Archive for the ‘Pressure Injuries’ Category

COVID-19 Complicates Skin and Wound Care

Thursday, July 7th, 2022

The pandemic has brought skin and wound care challenges on many levels. One challenge is that COVID-19 can compromise the skin, leading to wounds that are harder to heal, according to Dianna Dashner, DNP, WCC, CLNC, LLE, senior nurse practitioner at ProMedica Skilled Nursing and Rehabilitation.

SARS-CoV-2 infection can cause virus-mediated endothelial dysfunction, which decreases tissue tolerance, authors wrote in a paper published in the summer 2022 issue of AACN Advanced Critical Care.

Dashner said the body’s inflammatory markers remain high long after an infected person’s symptoms go away.

“Inflammation markers actually take one year from the time you’ve been infected to go back to normal. So for patients who have an autoimmune disease or an inflammatory process in their bodies from a condition they already have, their markers are going to be sky high,” said Dashner, who is presenting “COVID’s Impact on the Skin: A Look at What We Know” at the September Wild on Wounds conference in Hollywood, Florida. The conference explores skin and wound care challenges and provides hands-on learning opportunities.

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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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Non-Weightbearing vs. Offloading: Is There a Difference?

Wednesday, October 14th, 2020

Have you ever been confused about the difference between non-weightbearing and offloading?  

These wound care terms are often used when referring to the treatment of diabetic and neuropathic ulcers and pressure injuries.

Both can be critical in the successful healing of either type of wound. However, they are not the same thing.

Let’s begin with defining the terms.

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Decoding Foot Wounds: Pressure Injury Vs. Diabetic Foot Ulcer (DFU)

Wednesday, August 5th, 2020

How often have you found yourself in the conundrum of deciding whether a wound on the foot of a diabetic patient is a diabetic foot ulcer or a pressure injury? 

Probably more than once. This is a hotly debated issue among wound care clinicians.

In this post, we’ll dissect the facts and provide a clear understanding of how to differentiate the two types of foot wounds.

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Reduce Pressure Injuries When Prone Positioning COVID-19 Patients With ARDS

Thursday, July 9th, 2020

As the COVID-19 pandemic endures, there is an increased awareness of the practice of placing patients in prone positioning versus supine positioning.

Prone positioning is important when patients are experiencing acute respiratory distress syndrome (ARDS), which is a risk for those who have the virus.

Prone therapy is not new, however.

“Critical-care nurses have known for many years that prone positioning patients with ARDS results in lower mortality rates and less incidence of lung injury,” said Kathleen M. Vollman, MSN, RN, CCNS, FCCM, FCNS, FAAN, clinical nurse specialist and consultant at Advancing Nursing, LLC.

Prone therapy was a nursing intervention first used personally by Vollman on an ARDS patient in 1981.

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PPE: How to Reduce Your Chance of Pressure Injuries During COVID-19

Wednesday, June 3rd, 2020

Personal protective equipment (PPE) is critical to your safety while caring for patients during the COVID-19 pandemic.

But healthcare workers also should be aware of PPE guidelines to prevent side effects. For example, pressure injuries can occur from wearing the items meant to keep you protected.

Because of the nature of how the virus spreads, those caring for infected patients are required to wear masks in an effort to reduce risk of acquiring the virus.

Working an entire shift in this environment requires wearing a mask almost continually, which has led to the development of tissue damage from moisture and pressure.

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Wipe Out Wounds Tour Explores Updated NPIAP Guideline

Wednesday, April 15th, 2020

NOTE: Due to the COVID-19 pandemic, and concerns for the health and safety of our attendees, sponsors and instructors, the 2020 Wipeout Wounds Tour is being rescheduled for 2021, with our first sessions scheduled for the spring. To view current dates and information on the 2021 Wipeout Wounds National Conference Tour, please click here.

Are you aware of the new pressure injury guidelines?

The National Pressure Injury Advisory Panel (NPIAP) and its partner organizations released the 2019 Clinical Practice Guideline for the prevention and treatment of pressure injuries.

The new NPIAP Guideline consists of a 409-page document. As a wound care clinician, you’ll be expected to integrate these current standards of care and pressure injury guidelines into your practice.

Donna Sardina, MHA, RN, WCC, CWCMS, DWC, OMS, co-founder of the Wound Care Education Institute (WCEI) and the Wild on Wounds (WOW) Conference, shared some highlights of the new guideline that you should know.

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Pressure Injuries Often Result in Serious Punitive Damages

Wednesday, February 12th, 2020

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

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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Some Hospital-Acquired Pressure Injuries Are Unavoidable, Says Study

Tuesday, November 5th, 2019

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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