Outcomes

Christine Miller's picture
Patient Noncompliance

Christine Miller, DPM, DMM, PhD, FACCWS

One of the most difficult aspects of patient care is dealing with non-compliance. How do we help those who refuse to help themselves? This question is very convoluted indeed! The best treatment protocols in the world will be unsuccessful if the patient does not follow the recommendations. Patients with chronic wounds are usually those with multiple comorbidities such as uncontrolled diabetes, autoimmune disease, and uncontrolled hypertension. This complex medical picture is challenging enough for all of us trying to heal them, but add the patients' lack of concern for their own health and it is quite frankly maddening. I find myself often saying, "Help me help you" or "Healing is a team event," although mostly my genuine pleas for partnership fall on deaf ears.

Blog Category: 
Christine Miller's picture
Coordination of Care

By Christine Miller, DPM, DMM, PhD, FACCWS

One of the gratifying aspects of being a wound care physician is the ability to develop such rich relationships with our patients. The frequent and consistent contact with the same provider lays a strong foundation of open communication and trust. I work in an urban safety net hospital’s ambulatory care center, which sees a high volume of high-acuity patients. It is not uncommon for me to see patients with venous leg ulcerations with concomitant uncontrolled hypertension or diabetic foot ulcerations secondary to uncontrolled blood glucose levels. Patient education is a vital part of my clinical encounters, particularly focusing on the systemic nature of wound healing. I always emphasize that while we are treating your wound, it is the full body well-being that is needed for ultimate success.

Blog Category: 
Kelly Byrd-Jenkins's picture
Outpatient Wound Care

by Kelly Byrd-Jenkins, CWS

What you do in the outpatient center is not easy, and not everyone is doing it. In many cases, they'd prefer to let us decipher this challenging demographic's path to healing. Patients we're entrusted to serve are complex in their needs, diagnoses, and compliance with our treatment plans. We see them frequently, often over extended periods of time, and due to the very nature of their mixed, long-standing wound etiologies, we don't always get to see complete and total healing for quite some time. These are etiologies we aren't managing, but must factor in to be effective. Considerable time is spent equipping these patients for personal success by coordinating resources and providing education. And for the patient whose end goal is stability, we recognize that outcome as success each time we see them.

Blog Category: 
Paula Erwin-Toth's picture
Communication

Paula Erwin Toth, RN, MSN, FAAN, WOC nurse

Northeast Ohio is now being enveloped by a polar vortex. The subzero temperatures put everyone at risk, but our patients with chronic wounds are especially vulnerable. Neuropathy can desensitize them to the cold and result in frostbite, inadequate shelter and heat, and an inability to go to health care appointments, shop for food, or pick up (or even afford) prescriptions and wound care products. This can have devastating effects.

Blog Category: 
Janet Wolfson's picture
Patient-Centered Communication

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

Last spring, I encountered that specific type of patient we sometimes meet, the one who has been through the chronic wound care revolving door so many times that he or she sets out on his or her own path and refuses any byways diverting from it.

Blog Category: 
Thomas Serena's picture
Wound Care Clinical Trials

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

A recent article by Kaiser Health News misquoted me as saying that we enroll only "healthy" patients in our clinical trials. At moments like this, one feels that something has been overlooked. One of my research coordinators, recalling the serious adverse events (SAEs) of the previous week said, "The only patients sicker than ours are underground."

Blog Category: 
Holly Hovan's picture
wound care education

by Holly Hovan MSN, APRN, ACNS-BC, CWON-AP

As a wound, ostomy, and continence nurse in long-term care, education is a huge part of my role working in our Community Living Center (CLC), Hospice, and Transitional Care Unit (TCU). Unit specific, evidence-based training and continued follow-up are integral to the success of our pressure injury prevention program. The unit-based skin care nurses (UBSCNs) are at the frontline of prevention, along with all nursing staff, especially nursing assistants (NAs).

Blog Category: 
Lindsay Andronaco's picture
patient centered care

by Lindsay Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Medicine changes constantly, and we must stay up to date on the best options for our patients. You're reading this because you want to be a better caretaker for the sick and injured - you want to be a better provider.

We should all strive to be better and know more.

Blog Category: 
Paula Erwin-Toth's picture
Affordable Care Act

by Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN

As we embark on our journey into 2017, many are concerned about the road ahead. A new President and GOP dominated Congress have promised to make health care reform a priority. There have been numerous articles and opinion pieces written about the path these changes will take and what they will mean to patients, caregivers, and clinicians alike.

Blog Category: