Benchmarking: Benchmarking is using published wound outcomes reported by others as a framework within which to assess your facility’s outcomes and potential need for improved care.

Chronic wound: A chronic wound is a wound that has failed to progress towards healing in 30 days or more. There are varying factors that can cause a wound to stall, such as infection or a prolonged inflammatory phase. It is important to document the wound’s progress, any stalling factors, and interventions put into place to restart the healing cascade.

Digital wound measuring tool: Digital wound measuring tools include devices that may provide two- or three-dimensional assessment (length, width, depth, surface area) of a wound with electronic medical record software integration and may not require physical contact.

Up to 20% of all US medicolegal claims and more than 10% of settlements are wound related. Documentation is essential for all health care settings; however, there are differences in each setting. Knowing your clinical setting’s requirements from a documentation standpoint is critical in meeting documentation needs. Every setting has policies and procedures for skin and wound care that reflect current clinical and operational guidelines approved by the facility. Facilities should consider standardized workflow to provide a systematic process to capture, generate, track, store, retrieve, and retain documents of the medical record. These clinical workflows should be reviewed and updated routinely to avoid denial of claims based on missing documentation elements.

By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Most of us are familiar with the terms "prednisone skin," "thin skin," "fragile skin," or "easily bruises." One or all of these phrases are commonly used to describe our geriatric population's aging skin. As we age, so does our skin. Older adults have older skin. Skin loses elasticity and often gains wrinkles. Skin conditions that may never have been present earlier in life can crop up with aging. Keep in mind that the environment and different exposures (to sunlight, smoking, and stress) can cause our skin to age differently. Additionally, certain drugs, obesity, diet or lifestyle, habits, exercise, repetitive movements, and family history can also influence how our skin ages. Exposure to radiation (for cancer treatment) can also cause skin changes several years after treatment is complete. Regardless of the reason, as we age, our skin composition changes, and undoubtedly the risk for skin tears increases.

By Lauren Lazarevski, RN, BSN, CWOCN

Could metallic micronutrients be the missing link for your patient with a chronic wound? When we consider the nutrition required to optimize wound healing, protein supplementation is usually the star of the show. However, there are micronutrients involved in wound healing on a cellular level. Although the daily requirements may be small, they are mighty—and if deficient, they may be the missing step in healing a chronic wound.