Skin Conditions/Skin Care

WoundSource Practice Accelerator's picture

by the WoundSource Editors

The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. Maintaining skin integrity equals maintaining skin health, and this includes people of any age. Older adults are at a higher risk because of the skin aging process. As skin ages, the junction between the epidermis and dermis thins and flattens, reducing circulation. Moisturizing factors in older adults also reduce, thus causing dry, flaky skin and increased risk of skin breakdown.

Holly Hovan's picture
Medical Device Related Pressure Injury

by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

Recently, one of my awesome staff nurses coined a phrase that stuck with me—Mr. DoctoR Pressure Injury (MDRPI), also known as medical device-related pressure injury. MDRPIs are a common yet usually preventable problem. We wanted to raise awareness of MDRPIs for World Wide Pressure Injury Prevention Day in November of 2018, and one of our staff nurses was quite creative in doing so! She thought of using a doctor’s briefcase with medical devices inside, many of which can and do cause pressure injuries. Being creative and using acronyms are great ways not only to engage staff, but also to be sure that they remember the information provided to them. Additionally, hands-on props and interactive stations require engagement, which appeals to many different types of learners.

Heidi Cross's picture
Skin Changes at Life's End

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

"If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed sore, it is generally the fault not of the disease, but of the nursing." —Florence Nightingale

Ouch! What an indictment of nursing and, by extension, the facility in which the nurse works. We have a lot to thank Florence Nightingale for—a brilliant woman considered to be the founder of nursing and nursing standards and the first to ever put statistics to health care, among other valuable contributions.

Cheryl Carver's picture
Case Scenarios: Wound Documentation

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

Auditing documentation has always been part of my wound nurse role in some way or another. My first experience with auditing documentation with a fine-tooth comb was while working in the hospital wound center setting as a hyperbaric oxygen technician. Back then, hyperbaric oxygen therapy was more difficult to get reimbursed, and there were a lot of Medicare appeals. I would search through stacks of documentation to find validation for the diagnosis specific to the hyperbaric oxygen therapy indication. I quickly found out how ONE word determined reimbursement, and we are not talking pennies. The documentation is either there or it isn’t. Wound care documentation also requires the same impeccable documentation. Reimbursement is driven by Centers for Medicare & Medicaid Services (CMS) guidelines. We must follow the rules, or we do not get paid.

Holly Hovan's picture
Skin Tear Protocol

Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

Payne and Martin brought skin tears to the attention of wound and skin specialists and to the wound care community when they reported an incidence rate of 2.23% in individuals aged 55 years and older, living in a long-term care facility. A skin tear is "a wound caused by shear, friction, and/or blunt force resulting in a separation of skin layers." Skin tears may be partial- or full-thickness wounds, develop into chronic wounds without proper treatment and follow-up, and, most importantly, are preventable.

Janet Wolfson's picture
A Multidisciplinary Approach to Incontinence

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

My current job as wound coordinator has pulled me into the world of incontinence and the many disciplines that care for people challenged by this disorder. I was previously acquainted with the therapy side as I worked with therapists certified in pelvic floor therapy. My work with venous edema acquainted me with medications that caused continence-challenged people to resort to absorbent adult briefs. As I work more closely with physicians, I am more familiar with medications to support weakened or sensitive pelvic muscles and nerves. On the nursing side, I have researched support surfaces, incontinence pads, and barrier creams. I see patients and occupational therapists working together to regain continence independence through problem-solving mobility issues.

Cheryl Carver's picture
Terminology

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

It is 2018, and health care professionals around the world are still debating what to call skin damage. I totally immersed myself in wound care because of losing my 47-year-old mother to what was then called "decubitus ulcers." I was young when my mother died, and I wanted to know why and how this could happen. My perspective is different from that of most clinicians because of my personal experience.

Cathy Wogamon's picture
Veteran with Spinal Cord Injury

By Cathy Wogamon, DNP, MSN, FNP-BC, CWON, CFCN

Immobility and decreased sensation can cause major problems related to the skin in the patient with spinal cord injury. Even though the average age of the veteran with a spinal cord injury is increasing, there are still many younger veterans affected by spinal cord injuries. When skin issues arise in this population, the impact is not only physical but also emotional as skin issues sometimes make it difficult for the veteran to remain in their chairs, thereby decreasing mobility and socialization.

Holly Hovan's picture
Geriatric Skin

by Holly M. Hovan, MSN, APRN, ACNS-BC, CWOCN-AP

With a growing population of Americans aged 65 or older, it is important to know what skin changes are normal and abnormal and what we can do in terms of treatment, education, and prevention of skin injuries.