Pressure Injury

Holly Hovan's picture
Medical Device Related Pressure Injury

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

Recently, one of my awesome staff nurses coined a phrase that stuck with me—Mr. DoctoR Pressure Injury (MDRPI), also known as medical device-related pressure injury. MDRPIs are a common yet usually preventable problem. We wanted to raise awareness of MDRPIs for World Wide Pressure Injury Prevention Day in November of 2018, and one of our staff nurses was quite creative in doing so! She thought of using a doctor’s briefcase with medical devices inside, many of which can and do cause pressure injuries. Being creative and using acronyms are great ways not only to engage staff, but also to be sure that they remember the information provided to them. Additionally, hands-on props and interactive stations require engagement, which appeals to many different types of learners.

Heidi Cross's picture
Skin Changes at Life's End

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

"If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed sore, it is generally the fault not of the disease, but of the nursing." —Florence Nightingale

Ouch! What an indictment of nursing and, by extension, the facility in which the nurse works. We have a lot to thank Florence Nightingale for—a brilliant woman considered to be the founder of nursing and nursing standards and the first to ever put statistics to health care, among other valuable contributions.

Cheryl Carver's picture
Case Scenarios: Wound Documentation

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

Auditing documentation has always been part of my wound nurse role in some way or another. My first experience with auditing documentation with a fine-tooth comb was while working in the hospital wound center setting as a hyperbaric oxygen technician. Back then, hyperbaric oxygen therapy was more difficult to get reimbursed, and there were a lot of Medicare appeals. I would search through stacks of documentation to find validation for the diagnosis specific to the hyperbaric oxygen therapy indication. I quickly found out how ONE word determined reimbursement, and we are not talking pennies. The documentation is either there or it isn’t. Wound care documentation also requires the same impeccable documentation. Reimbursement is driven by Centers for Medicare & Medicaid Services (CMS) guidelines. We must follow the rules, or we do not get paid.

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Holly Hovan's picture
Pressure Injury Prevention

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

What does your facility do to raise awareness regarding pressure injury prevention? We have lots of educational opportunities throughout the year, but one of our most important and prepared for days is the third Thursday in November – World Wide Pressure Injury Prevention Day! This is a day to raise awareness that has been promoted by the National Pressure Ulcer Advisory Panel (NPUAP). Every year, the NPUAP puts out a press release and lots of good information in terms of ways to educate and engage staff on such an important topic, on a national level.

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Heidi Cross's picture
Turning and Positioning

by Heidi H. Cross, MSN, RN, FNP-BC, CWON

Failure to T&P (turn and position) is always part and parcel of a pressure ulcer lawsuit and a key element of a complaint related to pressure ulcers, as illustrated in the opening quotation. T&P documentation is a dominant focus in chart analysis and is usually one of the first things that an attorney and the expert witness look for. If T&P documentation is satisfactory, the defendant is likely to prevail; if not, then the plaintiff may have a pretty rock-solid case. But as I have opined in previous blogs, is there such a thing as perfect documentation? Alas...NO! (Or at least, rarely.)

Margaret Heale's picture
Details

By Margaret Heale, RN, MSc, CWOCN

In our point, click, fill-in-the -blanks world of ever increasing wound care algorithms and MOs, I have an ax to grind (straight into my so-called smart phone if I had the courage).

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Cheryl Carver's picture
Terminology

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

It is 2018, and health care professionals around the world are still debating what to call skin damage. I totally immersed myself in wound care because of losing my 47-year-old mother to what was then called "decubitus ulcers." I was young when my mother died, and I wanted to know why and how this could happen. My perspective is different from that of most clinicians because of my personal experience.

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WoundSource Practice Accelerator's picture
Palliative Care

by the WoundSource Editors

Pressure Injury/Ulcer Risk Management in Palliative Care and Hospice

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.1

WoundSource Practice Accelerator's picture

by the WoundSource Editors

Calciphylaxis – A disorder—generally found in end stage renal disease but not limited to renal patients—with widespread calcification of small and medium-sized vessels that leads to occlusion, thrombosis, and tissue necrosis. Extreme cases can be life-threatening.