COVID-19

The digital age is upon us, like it or not, ready or not. For the past few years, payers have incentivized, encouraged, reimbursed, and adopted various digital, remote monitoring systems and devices as a way to encourage providers to adopt more digital, remote methods. Although complete telehealth services were not reimbursed in all care settings in all Zip Codes by all payers throughout the United States at the beginning of 2020, many of the restrictions and barriers to provide nearly complete digital services were suddenly released in response to the needs of a nation in the throes of a pandemic.

Catherine T. Milne, MSN, APRN, ANP/ACNS-BC, CWOCN-AP; Editor, WoundSource

The Boston Marathon, a grueling 26.2-mile trek from Hopkinton, Massachusetts, to downtown Boston, features the notorious Heartbreak Hill at mile 20 – a half-mile climb up a steep 3.3% grade that follows on the heels of three smaller, successive inclines. Once you scale it, you still have another 6.2 miles to go. It’s broken more than a few runners over the years.

Since the advent of coronavirus disease 2019 (COVID-19), I haven’t done much flying, but I love travel and I love flying. One of my favorite experiences is a window seat at about 30,000 feet on a clear sunny day. The views can be spectacular – whether flying across the Rockies or the Plains or any of the stunning and varied scenery of this country or the world. A couple of my most memorable flights involved flying into New York City with views of the New York skyline with Lady Liberty in clear sight, or into Washington, DC with clear views of the Mall, the Jefferson Monument, and the Capitol. The Alps and the Rockies are incredibly awe-inspiring, beautiful, and breathtaking. From there, you get a good overall picture of the landscape.

By Elizabeth Faust, MSN, CRNP, CWS, CWOCN-AP, DAPWCA

As I reflect on 2020, and I try to think of words to describe it, connected is not a word that I would use. If nothing else, last year isolated us mentally, physically, and emotionally. I have said for years that wound care clinicians often work in silos. Some institutions have only one wound care provider. Even at the larger institutions, the depth of the work to be done may not allow for a team approach. Now there are additional infection prevention guidelines. Wound care specialists are split into teams, clinicians are trying to limit exposure, and telehealth is on the rise. Additionally, our vendor and sales representatives are unable to come in and help us in person. Even when we do get to collaborate with other clinicians or vendors, it is behind masks and goggles, six feet away, or even over the phone. The sense of connection is lost, or perhaps dwindling.

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.

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/

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.

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.

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:

Paula Erwin-Toth, RN, MSN, FAAN

Hello to my wound care colleagues around the world. As I write this blog, the news relating to the results of COVID-19 continues to provide evidence of the profound impact this pandemic has had on those suffering from the disease and the negative impact shut downs and quarantines have had on the health of people with chronic illnesses. We, as health care providers, are under tremendous stress as many of us have been re-deployed to maintain and support the overwhelming challenges of front-line health care providers serving patients with COVID-19. We, too, are on the front lines helping to maintain skin integrity in critically ill patients who are often intubated and placed in the prone position. The physical, emotional, and financial strains on patients, health care providers, businesses, and governments are going to affect us for years to come.