Archive for the ‘pressure injuries’ Category

What does an allegation of ordinary negligence mean?

Thursday, March 5th, 2020
ordinary negligence

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.”

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Prior authorization: New rule in effect for pressure reducing support surfaces

Wednesday, February 26th, 2020
prior authorization

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.

The Prior Authorization Request for Pressure Reducing Support Surfaces is a rule established by the Centers for Medicare and Medicaid Services (CMS) that took effect Oct. 21, 2019.

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.

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Pressure injuries often result in serious punitive damages

Wednesday, February 12th, 2020
Punitive damages can be serious in pressure injury rulings.

Pressure injuries should be avoided at all costs. 

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.

Jacqueline Genesio identifies several lawsuits that resulted in significant verdicts in the article “Pressure Ulcers Are Easy Pickings For Lawsuits.”

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.

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Study: Pressure injuries at ICU admission predict outcomes

Wednesday, January 22nd, 2020
A senior patient holds a nurses' hand in the ICU.

Pressure injuries are a pervasive problem.

They present a real cost for patients physically, psychologically and monetarily. Plus, pressure injuries have an annual financial burden estimated at $11 billion per year in the U.S., especially in the ICU.

A study published in June 2019 by the journal Critical Care Nurse reports pressure injuries present at ICU admission are associated with longer hospital stays. They also have a modest association with higher in-hospital mortality rates.

“I was looking for an unambiguous clinical marker that could predict patient outcomes and mortality in ICU patients,” said William T. McGee, MD, MHA, associate professor of medicine and surgery at the University of Massachusetts Medical School.

He said different modeling tools try to predict outcomes and mortality in ICU patients, but they are not used routinely for all patients at all hospitals.

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Is the Kennedy terminal ulcer diagnosis outdated?

Wednesday, November 27th, 2019
A nurse holds the hand of a patient who as a Kennedy terminal ulcer.

The term Kennedy terminal ulcer was identified by Karen Lou Kennedy-Evans.

She and her colleagues came up with the name Kennedy terminal ulcer in 1983 at the Byron Health Center in Fort Wayne, Ind.

The term specifically refers to a pear, butterfly or horseshoe-shaped wound ranging in color from red to yellow to black.

These wounds typically appear over the coccyx and sacral area of patients who are near death.

The wounds also have been noted to occur in other areas of the body, such as the heels, posterior calves, arms and elbows.

Named by Kennedy at the time, she and her colleagues formally presented their subsequent observational research on the topic, which was published in 1989. 

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Some hospital-acquired pressure injuries are unavoidable, says study

Tuesday, November 5th, 2019
A clinician measures a patient's hospital-acquired pressure injuries on his backside.

Pressure injuries are the bane of wound care clinicians and other healthcare professionals who work diligently to provide the best patient care.

When patients develop hospital-acquired pressure injuries, financial penalties are placed on the organization by the federal government.

And high rates of hospital-acquired pressure injuries are perceived as a negative indicator on the quality of nursing care — the more hospital-acquired pressure injuries, the lower the quality of care is the consensus.

However, a new study revealed that sometimes even if everything is done right for a patient, a pressure injury can still form, and especially in critical care patients, said Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, a nurse practitioner and coordinator in the wound/ostomy department at Indiana University Health Academic Health Center in Indianapolis, and associate professor at the University of South Alabama in Mobile.

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Buzz Report recaps wound care news from past year

Wednesday, October 23rd, 2019
Clinicians sitting on the subway read the latest about wound care news.

The wildly popular Buzz Report is one of the main attractions of our annual Wild On Wounds (WOW) conference.

Wound care clinicians from across the U.S. look forward to attending our Buzz Report session each year to learn the latest about wound care news, research and products that came out.

The Buzz Report is the brainchild of Donna Sardina, MHA, RN, WCC, CWCMS, DWC, OMS, co-founder of WCEI and the WOW conference.

Sardina said she created the first Buzz Report in 2004 as an overview for clinicians, in response to WCEI student requests on how to stay current on the latest developments in the world of wound care news.

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Skin and wound management course helps you prep smart

Monday, August 12th, 2019

skin and wound management course

“We should remember that good fortune often happens when opportunity meets with preparation.” – Thomas Edison

wound expert

Nancy Morgan, MBA, BSN, RN, WOC, WCC, DWC, OMS

As the inventor of the phonograph, the motion-picture camera and, of course, the electric light bulb, Edison took on plenty of challenges in his time.

For healthcare clinicians of today, one of the biggest challenges is chronic wounds, which include diabetic foot ulcers, pressure ulcers and venous, arterial leg ulcers. An estimated 67 million people are suffering with chronic wounds across the globe.

According to our co-founder Nancy Morgan, MBA, BSN, RN, WOC, WCC, DWC, OMS, “as of last count, 6.5 million chronic wounds are being treated in the U.S., at a cost of $11 billion — not to mention the pain and suffering for patients.”

The reason, said Morgan, is patients are living longer with chronic diseases, such as diabetes and obesity.

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Nurse expert witness impacts pressure injury case

Monday, August 5th, 2019

nurse expert witness

Many of you have provided expert testimony in lawsuits in your own state, or other states, concerning wound care and whether that care was consistent with the applicable standard of care and standards of practice in that situation.

wound care

By Nancy J. Brent, MS, JD, RN

The following Arizona case — Rasor and Donald Miller, Wife and Husband, v. Northwest Hospital LLC — determined if a wound care nurse expert could testify to the cause of a wound sustained by the plaintiff (patient).

The female patient had open-heart surgery at the hospital and received an intra-aortic balloon pump “threatened through her femoral artery.” This required immobilization of her leg.

The patient was in the ICU for several days and the nursing staff discovered a pressure injury on her coccyx that reached stage IV and required 31 debridement procedures.

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Study: Wound care certified nurses reduce pressure injury rates

Tuesday, July 23rd, 2019

pressure injury

Just how much of an impact do wound care certified (WCC) nurses and other clinicians have on their patients? More than you might imagine.

Carole Jakucs

By Carole Jakucs, MSN, RN, PHN

A formal study was conducted under the auspices of a Centers for Medicare and Medicaid Services (CMS) program known as the Hospital Improvement Innovation Network (HIIN). The findings of the study revealed a correlation with the presence of onsite WCC staff and a reduction in pressure injury rates for patients.

More than 2.5 million people in the U.S. are affected by pressure injuries, and more than 60,000 patients die each year as a direct result of the condition, according to the Agency for Healthcare Research and Quality.

The HIIN study was funded by a grant program through the CMS using civil monetary penalty funds. These funds are used to support projects that benefit patients and residents of nursing homes with the goal of improving the quality of care they receive.

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