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WoundSource Practice Accelerator's picture

When pressure injury prevention fails as a result of non-adherence, various comorbidities, or gaps in care, it makes a major impact on the nation’s economy and has estimated costs of more than $100 billion in the United States.

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WoundSource Practice Accelerator's picture

Pressure injuries are among the most significant health and patient safety issues that health care facilities face daily. Aside from the strong impact on patients’ quality of life, they also have high costs of treatment, not just to the patient, but also to the health care industry. The Agency for Healthcare Research and Quality reported $20,900 to $151,700 per individual patient and pressure injury in health care costs. The prevalence of present-on-admission (POA) pressure injuries is 26.2% among those admitted to the hospital from a nursing home and 4.8% among those admitted from another living setting. Hospital-acquired pressure injuries (HAPIs) cost the US health care system $9.1 to $11.6 billion a year.

WoundSource Practice Accelerator's picture

The coronavirus disease 2019 (COVID-19) pandemic has forced health care professionals to take a closer look at the most effective and appropriate measures for pressure injury prevention. In 17% of all COVID-19 cases pneumonia secondary to acute respiratory distress syndrome is the most common complication; therefore, prone positioning is used as an adjuvant therapy. The prone position allows for dorsal lung region recruitment, end-expiratory lung volume increase, and alveolar shunt decrease. To be most effective, this position should be maintained for 10 to 12 hours, thereby increasing prolonged pressure on certain areas of the body. However, prone positioning should be supervised and monitored regularly by nursing staff experienced with this positioning technique.

WoundSource Practice Accelerator's picture

Adherence: Adherence is a term used to replace "compliance" in reference to a patient following clinician orders for wound care. Compliance implies that the patient should passively comply with the health care provider’s instructions, whereas adherence allows for patients to have the freedom to follow the provider’s recommendation without blame being focused on them if they do not or are not able to follow these recommendations.

Medical device–related pressure injury (MDRPI): MDPRIs are localized injuries to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace, splint, cast, respiratory mask or tubing, or feeding tube.

Offloading: Offloading refers to minimizing or removing weight placed on the foot to help prevent and heal ulcers, particularly those caused by poor circulation to the feet due to diabetes.

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WoundCon Faculty's picture

By: Dianne Rudolph, DNP, GNP-BC, CWOCN

What are some ways to achieve insurance coverage for fistula pouches or to use ostomy supplies for a fistula? We often run into the issue of supplies not being covered for Medicare or Medicaid patients.

Unfortunately, coverage is inadequate. CMS (Centers for Medicare & Medicaid Services) coverage for fistulas is limited for fistulas caused by or resulting from a surgical procedure, and even then, it may be difficult to get reimbursed. Spontaneous fistulas (15% to 25%) are generally not covered. The Wound, Ostomy and Continence Society is working on trying to effect a change in coverage. Some insurance companies may be more amenable to reimbursement, and it may require a case-by-case application or appeal. For patients being discharged home, it may be possible to secure a short-term supply of 10 to 14 days. The cost for the pouches may run $255 and up for a box of 10.

Susan Cleveland's picture

By Susan Cleveland, BSN, RN, WCC, CDP

The subject of my previous blog on skin assessment was interview; here in part 2, we will look at the elements of observation. Interviewing clients and significant others can provide the clinician with valuable information related to the client’s knowledge of their situation and a historic review of skin issues or potential events. However, observation is also necessary in a comprehensive skin assessment.

Holly Hovan's picture

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

Identifying wound etiology before initiating topical treatment is important. Additionally, correctly documenting wound etiology is significant in health care settings for many reasons. Accurate documentation and appropriate topical treatment are two critical components of a strong wound treatment plan and program. Bedside staff members should be comfortable with describing wounds, tissue types, and differentiating wound etiologies. Training should be provided by the certified wound care clinician, along with follow-up (chart reviews and documentation checks, one-on-one education as needed, and routine competency or education days). Additionally, the wound care clinician should be able to develop an appropriate treatment plan based on wound etiology, by involving additional disciplines as needed to best treat the whole patient.

Lauren Lazarevski's picture
Leeches

By Lauren Lazarevski, RN, BSN, CWOCN

As summer begins to wind down and we look ahead to Halloween, let’s discuss some “creepy crawlies” we may encounter in wound care that may cause apprehension in even the most seasoned health care staff.

Ivy Razmus's picture
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By Ivy Razmus, RN, PhD, CWOCN

The coronavirus disease 2019 (COVID-19) pandemic has left many people with free time on their hands as other activities are cut to avoid exposure to the virus. What if we used this time during the pandemic to strengthen screening for cancers? When later-stage cancers are discovered, patients often undergo surgery with open wounds, new stomas, and other risk factors for infection. These wounds may require wound vacuum devices, complex dressing changes, increased nursing time, and in some cases an increased length of hospital stay. After discharge, these patients often require care in a skilled nursing facility to help them transition to home care. Can we prevent ostomies and wounds by making screening more accessible? Further, the diagnosis of cancer can lead to hospitalization and an increased need for adjuvant therapy such as chemotherapy or radiation, which weakens the immune system.

Cathy Wogamon's picture

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

Communication issues have arisen in the wound care world while providing care during the coronavirus disease 2019 (COVID-19) pandemic. Many of our older adult patients may already have hearing issues and rely on reading lips, which is impossible with the recent advent of masking and face shields. In addition to the masks, it is often difficult for patients to differentiate who is who when we are all in full protective gear. How can we make communicating with our patients less difficult during these trying times? Here are a few suggestions: