Archive for the ‘Assessment’ Category

What happens when orders don’t meet wound care standards

Wednesday, September 11th, 2019
standards of wound care

Does your ordering clinician’s wound care knowledge rest on outdated education and assumptions?

A wound care certified physician says his peers often ignore the scientific evidence on effective treatments that form wound care standards.

This is problematic because success in wound care requires understanding basic principles and evidence.

With this in mind, we developed our multi-disciplinary course in Skin and Wound Management to build the ranks of competent, certified specialists.

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Don’t be a wound dabbler: Proper wound care must be science based

Monday, August 19th, 2019

proper wound care

Ever wonder where clinicians come up with some of the treatments we unfortunately see in wound care today?

wound care

By Bill Richlen, PT, WCC, DWC

Does it leave you scratching your head or pulling out your hair? I am sure there are plenty of wound care examples we could discuss for hours (with plenty of laughs).

Yet that doesn’t solve the problem or change the hearts and minds of clinicians — or wound dabblers — who feel those treatments are proper wound care.

Here’s a look at a few “inappropriate” treatments I have come across in my years as a wound specialist.

Let’s dissect them to understand what the “rationale” may have been and discuss why common sense, logic and scientific evidence doesn’t support them as proper wound care.

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FIRST things first when evaluating wound healing research

Thursday, July 18th, 2019

You hear more and more about evidence-based wound care. But what does that mean and how can you tell when a study is a good one?

wound care

By Bill Richlen, PT, WCC, DWC

To evaluate the reliability of wound healing research, you can use the acronym FIRST to help. Here’s what each step means.

F — Funding

Who funded the study? Was the data published for the financial gain of a company?

You should compare these studies to other existing data to determine whether the results are true or manipulated. Studies funded by a manufacturer, or those in which the researchers and authors have a financial relationship with the manufacturer, tend to be biased.

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Learn how written discharge instructions can protect your practice

Tuesday, July 16th, 2019

discharge instructions

Accurate, complete and defensive documentation is essential in all areas of practice, and wound care nursing is no exception.

wound care

By Nancy J. Brent, MS, JD, RN

One component of documentation that is of utmost importance is written discharge instructions. In the following case, this was one of the central issues the federal court had to evaluate — Shelton v. United States, 804 F. Supp. 1147.

The patient sought treatment at a VA hospital after he was bitten on the tip of the middle finger of his right hand during an altercation with a female after they left a bar.

The wound was painful and bleeding.  He called 911, stating he had been shot. He would not allow the paramedics to examine his finger.

The ED admitting nurse noted on the admission form he had suffered “trauma” to his right middle finger. He was then seen by an ED physician, whom he told he was bitten and that he had been shot.

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How to persuade clinicians to change a wound care order

Tuesday, July 9th, 2019

wound care order

How can you convince an ordering clinician to consider a more effective wound treatment? Psychology offers some clues.

By Keisha Smith, MA, CWCMS

If you’re a knowledgeable, certified wound care clinician, receiving an outdated or illogical wound care order can be frustrating.

So, what can you do when you’re tasked with administering treatments you believe will be ineffective or harmful to a patient?

First, practicing substandard wound care can land you in legal hot water, even if you are following orders.

To protect your license, reputation and financial well-being, you need to speak up about wound care orders that contradict your knowledge and training.

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Top 6 facts you need to know about pressure injuries today

Monday, May 27th, 2019

pressure injuries

Wound care is an exciting specialty that can sometimes prove challenging.

Carole Jakucs

By Carole Jakucs, MSN, RN, PHN

With various wound types and multiple wound care products and treatments available, clinicians strive to stay up to date on the best practices to ensure they are providing their patients with the current standard of care.

Managing pressure injuries is one area of wound care that many wound care professionals encounter regularly, as pressure injuries are pervasive across the healthcare continuum.

Whether you work in home health, acute care or long-term care, below are some of the top facts to know about managing pressure injuries today from Don Wollheim, MD, FAPWCA, WCC, DWC.

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What happened to practicing wound care basics?

Tuesday, April 30th, 2019

wound care basics

Having been involved in wound care for about 25 years, I have seen many changes in our understanding of wound healing, research evidence and technology.

wound care

By Bill Richlen, PT, WCC, DWC

As I hear my students describe common practices today and the many myths of wound care, I’m led to wonder, “What happened to starting with wound care basics for healing?”

A colleague of mine once stated there are basically two fundamentals to healing wounds: a healthy patient and a healthy wound environment. Once those are accomplished, topical treatments will not make that big of a difference.

However, clinicians often cling to some “holy grail” treatment in the form of a dressing or adjunctive modality that will somehow overcome the need to practice solid, evidence-based wound care.

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Legal issues clinicians should know when taking wound care pictures

Wednesday, April 3rd, 2019

wound care pictures

Regardless of where a wound care professional practices, following the trajectory of a wound is essential to providing the best care.

Carole Jakucs

By Carole Jakucs, MSN, RN, PHN

In addition to measuring wounds, part of today’s practice sometimes includes taking wound care pictures. The steps involved when photographing wounds depends on your organization’s written policies and procedures.

Some healthcare organizations provide computer-based applications and devices that wound care staff are required to use when taking wound care pictures. These photos are typically uploaded into each patient’s electronic medical record.

Other employers may not provide these tools, however. When this occurs, wound care clinicians may be tempted to use their personal cell phones to take wound photos to monitor the success of their care or share with other clinicians for advice.

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The Head to Toe Search for Wounds

Tuesday, June 12th, 2018

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

A comprehensive skin assessment should look for more than just wounds because many medical problems have telltale signs that are easy to see if you know what to look for.

comprehensive skin assessment

 

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

 

POA. These three little letters have become very important in wound care because we must document any wounds present on admission (POA). By doing so, we are saying that these wounds began somewhere else—maybe at home, maybe in another care setting, but definitely not while under the present facility’s care. This distinction of origin has great implications both financially and legally.

 

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Lower Extremity Ulcers and Angiosomes

Wednesday, May 16th, 2018

What is an angiosome and how does it relate to wound healing? A grand prize-winning Wild On Wounds poster presenter discusses how angiosomes can help identify patients who need vascular intervention.

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