Practice Management

After attending the Spring Symposium for Advanced Wound Care and hearing many great lectures, I got to thinking, “What are the pillars of chronic wound care?” We have all heard of the concept “look at the whole patient and not the hole in the patient.” Heck, I have even written about it. But we also need to have a good foundation for how to implement this phrase or where to even start. I did a quick Internet search and came up with some interesting articles that talked about the basics of wound care and management. I found discussions on everything from maintaining a moist wound environment to being financially responsible. All of this information leads me to the concept of developing easy-to-understand pillars or categories to consider when caring for a patient with a chronic wound.

Editor's Note: How can a multidisciplinary approach aid in pressure injury prevention? In this interview, Kelly McFee, DNP, FNP-C, CWS, CWCN-AP, FACCWS, DAPWCAshe discusses how using the multidisciplinary approach to prevent PIs has helped her practice, along with promoting education and the use of prophylactic dressings.

The use of Artificial Intelligence (AI) in health care is gaining significant attention and interest. AI is revolutionizing how providers diagnose, treat, and care for patients, but how did we get here? The origins of AI in health care and its development are essential to understanding its applications today. Knowledge of key advancements in AI and what the future holds for its use in wound care is vital to consider for any level of integration into one’s practice.

by Lydia A Meyers RN, MSN, CWCN At the start of December, I was looking at graduation from my Master's Degree program and the completion of my final paper. A capstone to the Master's program is much like the dissertation to the doctoral program. My journey has been long and along the way I have increased my base of knowledge. What I have learned on this journey will enhance my practical knowledge of wound care and patient care. I learned that health care must change, and we must look hard at how we are doing business and be willing to challenge the status quo. Health care needs highly knowledgeable leaders to assure patients receive quality care by being good stewards of the money given to promote that care. The provider must be educated to assure the patient's wishes are followed first and always.

Hospitalized patients of all ages are at risk for iatrogenic injuries. Peripheral intravenous extravasation and infiltration (PIVIE) injuries are one of the most common types of hospital-acquired injury, with the potential to cause long-term disfigurement or loss of function. While the administration of fluids and medications through intravenous catheters is a common practice in the hospital, it is not without significant risk if fluids leak from the vasculature into surrounding tissues. Depending on the type and amount of fluid that enters the tissue, varying degrees of tissue damage may result. The pathophysiology of this tissue damage may also vary.

Benjamin Franklin famously stated, “An ounce of prevention is worth a pound of cure.” This statement was made in reference to the importance of fire prevention in 18th century Philadelphia, but it aptly applies to modern diabetic limb salvage. The multidisciplinary model for amputation prevention has been in place now for almost two decades, but how far have we really come? Recent literature suggests that there has not been a significant decline in reamputation rates for diabetic patients despite the team approach to care. Diabetes is a complex and aggressive disease that affects multiple organ systems and robs patients of sight, sensation, limb, and quality of life. Treating such an aggressive disease is challenging, to say the least, and often the desired outcome is not achieved.

Although the potential benefits of AI in health care have been widely theorized, the practical and ethical concerns have been less well-characterized. Discussed below are important considerations involving patient privacy (ie, HIPAA concerns) as well as the ethical use of AI in daily clinical practice.

Pain is an important factor when performing wound care procedures, especially dressing changes, which account for moderate to severe pain in 74% of wound care patients. Traditional pain management methods commonly employed, such as opioids, may not always produce a desirable result or be effective due to potential side effects, addiction risk, and delayed wound healing.

Wound bed preparation is vital to treating biofilm. Resistant to antibiotic treatment, biofilm not only stalls the healing process of chronic wounds but also puts patients at greater risk for amputation. Clinicians should follow the process of successful wound healing described in the TIMERS framework (Tissue, Inflammation/infection, Moisture imbalance, Epithelial edge advancement, Repair/regeneration, and Social factors) to guide wound care. Proper wound bed preparation recognizes that biofilm prevention and treatment in chronic wounds incorporate aggressive wound debridement to suppress biofilm regrowth, disrupt the bacterial burden, and promote a healthy wound bed environment

February 6th to the 12th marks the American Burn Association's Annual Burn Awareness Week. The topic for 2022 is burning issues in the kitchen. It is estimated that almost 50% of home fires are started when people have been cooking, and so, it's really important that we use some prevention techniques.