Holly Hovan's blog

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Interdisciplinary Journal Club

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

Wound, ostomy, continence (WOC) nurses wear many hats. A significant role that we play is that of an educator, both with our patients and with our staff. I'm sure we've all heard "How on earth did you ever get interested in wounds? What made you want to be a wound specialist?" or similar comments. There are so many specialties in nursing, so why this one? For me, it is about helping others.

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Wound Certification

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

I recently posed a question to a nursing Facebook group regarding feelings on certification. Basically, I was wondering what nurses think about being certified… What does it mean to you? I received a lot of feedback on this question, with comments on cost, renewal of certification, monetary benefits (vs. exam cost) along with career advancement benefits, the level of difficulty for exams, the cost of study materials, added time, recognition from employers, displaying credentials, and being recognized as someone who went above and beyond.

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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.

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Medical Device-Related Injury

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

As specialists in wound, continence and ostomy care, we are we are forever in a role of wearing many hats. We are educators to patients, staff, and providers… we are patient advocates and supporters of our bedside nurses… we are liaisons in many aspects of care and help to coordinate care and services for our patient population. We are often referred to as the specialist and are called upon when there is a patient with a wound, skin, ostomy, or continence concern. Our peers trust us, and it is important that we possess the knowledge and skills to share with others when determining etiology and treatment of wounds and skin issues.

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Causes of Incontinence

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

With World Continence Week upon us, it is an appropriate time to discuss some types and causes along with treatment of urinary incontinence. The most common types of incontinence that we learn about are stress, urge, mixed (stress and urge), transient, neurogenic, and functional.

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Nurse Removing Adhesive Bandage to Prevent MARSI

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

Medical adhesive-related skin injury, or MARSI, is a common type of skin injury, often seen in inpatient settings and in vulnerable populations with fragile skin such as older adults (decreased elasticity, usually multiple pre-existing comorbidities) or pediatric patients (skin is not fully developed). MARSI is caused by trauma to the skin from medical adhesives (think of things such as… tape used to secure a dressing after a blood draw, clear film dressings, ostomy pouches, external catheters in men, tube securement devices, surgical dressings, etc.). MARSI is not a pressure injury and is not caused by pressure.

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woundwound assessment - skin tear on arm assessment - skin tear on arm

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

After determining our goals of wound treatment (healing, maintaining, or comfort/palliative), we need to choose a treatment that meets the needs of the wound and the patient.

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The Importance of Palliative Care

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

As wound care clinicians, one of the first steps we take after meeting our patient and assessing their wound is identifying our treatment goals. Much like managing a complex medical problem, we need to identify if our goals of care are curative or palliative. This is important with all wounds, not just those present at end of life. There are many patients with vascular disease, diabetes, or other co-morbidities that may want to take a palliative approach versus aggressive debridement or amputation. You may have heard the term, “keeping it dry and stable.” This can work at times, but as with any wound, we need to keep an eye out for signs of an active infection and determine if/when we need to further intervene. Wounds can and do resolve with a palliative approach, but it is very important to understand, and explain to our patients, the difference.

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fistula management

By Holly Hovan MSN, APRN, CWOCN-AP

A fistula is an abnormal opening between two areas that typically shouldn't be connected, or with an epithelialized tract. An example is an opening from the bowel to the abdominal wall, termed enteroatmospheric or enterocutaneous (the terms are sometimes used interchangeably) because this fistula is exposed to the atmosphere, or is open from the abdomen to the skin, and typically needs to be pouched or some type of containment of the effluent.

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patient repositioning

By Holly Hovan MSN, APRN, CWOCN-AP

Friction and shear… what’s the difference and how do they cause pressure injuries? Are wounds caused by friction and shear classified as pressure injuries? What’s the easiest way to explain the differences between these critical components of the Braden Scale that are not always understood? How do I know if my patient is at risk?

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