Archive for the ‘Clinical – Documentation’ Category

What Happened to Practicing Wound Care Basics?

Friday, September 23rd, 2022

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, often straying from wound care basics.  

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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Why Wound Care Matters

Wednesday, July 27th, 2022

Wound care is essential in nearly every care setting, affecting patients across the care continuum. Understanding why wound care matters to both patients and caregivers alike is key, as wounds can prolong hospital stays, increase the risk of infection, and quickly raise costs for healthcare facilities.

A common issue requiring wound care is pressure injuries, which affect 1 to 3 million people per year in the U.S. alone. While pressure injuries occur in most care environments, they are particularly prevalent in both long-term and post-acute care environments — including hospice and home health settings — where patients remain sedentary for extensive periods of time. As the median age of the U.S. population continues to rise, an increasing number of people require wound care services, including treatment for pressure injuries.

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Spotting Signs of Wound Infection is the First Step in Proper Treatment

Tuesday, May 31st, 2022

Understanding the most current literature describing stages and signs of wound infection helps clinicians to accurately assess wounds.

“If we allow wounds to become infected then it certainly impedes the healing process,” said Patricia A. Slachta, PhD, RN, APRN, ACNS-BC, CWOCN, co-director of the Wound Care Nurse Education Program at Relias.

With an accurate assessment, wound care clinicians can prevent infection or identify signs of wound infection early and allow the body to heal the wound as quickly as possible, without using antibiotics, according to Slachta, who shared her expertise on how to determine if a wound is infected and needs antibiotic treatment.

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 All About the Braden Scale for Predicting Pressure Injury Risk

Monday, February 14th, 2022

As we shifted from “turning Q 2 hours” for positioning our patients to “individualized positioning based on tissue tolerance,” many clinicians were unsure how best to establish a plan of care.

How do we determine the positioning frequency? What is the pressure injury risk for our patients? How can we quantify risk to drive plan of care for positioning?

The Braden Scale for Predicting Pressure Ulcer/Sore Risk is a great tool to assist with those questions.

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Pediatric Patients Require Special Wound Care

Tuesday, September 21st, 2021

Pediatric patients with chronic and acute wounds need caregivers who are well-versed in wounds and in young patients’ unique needs. We spoke with three pediatric wound care experts to learn more about the most common wounds seen in kids, their etiologies, treatments, and recommendations for making dressing changes less traumatic.

 Acute Wounds Seen in Pediatric Patients

Pediatric patients can need treatment for a wide range of wounds. In fact, the list is quite extensive, according to experts.

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Unpacking the Fundamentals of Burn Wounds

Wednesday, August 25th, 2021

As a wound care clinician, you may be called to work in a burn unit or be consulted on burn wounds. If that is not your normal work setting, it can be overwhelming.

Our purpose in this article is to address the fundamentals and provide a solid working knowledge of how to manage burn wounds.

Let’s start with terminology. The American Burn Association changed the classification of burns from the traditional first-, second-, third-, and fourth-degree burns to the following:

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A Look at the UT and Wagner Scale Diabetic Foot Ulcer Classification Systems

Thursday, August 19th, 2021

Given the fact that DFUs occur in approximately 15% of patients with diabetes and there are more than 34 million people in the U.S. with diabetes, using a relevant diabetic foot ulcer classification system for patients is essential.

There are several diabetic wound classification systems. But how do you choose which one to use?

This decision generally involves clinician preference along with the organization’s policy.

Two wound care specialists provide an overview of two systems for DFU classification: The Wagner Scale and the University of Texas (UT) Diabetic Wound Classification System.

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State Practice Act Liability Affects All Members of Wound Care Team

Wednesday, November 25th, 2020

Potential liability under your state practice act is something to always be aware of.

If you face an alleged violation of your practice act, professional disciplinary action can be initiated by the applicable board that administers and enforces the act.

Disciplinary actions are determined by each professional board such as the board of medicine, board of physical therapy, occupational therapy board, or board of nursing.

Professional disciplinary decisions are public records, and most state boards provide online access to them.

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Legal Case Highlights Importance of Wound Care Documentation

Wednesday, November 4th, 2020

We have discussed the importance of nurse expert testimony in cases alleging professional negligence against you.

One blog addressed a breach of your standard of care when providing wound care.

A second reviewed the importance of your wound care documentation in the patient’s medical record.

This article takes a look at the 2016 case, Henson v. Grenada Lake Medical Center, to underscore both of these important points.

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Wound Treatment: 3 Questions to Help You Determine Appropriate Care

Thursday, September 24th, 2020

How many times have you wondered, or questioned, whether an ordered wound treatment was appropriate? 

I would not be not surprised if you said, “More often than I would like.” Unfortunately, that is the reality for wound care specialists today.

According to a 2018 BMJ Open article, nurse researchers found an overuse of wound treatments with limited evidence and low value. They also found an underuse of evidence-based treatments.

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