Risk Assessment and Prevention

Lauren Lazarevski's picture
mucosal pressure injuries

By Lauren Lazarevski RN, BSN, CWOCN

As I contemplate the current conversation around ventilators, I am encouraged to refresh my knowledge about mucosal pressure injuries. Pressure injuries on the mucous membranes present and are staged differently from cutaneous pressure ulcers, and they are usually attributed to a medical device or tube. Nasogastric or orogastric tubes, oxygen cannulas or masks, endotracheal tubes, and urinary and fecal containment devices pose a risk of causing local ischemia to tissue in the nose, mouth, genitals, or rectum, respectively. Once a mucosal injury occurs, the patient is at increased risk of other problems, including pain, infection (especially if injury occurs to the urinary tract), and even malnutrition, if pain from oral wounds makes it difficult to eat and drink. These hospital-acquired pressure injuries contribute to the physical burden on the patient, as well as the financial burden on the hospital because they do count as a nosocomial—and usually, preventable—ulcer.

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By the WoundSource Editors

The World Health Organization declared COVID-19 a pandemic on March 11, 2020. Whether you are a provider or a frontline health care professional, we are experiencing a worldwide increase in “unavoidable” medical device–related pressure injuries (MDRPIs) during the current COVID-19 pandemic. Health care workers are challenged with a higher risk of pressure injury development secondary to prolonged wear time of the N95 mask, face shield, and goggle personal protective equipment (PPE). The intensity of one or more factors of pressure, moisture, shear, and friction influence pressure injury risk.

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By the WoundSource Editors

COVID-19: The name of the disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The abbreviation COVID-19 is short for coronavirus disease 2019.

Fit test: A 15- to 20-minute testing of the seal between the respirator's facepiece and your face. After passing a fit test with a respirator, you must use the exact same make, model, style, and size respirator on the job.

Liquid sealant: Liquid skin sealants are designed to protect vulnerable areas from the effects of skin injury. They form a transparent protective coating on the skin. Indicated for use on stage 1 pressure injuries and low-exudating stage 2 pressure ulcers, pressure points and bony prominences, and under adhesive products to protect the skin.

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By the WoundSource Editors

Scrotum injuries can be caused by one or more mechanisms of injury such as trauma, pressure, friction, and moisture. Minor injuries frequently result in pain to the afflicted area, swelling, or ecchymosis.

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Keywords: 
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.

Cathy Wogamon's picture
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.

WoundSource Practice Accelerator's picture
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.

Holly Hovan's picture
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.