Posts Tagged ‘WCEI. Wound care Education Institute’

Wound Care Champions: A Nurse and a Five-Star Company

Friday, June 2nd, 2017

What does it take to build a five-star home health agency? Wound care education – and a credentialed staff – are a big part of it. 

Deer Meadows Home Health and Support Services

 

We know how wound care education helps transform the careers and lives of individuals. We also know that it can positively affect entire facilities, make a difference in communities, and drastically influence the lives of patients and professionals. That’s why we love to share success stories when we hear them.

Take, for example, Deer Meadows Home Health and Support Services, LLC (DMHHSS), a five-star, nonprofit (and stand-alone) home health company in Philadelphia. It is known for excellent care, an exceptional staff, and wound care education advocacy. But it didn’t happen overnight. It did happen, however, with very specific goals in mind: to heal patients and treat them like family; forge relationships; and promote wound care education.

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Pressure Injury Case Shines Spotlight on Wound Care Education

Friday, March 10th, 2017

Trained wound care clinicians truly make a difference in the lives of their patients. This caregiver knows first-hand, and wanted to share her story. 

Pressure Injury Case Shines Spotlight on Wound Care Education

January 10, 2017

 

Recently, a 45-year-old caregiver by the name of Annie* contacted WCEI for help. She was desperate and in search of answers. Her personal account serves as a sobering reminder of why we do what we do. Here is her story.

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Dry Skin Alert: Foot Xerosis in Diabetic Patients

Thursday, January 14th, 2016

Diabetic wound management requires awareness, including knowing the signs and progression of xerosis – an abnormal dryness of skin.

Xerosis in Diabetic Patients

Patients with diabetes are prone to dry skin, particularly when blood glucose levels are running high. And as a clinician, one of the most common types of skin conditions you will see in your diabetic patients is xerosis, which is an abnormal dryness of the skin. This is just one reason why clinicians should routinely inspect the feet of diabetic patients.

According to research, 82.1% of patients with diabetes had skin with dryness, cracks or fissures, which serves as a predictor of foot lesions. In addition, an unpublished survey of 105 consecutive patients with diabetes revealed that 75% had clinical manifestations of dry skin. This serves as further evidence that xerosis in diabetic patients is a threat to foot ulcers, and the more we know about the condition, the better we can treat and heal our patients.

The Signs

The most common characteristics of xerosis include excessively dry, rough, uneven and cracked skin. Other signs include:

  • Possible raised or uplifted skin edges (scaling), desquamation (flaking), chapping, and pruritus.
  • Excessive dryness and scaling on the heels and feet.
  • Possible fissures (linear cracks in the skin) with hyperkeratotic tissue.

Progression and Patterns

The progression of xerosis follows a defined pattern that begins when the skin becomes dry and rough, with pronounced skin lines. As the condition progresses, you’ll see the development of superficial scaling, with fissuring and erythema. In severe cases, a crisscrossing pattern with superficial scaling is present. The skin becomes less elastic and loses both its flexibility and its ability to withstand trauma, which may result in skin breakdown and subsequent infection.

Causes

A number of conditions contribute to the onset of xerosis in diabetic patients, including the loss of natural moisturizing factors and moisture from the stratum cor­neum and intercellular matrix of the skin. Additionally:

  • Sebaceous and sweat glands normally maintain skin lubrication and control the oil and moisture in the foot, but they become atrophied when autonomic neuropathy occurs.
  • Corneocytes (cells that make up the top layer of epidermis) are aligned parallel to each other in normal skin; xerosis causes structural changes to these cells and disrupts the surface, resulting in a rough epidermal surface.
  • The dryness is due to the redistribution of blood flow in the soles of the feet by persistent and inappropriate dilatation of arteriovenous shunts. This activity diverts blood away from the skin surface. When this occurs in combination with alterations in the elasticity of the skin (due to nonenzymatic glycosylation of structural proteins and glycoproteins), the skin splits, creating portals for bacteria to enter.

Treatment

Once you see initial signs of xerosis in your patients, what should you do? Start by applying an agent to the feet every day in order to maintain skin moisture, such as an emollient lotion or cream. Use moisturizers that contain urea or lactic acid.

  1. Urea works by enhancing the water-binding capacity of the stratum corneum. Long-term treatment with urea has been demonstrated to decrease transepidermal water loss. Urea also is a potent skin humidifier and descaling agent, particularly in 10% concentration.
  2. Lactic acid (in the form of an alpha hydroxy acid) can accelerate softening of the skin, dissolving or peeling the outer layer of the skin to help maintain its capability to hold moisture. Lactic acid in concentrations of 2.5% to 12% is the most common alpha hydroxy acid used for moderate to severe xerosis.
  3. Examples of products with urea or lactic acid include Atrac-Tain Cream, Eucerin 10% Urea Lotion, Lac-Hydrin 12%, and AmLactin Foot Cream Therapy.

