Nutritional Assessment

Mary Ellen Posthauer's picture
Nutrition and medicine

by Mary Ellen Posthauer, RDN, CD, LD, FAND

The World Union Wound Healing Society (WUWHS) held their 2016 meeting in historic Florence, Italy in September. The initial meeting of the WUWHS was held in Australia in 2000 and is convened every four years. I have had the unique opportunity to present in Paris, Toronto, Yokohama and this year in Florence on the topic of nutrition and wound healing.

Mary Ellen Posthauer's picture
health care quality measures

by Mary Ellen Posthauer RDN, CD, LD, FAND

The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) amends Title XVIII of the Social Security Act by adding a new section – Standardized Post-Acute Care (PAC) Assessment Data for Quality, Payment, and Discharge Planning. The goal of the IMPACT Act is to reform PAC payments and reimbursement while ensuring continued beneficiary access to the most appropriate setting of care. The act requires the submission of standardized and interoperable PAC assessment and quality measurement data by Long-Term Care Hospitals (LTCH), Skilled Nursing Facilities (SNF), Home Health Agencies (HHA) and Inpatient Rehabilitation Facilities (IRF).

Mary Ellen Posthauer's picture
Nutrition and wound healing

by Mary Ellen Posthauer RDN, CD, LD, FAND

Congratulations to Bruce Ruben, MD, for his #1 WoundSource blog for 2015; Wound Healing: Reasons Wounds Will Not Heal. I certainly concur with Dr. Ruben that inadequate nutrition is an often-overlooked reason for delayed wound healing.

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Bruce Ruben's picture
Nutrition and protein intake

by Bruce E. Ruben MD

A day doesn't go by that I'm not bombarded with information on the newest diet, the latest exercise trend or the fastest way to get in shape. My email inbox opens with message subjects like "click here to drop 10 pounds fast" or "how to get a Kardashian body without surgery." I overhear women at a local breakfast haunt order egg whites instead of whole eggs, because they contain less fat and they are worried about gaining weight. How about the latest craze of ordering sandwiches wrapped in lettuce because everyone is afraid of the dreaded carbohydrates? Our culture is so focused on losing weight, getting in shape, and looking like the latest model on the cover of Vogue or GQ that we have lost sight of what is healthy.

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Bruce Ruben's picture
hand wound

by Bruce E. Ruben MD

A non-healing wound is generally defined as a wound that will not heal within four weeks. If a wound does not heal within this usual time period, the cause is usually found in underlying conditions that have either gone unnoticed or untreated. In general, there are five reasons why wounds will not heal and more than one of these conditions can be operating at the same time.

Mary Ellen Posthauer's picture
medical records

by Mary Ellen Posthauer RDN, CD, LD, FAND

As Dr. Aletha Tippett noted in her December blog, following wound documentation standards can help clinicians avoid legal issues. Pressure ulcer litigation often involves nutrition issues. Patients with chronic wounds frequently have unintended weight loss, dehydration and malnutrition. In long-term care facilities, the most prevalent types of alleged harm are falls, pressure ulcers, weight loss and dehydration. The odds of being sued are positively associated with pressure ulcers and weight loss.

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Image from the National Cancer Institute

by the WoundSource Editors

A myriad of factors need to be addressed when evaluating a patient with a wound. A thorough patient history, including previous wounds, surgeries, hospitalizations, and past and existing conditions will help guide your clinical assessment, in addition to a number of questions specific to the wound(s) being assessed. Following is a list of general questions to ask when evaluating a wound care patient. (Please note that this list is not comprehensive and is intended only to serve as a guide):

Mary Ellen Posthauer's picture

by Mary Ellen Posthauer RDN, CD, LD, FAND

For the past two years I have been involved in the research and development of the second edition of the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Members of the Pan Pacific Pressure Injury Alliance joined National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) in producing a document that could be used by health professionals around the world.

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Janis Harrison's picture

THE LIFE AND LESSONS OF A WOUND, OSTOMY AND CONTINENCE NURSE, CHAPTER 2

To read the preceding chapter, Click Here.

Janis E. Harrison, RN, BSN, CWOCN, CFCN

My husband Daryl had gone in to a same-day surgery center for incisional hernia repair and possible "tummy tuck" after losing 85 pounds. We had searched for a good surgeon and opinions on any complications that might need to be considered, since Daryl had an ileostomy. We discussed whether or not mesh should be used, infection possibilities, and if he should have the skin tucked that was now loose from weight loss. One surgeon was not sure he wanted to tackle the task and possible complications. Another surgeon just said "sure, I can do that." Well, of course we wanted a competent surgeon; one with confidence and a little arrogance, but then, this was just a "simple" incisional hernia repair, right? WRONG!

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Bruce Ruben's picture

by Bruce E. Ruben MD

Today in 2014, there should be no question that tobacco use is one of the worst things you can do to your body. There have been hundreds of scientific studies. This subject is extremely well documented.

From the Centers for Disease Control and Prevention (CDC) alone:

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