Pressure Injuries

By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 16

As I write my blog, I wonder whether anyone really reads it. I know that my wife and daughters do, because they have no choice. For all the foibles my 24 year old is quick to point out --Dad, you’re not really going to wear that; Dad, you have a stain on your shirt; Dad, you need to empty the cat litter (to which I reply, “why, they didn't eat what I poured them yet!”)--, she has commented on an occasion or two, “That was funny” or, “Yeah, it’s pretty good this time.”

By Karen Zulkowski DNS, RN, CWS

Taking a positive approach when a pressure ulcer develops at your health care facility usually isn’t the first thing that comes to mind. However, it should be. When a patient develops a pressure ulcer the first thing that usually happens is the blame game: It wasn’t our fault—it must have happened at the (take your pick) nursing home, hospital, OR, ER, etc. In reality, the pressure may have happened prior to the patient’s arrival at the facility.

By Aletha Tippett MD

What steps should be taken the first time you encounter a patient with a wound? Here is my list of priorities when I assess a wound:

em>By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 12

There are many colloquialisms we use to describe a variety of situations. When someone appears to make a real commitment, we call it “full bore” or “going whole hog” or to use the gambling epithet, “all in”. Commitment is an important part of what we as health care practitioners stand for. You have all read ad infinitum, ad astra, ad mortem of my strongest belief that patients must take an equal role in their care. We provide the recommendations, the rationale and the risks (and benefits, of course) and they decide which of our offerings best suits their beliefs, their desires and for better or worse, their purses. The marketing profession has made millions of consumers purchase items they do not need based on the sex appeal of the turn of a phrase, changing a question of doubt into “iron clad”.

By Karen Zulkowski DNS, RN, CWS

How do you act when giving a deposition? It’s not something we covered in school. As I said last month, you probably won’t remember the plaintiff (patient). You may have only taken care of the person once or twice or when they were your patient. They may have gone back and forth to ICU and different units, or between the hospital and nursing home, so you had limited contact with them.

By Karen Zulkowski DNS, RN, CWS

Being involved in a lawsuit is never fun. However, if your facility is sued because a patient developed a pressure ulcer, you may have to testify. Pressure ulcers are the second most common reason for medical lawsuits. The facility and physicians are usually the ones targeted for monetary damages, but everyone that has taken care of the patient, the family that brought the lawsuit, and experts hired by both sides will have to be deposed.

From The Clinical Editor

By Diane Krasner PhD, RN, CWCN, CWS, MAPWCA, FAAN

Introduction

The push towards safety by regulators and payers reflects the evidence that safe healthcare practices have numerous benefits – from reducing sentinel events to improving quality outcomes and helping to avoid litigation (1, 2, 3, 4). The wound care community has been slow to adopt the safety mantra . . . but the time has come to put your “safety lenses” on and to view wound prevention and treatment as a safety issue.

By Aletha Tippett MD

What is palliative care relative to wound treatment? In short, it is about humanity, caring and compassion. Today I saw a 90 year-old woman in a nursing home. She had hip and ankle fractures, and developed a sacral ulcer in the hospital. She was in excruciating pain, screaming at every touch. To correct her turned-in hips, she was trussed up in a hip abductor device – she called this “the dragon” – that was both uncomfortable and painful.