Additionally, it’s important to avoid:

  • Products that contain alcohol – because they evaporate, and their drying action compounds the original problem.
  • Petroleum-based products, because they seal the skin surface and prevent what little lubrication is made from evaporating. These products don’t penetrate the surface of the skin and don’t replace skin moisture.

Patient education

As always, part of our job is to continuously educate patients and their family members or caretakers. When it comes to your patients suffering from xerosis, make sure they know to:

  • minimize bathing to no more than once a day (or even every other day)
  • use cool or lukewarm water
  • pat – don’t rub – to dry the skin
  • avoid harsh soaps
  • avoid lotions with dyes or perfumes
  • ensure skin moisturizers are applied appropriately and at the right frequency

What do you think?

Knowing the signs of xerosis and how to treat it is crucial for diabetic patients. Have you had experience with this condition, and are there any specific techniques, treatments or products you find most effective? And what are the biggest challenges you face when it comes to this particular type of wound management? We would love to hear about and learn from your experiences! Please share your stories below.

 

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.

News Flash: Document Education or Risk Facing Pressure Ulcer Citations

Thursday, December 17th, 2015

Failing to provide and document wound care educational efforts can lead to citations! Most recently, a facility was cited for not providing written documentation to a patient and his family about his Stage II pressure ulcer.

Document Education or Risk Citation

Wound care clinicians love to talk about wounds – preventing, treating and healing them. We love to compare notes, study photographs and learn about new techniques and strategies. But another vital piece of our job involves educating others, whether it be patients, family members or colleagues. Keeping everyone in the loop is essential to achieve the best outcomes, and avoid citations.

What it might look like now

Pressure Ulcer Staging Guide

Click for our FREE Pressure Ulcer Staging Guide

When we say that education must be a part of our pressure ulcer treatment and prevention program, we’re talking about routinely:

  • Providing printed information on the etiology of risk factors
  • Discussing the importance of risk and skin assessments
  • Explaining the role of support surfaces and the importance of positioning
  • Ensuring that each patient has a skin-care program individualized to meet their needs

These components of care are often accomplished during a staff in-service, or at care team meetings that focus on individual patients. But how are our patients and family members being educated on this issue?

Most clinicians would say that it is done by the individual licensed caregiver (often a nurse), as part of their normal daily activities on the unit.  The problem with this approach is that it’s not always documented, and often not very structured.  And this can lead to trouble.

What it must look like now

So what exactly are the expectations when it comes to pressure ulcer education according to today’s standards? Let’s consider what the 2014 International Guidelines for the Prevention and Treatment of Pressure Ulcers has to say about it.

In the section on implementing the guidelines, it speaks directly to patient consumers and their caregivers, and advises us to work with our healthcare teams and learn about pressure ulcer risk factors (and how this relates to their individual situation).  In order to meet this important objective, health care professionals must provide language appropriate printed materials, e-learning packages, and internet resources for the patient.

And where can you get such materials? Patient and consumer recommendation documents are currently being developed by the Guideline authors (we will let you know when they are available), but until then, one resource is MedlinePlus, where you can find the following patient handouts:

  • How to Care for Pressure Sores
  • Pressure Ulcer
  • Preventing Pressure Ulcers

No education? Hello, citation!

So besides the fact that a comprehensive pressure ulcer education program is crucial for better outcomes, failing to do so can lead to citations. All patient education, topics, methods, and responses must be documented.

Lesson learned?

The standards of care are always changing, and as wound care professionals, it’s critical to keep up with these changes. Do you and your facility currently meet these expectations when it comes to pressure ulcer education? How do you make sure patients and family members are not only being educated properly, but that these efforts are being documented as complete in the medical record? Please leave your thoughts or comments below.

Complete Decongestive Therapy Certification Course

Wednesday, December 15th, 2010
Introducing New Course Offering!
Brought to you by Wound Care Education Institute (WCEI®)

$350 Discount for all WCC’s
PROFESSIONAL TRAINING FOR THE TREATMENT OF LYMPHEDEMA

WCEI® is proud to offer you a powerful new partnership with The Norton School of Lymphatic Therapy. The Norton School is the premier educational institution for training MDs, PTs, PTAs, OTs, COTAs, RNs, and massage therapists to become experts in the treatment of pathologies related to the lymphatic system. Taught by the finest and most experienced faculty in the field, Norton School students receive thorough and rigorous training in the Földi Method of Complete Decongestive Therapy (CDT), the therapeutic system regarded as the “Gold Standard” for the treatment of lymphedema by the International Society of Lymphology (ISL).

Students become qualified to treat lymphedema (both primary and secondary), lipedema, phlebo-lymphostatic edema, chronic venous insufficiencies, and post traumatic edema. Additionally, as graduates fully certified in the treatment of lymphedema, Norton School alumni are eligible to sit for the Lymphology Association of North America (LANA®) Examination® for lymphedema therapists.

WCC’s receive $350 Discount
towards the full CDT Certification course.
Click here for more information about the course
Click here to register for the course

The information contained herein is for the sole purpose of information and education. WCEI® does not control course content provided by Norton School.