Outcomes

Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Patient care must always be centered holistically, considering the specific problem that the patient is being treated for, as well as all other factors that may affect patient wellbeing. Wound care is no different: in addition to wound assessment and treatment, all other considerations that may impact the patient must be taken into account. Such considerations may include social, psychological, physical, nutritional, and lifestyle factors. Overlooking one of these important realms may lead to non-adherence on the part of the patient, which in turn may lead to a non-healing, chronic wound.

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Michael Miller's picture

by Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY PT. 2

I recently recognized a puzzling aspect of my wound care practice; I am just not seeing that many infected wounds. Moreover, I seem to use much fewer antibiotics and antimicrobial agents than almost everybody else I know practicing in wound care.

I have come to the conclusion that there must be a dearth of bacteria in my clinics, nursing homes, and at the house calls I make. At the risk of sounding delusional and daft, allow me to rephrase: I know that there are bacteria everywhere, and on everything, and in fact, I overheard a statement that may truly capture the spirit, “the Earth is covered with poo, it’s just thicker in some places than others.”

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Aletha Tippett MD's picture

by Aletha Tippett MD

Every six minutes, somewhere in the United States, someone loses a limb due to amputation because of peripheral neuropathy. Neuropathy can cause pain, balance problems, loss of dexterity, and loss of sensation, all of which can lead to foot ulcers.

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Diane Krasner's picture

From The Clinical Editor

by Diane Krasner PhD, RN, CWCN, CWS, MAPWCA, FAAN

Introduction

The push towards safety by regulators and payers reflects the evidence that safe healthcare practices have numerous benefits – from reducing sentinel events to improving quality outcomes and helping to avoid litigation (1, 2, 3, 4). The wound care community has been slow to adopt the safety mantra . . . but the time has come to put your “safety lenses” on and to view wound prevention and treatment as a safety issue.

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Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, FACCWS

Heels are particularly vulnerable to skin breakdown. The posterior heel is only covered by a thin layer of skin and fat, and that makes breakdown a very real risk. When patients lie supine, all of the pressure of their lower legs and feet rest on the heels, which have relatively poor skin perfusion and a paucity of muscle tissue to absorb stress.

Prevalence rates for heel pressure ulcers vary, but have been estimated to be as high as 25% across a mixture of continuing care and acute care settings. Heel ulcers represent approximately one third of pressure ulcers acquired, resulting in increased morbidity and mortality. In some cases, heel pressure ulcers can lead to amputation of the affected limb.

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