Fecal Management

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

As you may have already heard, the World Health Organization (WHO) has designated 2020 as the year of the nurse and midwife. The WHO has informed us that in order to achieve universal health coverage by 2030, we need 9 million more nurses and midwives! This is a huge number. Just think, if 9 million more nurses and midwives are needed, how many more wound, ostomy, and continence (WOC) specialists are going to be needed?

By Margaret Heale, RN, MSc, CWOCN

Not very long ago, when working in an in-patient rehab center, I was shocked to discover patients calling the adult incontinence garments "hospital underwear." We were making good inroads into reducing the use of these products with the hope that if we used less it would be possible to acquire higher-quality products that would function optimally for patients who really needed them. It was of concern that some facilities had become diaper-free because many of our patients benefited from briefs, particularly as a "just in case security blanket" and we felt it was unrealistic for our patient population to be brief-free.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

My current job as wound coordinator has pulled me into the world of incontinence and the many disciplines that care for people challenged by this disorder. I was previously acquainted with the therapy side as I worked with therapists certified in pelvic floor therapy. My work with venous edema acquainted me with medications that caused continence-challenged people to resort to absorbent adult briefs. As I work more closely with physicians, I am more familiar with medications to support weakened or sensitive pelvic muscles and nerves. On the nursing side, I have researched support surfaces, incontinence pads, and barrier creams. I see patients and occupational therapists working together to regain continence independence through problem-solving mobility issues.

By Sharon Baranoski, MSN, RN, CWCN, APN-CCNS, FAAN and Kimberly LeBlanc, PhD, RN, WOCC©, IIWCC

Editor's note:This blog post is part of the WoundSource Trending Topics series, bringing you insight into the latest clinical issues and advancement in wound management, with contributions by the WoundSource Editorial Advisory Board.

by Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

Part 2 in a two-part series looking at the basics of preventing and managing moisture-associated skin damage in the long-term care setting. For Part 1, click here.

by Hy-Tape International

Ostomy surgery is an increasingly common treatment for patients with Crohn's disease. With over 450,000 people with stomas in the United States and 120,000 new ostomy surgical procedures performed each year, a growing number of patients must contend with the difficulties of stoma management. However, with guidance from a health care professional, stoma patients can live healthy, active lives while minimizing their risk of injury, infection, and other problems.¹

by the WoundSource Editors

Although clinical practice is hampered by a lack of rigorous studies, standardized terminology, or definitions of incontinence-associated skin damage, it is well known among health care providers that this damage places patients at increased risk for pressure ulcer/injury development. The worldwide challenge represented by incontinence-associated skin damage prompted the development of a global expert panel on the topic in 2014. The group, chaired by Professor Dimitri Beeckman, a leading authority on the topic, collaborated to develop international best practice guidelines for prevention and treatment of incontinence-associated dermatitis (IAD) that were published in 2015.¹

by the WoundSource Editors

The performance of an accurate and complete skin assessment is of utmost importance to obtaining and maintaining healthy skin. Understanding the structure and function of the skin is key to the differentiation of normal from abnormal findings. Having this baseline knowledge aids in determining the patient's level of risk, how skin is damaged, the impact of moisture on the skin, the resulting type of moisture-associated skin damage (MASD), and whether current skin care protocols are effective and adequate.

By Joy Hooper RN, BSN, CWOCN

Some people choose the J-Pouch procedure rather than the traditional colostomy or ileostomy.

By Joy Hooper RN, BSN, CWOCN

The "J-Pouch" is an example of an internal intestinal pouch constructed of small intestine. The surgery is performed as an alternative to a permanent ileostomy when the large intestine (colon) needs to be removed. The J-Pouch procedure can be performed in a I, II, or III stage surgical procedure. Although there are many complications associated with this procedure such as anal leakage after surgery, bowel obstruction, and pouchitis, there are many people that feel the J-Pouch procedure literally gave them their life back. Below is a comment from a J-Pouch patient: