End of Life Wounds

By Diane L. Krasner, PhD, RN, FAAN

Scope of Practice and Standards of Practice guide nurses and other members of the interprofessional wound care team in caring for patients with wounds. Documentation in the medical record is a key aspect of the standard of practice and serves to record the care delivered to the patient or resident. Your documentation should follow your facility guideline for documentation. Accurate documentation helps to improve patient safety, outcomes, and quality of care.

This WoundSource Trending Topic blog considers general wound documentation dos and don'ts and presents 10 tips for success. Good, better, and best documentation examples are included for each tip.

By Heidi Cross, MSN, RN, FNP-BC, CWON

"It was the best of times, it was the worst of times." – Charles Dicken

When Charles Dickens wrote this introduction to his Victorian-era novel, A Tale of Two Cities, his novel was aimed at the brewing French Revolution, but he could have been writing about the best and worst of modern American health care. His novels depicted how life could be pretty miserable during those times, with no social safety net and no real medical care. Fortunately, times have changed, and we have improved social supports as well as, some would argue, the best health care system in the world (although, sadly, not all people in the United States enjoy access to our great health care system, but I digress).

By Diane L. Krasner, PhD, RN, FAAN

Originally a poster first conceived in 2009, "Six Sticky Wickets That Commonly Occur in Wound Care Lawsuits" is as relevant today as it was a decade ago. In my review of wound care medical malpractice cases, I see these six difficult situations ("sticky wickets") occurring all too often. Strategies for avoiding the Six Sticky Wickets have been updated and are discussed here.

By Heidi Cross, MSN, RN, FNP-BC, CWON

Ms. EB, a frail 82-year-old woman admitted to a long-term care facility, had a complex medical history that included diabetes, extensive heart disease, ischemic strokes with left-sided weakness and dysphagia, dementia, kidney disease, anemia, chronic Clostridium difficile infection, and obesity. Her condition was guarded at best on admission, and she had a feeding tube for nutrition secondary to dysphagia. Despite these challenges, she survived two years at the facility.

Article Title: Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study
Authors: Artico M, D’Angelo D, Piredda M, et al
Journal: J Pain Symptom Manage 2018;56(1):23-31
Reviewed by: Arden Harada, class of 2021, Temple University School of Podiatric Medicine

by Emily Greenstein, APRN, CNP, CWON, FACCWS

"When I grow up, I want to be a wound care specialist." That's not something you hear kids going around saying. Sure, kids want to be doctors or nurses. But wound care specialist?

When you think about it, being a wound specialist is not a glamorous position, unlike being a neurosurgeon. The best quote that I ever heard from a colleague of mine was, "No one wants to do wound care; wound care isn't sexy." This may be true, but what is wound care then? To me it is ever changing, it is learning new things (most of which are not found in text books), and it is about helping patients heal both emotionally and physically from a chronic condition.

by the WoundSource Editors

Palliative care and hospice care are not the same, but they both share one goal. They both focus on a patient's physical, mental, social, and spiritual needs. Palliative care can begin at diagnosis and treatment or for patients at any stage of their illness. Patients may not want to receive aggressive treatment of non-healing wounds because of underlying diseases, pain, and/or cost.

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

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

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.