Cheryl Carver's blog

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off label drug prescription

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

Providers may view off label drug use (OLDU) for wounds as the "new wave". However, if there is little or no scientific evidence supporting the practice, it can possibly lead to more problems than good. Keep in mind that not every health care setting embraces off label drug use. For example, state surveyors view OLDU differently in long-term care versus home care. Providers should avoid any risk of being involved in a pressure injury investigation. OLDU may be considered a factor in the event of such an investigation. Hospice patients are considered to be in more of a "dying with dignity" category, therefore OLDU may be considered more acceptable.

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making wound product selection decisions

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

Whether you are a provider or a clinician, the challenge of wound dressing selection is ongoing. I have been an educator for quite some time now, and have found that the easiest way to teach dressing selection is by dressing category and wound depth.

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patient repositioning for pressure injury prevention

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

I am very passionate about wound care, but pressure injury (pressure ulcer) prevention and awareness is at the top of my list for many reasons. My mother passed away in my arms at the young age of 47 due to complications of diabetes, amputation, and three pressure injuries. My mother's hospital-acquired pressure injuries were avoidable.

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advanced bioactive wound technologies

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

The growing market for bioactive wound care products has been very interesting and exciting to me. I have been involved the past couple years as an anonymous wound panel expert, council member, and consultant for upcoming bioactive wound care dressing research. We will start seeing an increase in various biomaterials, versus gauze and superabsorbent dressing types used globally. Multifunctional-type dressings will also make waves.

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eschar on heel pressure ulcer

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

Knowing the difference between a scab and eschar may not seem like a big deal. However, if you are being audited, or your facility is in survey, you might think otherwise. Here are a couple of scenarios for you to think about.

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wet-to-dry dressing changes using gauze

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

The big debate continues in regards to using wet-to-dry dressings. One thing that is for certain though is that this type of dressing is frowned upon in long-term care facilities per the National Pressure Ulcer Advisory Panel (NPUAP) Guidelines for pressure ulcers. However, long-term care facilities are put at risk for citations when using wet-to-dry dressings for any wound type.

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Long-Term Care Wound Management Formulary

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

With approximately $20 billion being spent a year on advanced wound care supplies, cost containment is a sought after goal. Long-term care facilities battle cutting costs under one reimbursement system like everyone else, but I assure you this challenge can be simplified, while continuing to bolster quality of care. I have learned that to contain cost, you must use experience, knowledge, and strong project management. So how do we accomplish this? I have broken down a cost containment plan for your long-term care facility. These key points will help you.

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medical documentation

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

In my role as a consultant and educator, I thought it would be interesting to acquire a handful of perspectives from wound care providers who work in the long-term care arena, and explore their responses.

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

It's November, and most people are thinking about turkey, stuffing, pumpkin spice, and the fall colors. But I think of Worldwide Pressure Ulcer Prevention and Awareness Day (November 19, 2015), National Caregivers Month, and how I can help. I have shared a holding sign video and personal photos on social media to share my story in hopes of educating others. My passion for wound care is driven by my mother dying in my arms at the young age of 47, due to complications of diabetes and stage IV pressure ulcers.

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Lab culture

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

I see it all of the time. Wound care clinicians performing wound cultures incorrectly, or obtaining cultures just because there is an open wound. With this being said, there are certain health care settings where per protocol, swab cultures are taken on every wound, even without signs and symptoms of infection. But I want you to always ask yourself a few questions when determining if a culture is warranted: Are there signs and symptoms of infection? Is there an odor after the wound has been cleansed? Has wound healing stalled? Maybe there is a biofilm present?

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