Holly Hovan's blog

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elderly patient skin tear prevention

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.

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

The third Thursday in November is a highly recognized day within many hospital systems and wound care programs. This day is recognized nationally as World Wide Pressure Injury Prevention Day, highlighted by the National Pressure Injury Advisory Panel (NPIAP). The third Thursday in November is a time to bring awareness to pressure injury prevention, treatment, and research. Each year, we highlight this day a little bit differently, but this year definitely looked much different from years past.

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

Every year, on the first Saturday of October, we celebrate ostomy awareness day. This is a significant day. Ostomies truly are lifesavers for so many people, and it is important that we bring awareness, education, and support to our patients, peers, and community.

This year, the United Ostomy Associations of America (UOAA) is celebrated the 10th anniversary of National Ostomy Awareness Day (this event began in 2010). More information on this day and virtual events can be found here: https://www.ostomy.org/ostomy-awareness-day/

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neuropathy testing for sensory perception (Braden Scale)

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

As wound care professionals, the Braden Scale for Predicting Pressure Sore Risk® is near and dear to our hearts. With that in mind, our evidence-based tool needs to be used correctly to yield accurate results. Working with long-term care and geriatric populations opens up a world of multiple pre-existing comorbidities and risk factors that aren’t always explicitly written into the Braden Scale categories. Additionally, the frequency of Braden Scale use may contribute to a multitude of different scores. The resident behaves differently on different shifts, for example, being asleep on the night shift but up and about on days. What is the correct way to score these patients? I believe that a less frequent Braden Scale assessment yields more accurate results. However, we should still complete a Braden Scale on admission, during transfer, when receiving, and most importantly, with any change in condition.

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

Diabetes is extremely prevalent in the United States. The Centers for Disease Control and Prevention (CDC) report that over 10% of the US population has this chronic disease, and 26.8% of older adults (65 and over) are impacted by diabetes, both diagnosed and undiagnosed.

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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.

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

Negative pressure wound therapy (NPWT) is an advanced wound care modality using a sponge with an occlusive dressing connected to a pump that creates a negative pressure environment to promote wound healing. NPWT has many indications and contraindications, and they should be discussed with the provider and interdisciplinary team before initiating or recommending treatment. Initially, a thorough history and physical examination should be completed, along with a review of prior treatments used for wound care, goals of wound care, underlying medical conditions, and allergies.

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

An abdominoperineal resection (APR) is an operation in which a surgeon removes the anus, rectum, and sigmoid colon, usually to treat low rectal cancers.

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Telehealth

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

The novel coronavirus, responsible for the COVID-19 disease, has certainly impacted us all somehow. Whether you work in a hospital setting, an outpatient clinic, a doctor's office, or a specialty setting, this pandemic has altered the lives and careers of all of us in health care.

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Nurses' Week

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

With National Nurses Week approaching, we will once again be seeing the work of Florence Nightingale highlighted, along with the concepts and values that have built the nursing profession. As we've heard many times, nursing is an art and a science. The basic foundations and concepts of nursing are built from evidence, books, and what we learn in school from our teachers, professors, and clinical instructors. The science behind nursing is important—there are formulas, math, research, memorizations, and concepts that must come from a book. However, there is also a huge piece of nursing that comes from our hearts. Nursing is caring, compassion, kindness, and wanting what is best for someone else. Nursing is wanting to help our patients and our peers. Being a nurse is a calling and a passion, and that piece can't always be learned... it starts in our hearts, and it shows in our practice.

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