Risk Assessment and Prevention

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COVID-19

By the WoundSource Editors

As a response to increasing rates of infection with the novel coronavirus (which causes an illness termedCOVID-19), the Centers for Disease Control and Prevention and all major medical organizations are advising individuals to wash their hands thoroughly and frequently and for at least 20 seconds. This step will likely make a tremendous impact on mitigating the spread of COVID-19. Although we don’t have current and available data on how effective hand washing will be to stop this specific virus, we do have extensive accurate and reliable data on how much hand washing can reduce the potential transmission of infection. One study found that proper hand washing cut the risk of respiratory infection by 16%, and a subsequent study demonstrated a 21% reduction in transmission.

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Hand Washing During COVID-19

By Cathy Wogamon, DPN, MSN, FNP-BC, CWON

From the first announcement to the current screening, closings, and practice modifications, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, which is the cause of coronavirus disease 2019 [COVID-19]) has increasingly created panic among the general public. For those of us in the health care profession, it has been an ongoing battle to keep up with the changing guidelines while helping the public and patients understand the virus, how it is spread, and why appointments are being rescheduled or modified in some fashion. Although the practices listed here are “preaching to the choir,” it’s always a good idea to review the basics.

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Wound Reepithelialization

By the WoundSource Editors

Wound reepithelialization is key in the goal of wound closure. Reepithelialization is a coordinated multifactorial systemic process that involves formation of new epithelium and skin appendages. The epithelialization process can be stalled by a number of factors, all of which must be resolved before wound healing can move forward.

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Burns

Burns occur when the skin comes into contact with a heat source or caustic substance, commonly fire or flames, boiling liquid, hot objects, electrical current, or chemical agents. Different mechanisms of injury that can cause a burn include scalding, fire, chemical exposure, electrical exposure, and radiation. The extent of injuries that can occur from a burn is highly variable, and morbidity and mortality tend to increase as the surface area of the burn increases. Proper classification of burns is essential in guiding the initial management of the burn wound and achieving optimal outcomes.

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Preventing Wound Chronicity

By the WoundSource Editors

Wound chronicity is defined as any wound that is physiologically impaired due to a disruption in the wound healing cascade: 1) hemostasis, 2) inflammation, 3) proliferation, and 4) maturation/remodeling. To effectively manage chronic wounds, we must understand the normal healing process and wound bed preparation (WBP). Wound chronicity can occur due to impaired angiogenesis, innervation, or cellular migration. The presence of biofilm and infection are the most common causes of delayed healing.

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Pressure Injury Prevention Carnival

By Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP

Education is key in sustained positive outcomes and it is the first step in understanding pressure injury prevention, for both patients and staff. It's very difficult to hold people accountable for something that they did not know. Therefore, prevention starts with education. For education to be impactful, it should also be fun. Interactive games, small prizes or candy, and engaged and energetic educators are key to fostering an environment where people will remember what they are taught. The teach-back method and continued follow-up and reinforcement are also essential elements of a successful education plan.

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Neonatal Pressure Injury Prevention

By Ivy Razmus, RN, PhD, CWOCN

There remain many unanswered questions regarding pressure injury and prevention practices among neonatal patients. Guidelines for pressure injury prevention were initiated in 1992 by the U.S. Agency for Healthcare Research and Quality (AHRQ). Pressure injury prevention practices are based on these guidelines, which recently expanded to include pediatric patients.

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Antimicrobial Stewardship Programs

By the WoundSource Editors

Antimicrobial resistance is one of the greatest health threats of the 21st century. The current number of deaths attributed to drug-resistant infections is 700,000, yet this figure is expected to grow more than 10-fold by 2050. Although the rapid administration of antibiotics to treat infections often reduces morbidity and saves the lives of many patients each year, it has also been shown that up to 40% of all antibiotics prescribed are either unnecessary or inappropriate, which contributes to the growing problem of antibiotic resistance.

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Wound Culture

By the WoundSource Editors

All wounds are complex non-sterile environments, often requiring a succession of intersecting phases of wound healing to repair completely. When epithelial tissue is compromised by a wound, contamination by common skin surface microbes may result in infection or the formation of a biofilm that impedes healing. Although systemic antibiotics are necessary for treating clinically infected wounds, the use of antibiotics and antiseptics in non-healing, non-infected wounds is debated.

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Antimicrobial Stewardship

By The WoundSource Editors

Antimicrobial stewardship is becoming an increasing concern for nearly all clinical professionals. Antimicrobial resistance is often considered one of the most serious health threats of the 21st century. It is estimated that currently approximately 700,000 people die each year of drug-resistant infections, and experts predict that this figure could increase to 10 million deaths each year by 2050. On a global scale, antimicrobial resistance compromises the ability of clinicians to treat infectious diseases and thereby undermines many of the recent advances in modern medicine.