Pressure Redistribution

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS Worldwide Pressure Ulcer/Injury Prevention & Awareness Day is November 21st. This day is considered pretty much a holiday at my home. I have Stop Pressure Ulcer tee shirts, and I order a cake or STOP sign cookies every year from the bakery in memory of my mother. To some it might sound crazy, but my life was strongly impacted forever in 1996 after my mother passed away in my arms at only 47 years old because of complications of diabetes and what was called at that time "multiple decubitus." The image and smell will never leave my mind. It changed my life forever as a daughter, a caregiver, and later as a wound nurse. I needed more answers to heal my heart. How could my mother acquire such horrible wounds while at the hospital to get better? My mind was twirling nonstop with the 5Ws. Who, what, when, where, why? So, then it began. I wanted to learn everything I could. This ended up being sort of my therapy, which transitioned into my passion and purpose.

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC It's November, and most people are thinking about turkey, stuffing, pumpkin spice, and the fall colors. But I think of Worldwide Pressure Ulcer Prevention and Awareness Day (November 19, 2015), National Caregivers Month, and how I can help. I have shared a holding sign video and personal photos on social media to share my story in hopes of educating others. My passion for wound care is driven by my mother dying in my arms at the young age of 47, due to complications of diabetes and stage IV pressure ulcers.

Hospital-acquired pressure ulcers (HAPUs) pose a challenge for acute and post-acute care environments and are listed as hospital-acquired conditions (HACs) by the Centers for Medicare & Medicaid Services (CMS). Other HACs include central line–associated blood stream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Although CLABSIs and CAUTIs have seen a decrease in prevalence over the past decade, the HAPU is the only HAC that has not. In my recent WoundSource webinar, I discussed the topic of building a pressure ulcer prevention program within hospitals. The webinar is still available for viewing on WoundSource.com.

Is there an irremovable offloading device suitable for lower extremity pressure injuries? “An irremovable heel offloading device encourages increased compliance,” says Dr. Lenz and Dr. Hussain within their poster presentation at SAWC, “Heel Offloading Posterior Splint for Treatments of Heel Ulcerations.” However, most total contact casting (TCC) proves a greater risk of injury through iatrogenic complications and possible increases in pressure. Dr. Lenz and Dr. Hussain present the use of a particular posterior splint application method that may resolve possible complications traditional splints pose.

by Kelly Byrd-Jenkins, CWS It may come as no surprise to some, but pressure ulcers are among the only hospital-acquired conditions that have been on the rise in recent years. Other hospital-acquired conditions—such as adverse drug events, falls, and catheter-associated urinary tract infections—have decreased, according to a statement by the Agency for Healthcare Research and Quality in January of this year.

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 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.