Most wound care clinicians see wounds related to peripheral artery disease (PAD) on a frequent if not daily basis.
So let’s learn about PAD’s prevalence, understand the different ways it presents and best practices for managing it.
We spoke with Donald Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery, to get his insight on PAD.
With 25 years of experience in general/vascular surgery and 13 years as a wound care specialist, educator and case reviewer, Wollheim also is a clinical instructor for our Wound Care Education Institute (WCEI).
“From a wound
care clinician’s point of view, it is critical to have good to excellent,
oxygenated, arterial blood providing the tissues of the lower extremity to heal
any wound of the leg,” Wollheim said.
Many of you have worked with wound care patients needing antibiotics and hyperbaric oxygen therapy.
In the 2016 Texas case of Gonzalez v. Padilla, the issue of whether the antibiotics or hyperbaric oxygen therapy were properly prescribed was a core issue in the case.
The patient was struck while riding his motorcycle and was taken to a university-based medical center with a broken lower right leg and a de-gloved heel.
An open external fixation procedure of his compound, comminuted fracture was successfully performed and a “halo type” fixation device was placed around the leg to hold the bones in place as the fracture healed.
The patient was also placed on IV
antibiotics, including Gentamicin and Cefazonlin for a period of five days. In addition,
he received daily wound care treatments.
The medical center’s records indicated his
right leg showed “obvious evidence of continued blood flow … and no obvious
necrosis beneath the heel tissue itself.”
The wound care industry has been inundated with antimicrobial products for years.
Companies with good intentions try to improve outcomes and move away from antiquated antiseptics, such as Betadine, Dakins and acetic acid, that are not actually approved for use in wounds.
But some products are cytotoxic and lack any solid evidence that they are antimicrobial.
Instead, companies are offering modern products with little or no cytotoxicity available in multiple forms, such as cleansers and dressings. The challenge facing you in this barrage of products is knowing whether they are actually antimicrobial in the wound.
This blog will arm you with proper ways to analyze these antimicrobial products and increase knowledge about them.
A 10-year veteran of the fashion industry and Wall Street, Anita Prinz, MSN, RN, CWOCN, decided she needed a career change.
Attracted to the nursing profession, Prinz went to nursing school after working in other fields. She earned her bachelor’s degree in nursing in 1995 at Samuel Merritt University in Oakland, Calif.
Soon thereafter, she moved to New York City and worked as a visiting nurse in Manhattan while engaging in a unique mode of travel to visit her patients. “I rode my bicycle to see patients in the late 1990s,” she said.
After seeing numerous wounds in her home care patients and working with exceptional wound care nurses, Prinz said she felt called to learn more about wound care. So she pursued certification as a wound, ostomy and continence nurse.
When you are named in a lawsuit alleging professional negligence, a requirement calls for a nurse expert.
The nurse expert is called for both parties (plaintiff and defendant) to establish whether the applicable standard of care in the situation was met or was breached.
The requirement of a nurse expert witness to establish whether the standard of care is met is based on the fact that an allegation of professional nursing negligence involves nursing judgment in the care of a particular patient.
The
overall standard of care in a professional negligence case against a nurse is
what ordinary, reasonable and prudent nurses would have done in the same or
similar circumstances.
The establishment of what you as a wound care nurse would have done in a particular case requires, as the court below stated, “highly specialized expert knowledge with respect to which a layman can have no knowledge at all, and the court and jury must be dependent on expert advice.”
Clinicians caring for Medicare beneficiaries who need pressure reducing support surfaces when discharged home are adapting to a new rule.
Those clinicians now need to submit a Prior Authorization Request for Pressure-Reducing Support Surfaces, said Cynthia Broadus, BSHA, RN, CHCRM, LNHA, CLNC, WCC, DWC, OMS, executive director at the National Alliance of Wound Care and Ostomy (NAWCO) in Somonauk, Ill.
Submitting the preauthorization documentation
will identify the need for the pressure reducing support surface
and provide the supporting documentation, according to Broadus.
“The authorization must be submitted before the support surface is supplied to the patient and before a claim can be submitted for payment,” she said.
The costs of pressure injuries are numerous, but one area of major concern is when their existence results in a lawsuit. These suits typically allege the pressure injury was the result of poor nursing and overall care of the patient and/or resulted in a patient’s death.
As she points out, not only can a verdict result in compensatory damages (money paid to compensate the patient for pain and suffering and lost wages, as examples), but also can include punitive damages.
In one 2015 case, Genesio reported an Arizona jury awarded $2.5 million in compensatory damages and $16.7 million in punitive damages to the estate of an 86-year-old woman.
Wounds in skin folds can be a challenge to prevent and, once present, involve ongoing surveillance and care.
Donald Wollheim, MD, FAPWCA, WCC, DWC, a board-certified surgeon of the American Board of Surgery, shared his insight on best practices for preventing and treating wounds in skin folds if they develop.
As a clinical instructor with our Wound Care Education Institute (WCEI), Wollheim has 25 years of experience in general/vascular surgery and 13 years of experience as a wound care specialist, educator and case reviewer.
If your goal is to become wound care certified, we can help.
At the Wound Care Education Institute (WCEI), we’re now offering flexible, low-cost financing to take your course.
The new financing option is provided in partnership with Affirm, Inc.
For learners who qualify, a special offer of 0% interest for 12 months is in effect for those who apply for the student loan on or before Feb. 29, 2020, said Janene Brubaker, senior product manager with Relias, the parent company of the WCEI.
This
new loan program is an alternative to credit cards and personal loans, and you will know
within minutes if you have received approval.
Don’t miss the latest wound care news! Subscribe to receive our newsletter to your inbox.
*By submitting this form you consent to receive communication via email from the Wound Care Education Institute®. Check out our privacy policy for more information. You can unsubscribe at any time.
