Posts Tagged ‘Dr. Nancy Collins’

Intake + Output = Big Documentation Problems

Friday, October 7th, 2016

Nancy Collins, PhD, RDN, LDN, FAPWCA, FAND

Inaccurate and incomplete intake and output (I&O) records pose a problem in litigation, as well as a risk to the patient who requires monitoring of fluid balance for medical reasons. 

Intake + Output = Big Documentation Problems

 

“Would you agree that the nurses did not know how to do basic arithmetic?”

Of course nurses know how to add and subtract, yet I was asked this question in a very challenging manner by a plaintiff attorney. He had just showed me 3 weeks of I&O tables excerpted from the medical chart of the deceased plaintiff, and almost every shift was incomplete. The plaintiff attorney was reducing the problem to poor math skills, implying that not a single day was complete because the nurses who cared for this patient lacked the skills to add a column of numbers. He knew I would disagree because I was not going to say these nurses lacked basic math skills. But he also knew his follow-up question was the real reason for this math ploy.

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Your Patient Died: Should You Send the Family a Card?

Friday, September 9th, 2016

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

Bereavement care is part of the job, no matter how difficult it is to talk about death and deal with grieving family members.

Your Patient Died: Should You Send the Family a Card?

 

“Callous disregard.” These two little emotionally loaded words are how the plaintiff complaint summed up the following story from a grieving daughter named Sally.* In her deposition, Sally recounted how nice and welcoming everyone was at the nursing home when she toured it 3 years ago prior to moving her mom in. It seemed like a good place where the staff could provide the care her mom needed; care Sally was no longer able to provide for her at home as her mom’s physical and mental condition continued to worsen. Those feel-good sentiments were replaced by anger, sadness, and ultimately litigation after her mom died. When Sally was asked why she was suing, she replied that no one at the nursing home cared about her mother.

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Great Expectations Unmet: The Real Reason Patients Sue

Friday, August 5th, 2016

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

Most lawsuits start not because of poor medical care but because families believe promises were made and broken and they are angry.

 

Great Expectations Unmet: The Real Reason Patients Sue

 

If you speak to any health care attorney about the proliferation of lawsuits against hospitals, nursing homes, and health care providers (HCPs) over the last decade or so, you will engage in a conversation peppered with a variety of legal terms. These may include breach of duty, negligence, malpractice, wrongful death, statutory standard of care, or even criminal culpability. It is important to understand that these are formal words with specific legal meanings, and at least a few of them appear on every plaintiff complaint as the reason for the lawsuit.

This is in sharp contrast to every deposition I have ever read from a plaintiff—usually the surviving spouse or child/children of the deceased. These family members never use legal jargon. Instead, they use emotional terms that reveal the true reason they are suing. Unless the family member works in the medical field, they rarely criticize the actual medical care but rather express great sadness with the personal care and the way they were treated. Plaintiffs frequently remark about the lack of caring they felt in health care. It is these words that we must focus on if we are to understand the patient perspective and thereby improve patient satisfaction.

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WOW in Las Vegas: 2015 Highlights

Thursday, October 1st, 2015

What happened at the Wild On Wounds Conference? We’ve got your event highlights right here.

WOW_recapIf you traveled to Las Vegas for the Wild On Wounds (WOW) conference Sept. 2-5, then you know the truth: Skin is In. That was the theme for this record-attendance event. Wound care clinical professionals came together in one place for an exciting, information-packed four days that left us all invigorated and ready to treat more wounds.

Nurses, therapists, physicians, students and industry professionals traveled from all over the country to attend this premier wound care convention. We laughed, we learned … we united over our mutual love of skin!

A popular session was Everything You Always Wanted to Know About Nutrition But Didn’t Ask, led by Dr. Nancy Collins. We learned about the important role of nutrition in wound care – and chronic non-healing wounds that can be a result of malnourishment. We were so pleased to hear such positive feedback about this session. Here are some comments from attendees:

“Two things that stood out: Arginine & Glutamine. Not even our dietician has mentioned these in their orders. Good to know that they are essential in healing a chronic wound.”

