currently in the United States, we can choose from several wound conferences, including the National Alliance of Wound Care and Ostomy cosponsored event Wild on Wounds (WOW). I encourage all wound and ostomy experts to support and advance our specialty by continually educating and updating ourselves—and one way to do this is to go to conference.

Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS
Clinical instructor
Wound Care Education Institute
Plainfield, Illinois

DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.

Securement Strategies

Monday, August 29th, 2011
Securement Strategies will be presented by Donna Sardina RN, MHA, WCC, Co-Founder WCEI at this year’s Wild on Wounds National Conference in Las Vegas September 7-10, 2011.
We have options other than tape to keep our dressings in place. But securing dressings isn’t always so cut and dry. Problems occur. In this session we’ll learn what can cause securement issues: body contours and movement, exudate, moisture, sensitive or broken skin, tissue types, depth and dimension of the wound. Does it have undermining or tunneling? You’ll come away with some creative techniques for large wounds, facial wounds, fragile, wet and hard to reach wounds. Learn about the other alternatives we have to keeping these dressings in place
Below is a Video of an innovative product by Tapeless Medical.
[youtube]http://www.youtube.com/watch?v=Ki7rjqzWxjU[/youtube]

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

Palliative Wound Management Basics (Parts 1, 2 & 3)

Wednesday, August 10th, 2011
Donna Sardina and Nancy Morgan

Palliative Wound Management Basics (Parts 1, 2 & 3) will be presented by Donna Sardina RN, MHA, WCC, Nancy Morgan RN, BSN, MBA, WOCN, WCC, CWCMS, Co-Founders WCEI at this year’s Wild on Wound National Conference in Las Vegas in September 7-10.2011.

This session will discuss the goals of Palliative Wound Management . Our approach to wound care is less aggressive, and we encounter many challenges. We’ll discuss those challenges, which include: wound odor, excessive bleeding, exudate, necrotic tissue, pain, peri-wound breakdown, itching, and body image and caregiver skills. We’ll learn about some of the wounds encountered in Palliative care such as Kennedy Terminal Ulcer, Marjolin, Kaposi Sarcoma, Fungating wounds, pressure ulcers, and fistulas. The session will provide you with knowledge on topical products and interventions you can utilize for palliative wound management

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

Heel Pressure Ulcers

Wednesday, July 13th, 2011

Heel Pressure Ulcer

Heel Pressure Ulcers will be presented by Donna Sardina RN, MHA, WCC, CWCMS, Co-Founder of WCEI in Las Vegas at this year’s Wild on Wounds National Conference this September 7-10-2011

What causes heel ulcers and how to prevent them. In this session we will discuss and differentiate the causes: Pressure, friction, arterial, diabetic, trauma, or dermatological. We look at the risk factors and some preventative measures we can incorporate in the daily care provided. Also discussed will be the complications we see, and effective treatment interventions.

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

Wild On Wounds 2011Session Highlight: The Buzz Report

Monday, June 13th, 2011

Buzz Report

The Buzz Report will be co-presented by WCEI Co-Founders Nancy Morgan RN,BSN,MBA,WOCN,WCC,CWCMS and Donna Sardina RN,MHA,WCC,CWCMS at this year’s Wild on Wounds National Convention in Las Vegas NV at Caesars Palace. This session will be presented on Thursday September 8,2011 form 9:45 a.m.-12:00 p.m.

Donna Sardina and Nancy Morgan

This is the Highlight of every WOW (Wild on Wounds)! This session is your source for the latest breaking wound care news: Whats New! Whats Now! Whats Coming Up!

Donna and Nancy, WCEI Co-Founders, will bring you up-to-date on all things buzzable in wound care-new products, guidelines, resources and tools. (Note: This session includes various brand name reviews).

For more Information about the Wound Care Education Institute and WOW 2011, Check out Wild on Wounds 2011 National Conference

WCEI Co-Founders Nancy Morgan RN and Donna Sardina RN interviewed on BlogTalkRadio.com

Tuesday, June 1st, 2010

Scroll Through to Find Nancy and Donna’s Interview

Listen to internet radio with WCEI on Blog Talk Radio

http://www.wcei.net The Wound Care Education Institute’s Nancy Morgan RN, BSN, MBA, WOCN, CWON, WCC, CWCMS,  and Donna Sardina RN, MHA, WCC, CWCMS were recently interviewed on BlogTalkRadio.com. Listen in above to the interview to get a sneak peak at what is in store for the upcoming Wild On Wounds National Seminar September 23-25, 2010 in Las Vegas NV.

Test Your Pressure Ulcer Staging Skills

Saturday, July 18th, 2009

Test Your Pressure Ulcer Staging Skills

Recently, we have been posting some Assessment skills related articles and WCEI co-founder, Donna Sardina RN, uploaded a slide presentation to Test Your Pressure Ulcer Staging Skills.

Go ahead and click on over to see how you do. Warning: The Presentation contains graphic photos

For more information about becoming Wound Care Certified, check out WCEI.net for upcoming class schedules

Lower Extremity Ulcers: What are the costs?

Friday, July 3rd, 2009

How many of you are taking care of lower extremity wounds? They seem to be very common to the wound care specialists. It appears that many of you are taking care of these wounds on a day to day basis. Costs are staggering for health care. Not only are lower extremity ulcers  monetarily costly in supplies, but the time we spend on education and actually treating the patients that have these wounds are costly.

What do you think the average costs are for treating a lower extremity ulcer? $10,000? $20,000? $30,000? What would you say if the costs were actually averaging $40,000 for the treatment of just one lower extremity ulcer? Hard to believe huh? Take a look at this video below as Donna Sardina RN briefly describes the costs of lower extremity ulcers.

As wound care certified nurses, we are called to care for individuals who have wounds. You can imagine what the costs are to care for these individuals and their wounds. If you are interested in becoming wound care certified, check out http://www.wcei.net for more information on the Wound Care Education Institute’s Wound Care Certification Course.