“Now I understand why increased caloric intake for overweight patients is important in the wound healing process, and I can now share this information to my co-workers, specifically to our CNAs and nurses alike.”

“Dr. Collins was on-point and presented the information in a very creative way. She also illustrated the importance, economical impact, and quality-of-life that medical nutrition has on the patient. Case study presentations were excellent! Very interactive session. It was a wakeup call for all facilities.”

And while it’s impossible to mention all the other educational sessions, demonstrations and presentations that took place, here are more of this year’s highlights:

  • Record attendance – 1100 nurses, therapists, physicians, students and industry professionals
  • Attendees who influence wound care decisions throughout the care continuum
  • 200+ exhibiting partners
  • Interactive, hands-on sessions for Sharp Debridement, Maggot Debridement
  • Fascinating clinical posters and more!

We should also mention the exciting and successful hands-on Topical Wound Management session led by Nancy Morgan RN, BSN, MBA, WOC, WCC, DWC, OMS, C0-Founder of WCEI.  This session focused on topical wound dressing categories and reviewed specific treatment recommendations, giving attendees the opportunity for one-on-one product demos.  This session will be part of the 2016 WCEI one-day seminar tour. Stay tuned for dates and locations.

“This was a great session divided in two parts: lecture and hands-on. Pacing was great, not rushed, and speaker made sure the audience grasped the important points of the topic, giving real-life examples from her bedside clinical experience which solidified information she wanted to impart.”

 “I have enjoyed every session at WOW, but the round-robin table set-up was superb!! Loved it.”

 

What Did You Think?

How was Wild On Wounds for you? We’d love to know what you liked the most about your experience at WOW. What were your favorite moments of the conference? And what types of sessions would you like to see on the agenda for next year? Please leave your ideas and reflections below.

 

Hot Topic at WOW – Nutrition Gems

Monday, October 6th, 2014
Dr. Nancy Collins PhD, RD, LD/N, FAPWCA, President/Executive Director Nutrition 411.com

Dr. Nancy Collins PhD, RD, LD/N, FAPWCA, President/Executive Director Nutrition 411.com

Dr. Nancy Collins received an overwhelming positive response from attendees after her lecture on “Nutrition Gems:  Hot topics in Nutrition”. One attendee remarked that she learned more from this one hour lecture than any previous presentation she has heard on this topic.

It was fascinating to hear about the advances in the field from an expert who has helped shape the current landscape yet remembers when her most common intervention when assessing wound patients nutritionally was to order “Milk and graham crackers!”

She covered a new development on the timing of when protein should be ingested based on recent research.
Breaking up protein ingestion at each meal has been shown to make it better available to the body to use verses protein loading at one meal, usually dinner. This can help our patients heal faster by providing the body with the protein it needs to build in that new tissue.

Did you know why Arginine and Glutamine, Conditionally Indispensable Amino Acids, are often need to be supplemented in the diet of our wound care patients?

Because under the stress of a wound, the body may not be able to keep up production of these important nutrients. Without adequate amounts of Arginine and Glutamine in the diet, the signaling pathway to build in new tissue is not activated and wound healing can stall.

Another key point made by Dr. Collins was the need to interpret lab data (Albumin, Pre-Albumin and Transferrin levels) only in conjunction with a full body nutritional assessment. These lab values have been shown to be inaccurate in patients with inflammation occurring in their bodies. Changes in Albumin, Pre-Albumin and Transferrin should not be used to suggest changes in protein status in individuals with acute or chronic inflammatory states. That can and should help all of us to do a better job in conducting a nutritional evaluation of our patients.

Dr. Collin’s passion for nutrition science and her ability to make it relevant to the wound care world was greatly appreciated by all who had the good fortune to attend this lecture.  To learn more about Dr. Collins go to: http://www.drnancycollins.com/