Pressure Ulcers

Ivy Razmus's picture
Wheelchairs and Pressure Injuries

By Ivy Razmus, RN, PhD, CWOCN

People in wheelchairs are limited in their mobility, sensory perception, and activity. These limitations can lead to increased temperature and moisture on the areas that are in contact with the wheelchair surface. These risk factors place wheelchair users at a higher risk for pressure injuries. A pressure injury is localized damage to the skin and underlying soft tissue, usually over a bony prominence or related to a medical or other device. Pressure from medical devices against the skin may also cause pressure injury. Patients with spinal cord injury (SCI) and its associated comorbidities are among the highest-risk population for developing pressure injuries. The incidence of pressure ulcers in patients with SCI is 25%–66%.

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Temple University School of Podiatric Medicine's picture
Temple University School of Podiatric Medicine Journal Review Club

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

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Nancy Munoz's picture
Arginine

by Nancy Munoz, DCN, MHA, RDN, FAND

Pressure injuries (pressure ulcers) claim over 60,000 lives and affect over 2.5 million Americans each year. The US health care system spends $9.1–11.6 billion annually in the treatment of pressure injuries. Aside from the financial cost, pressure injury is a devastating health concern that affects quality of life and well-being.

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Heidi Cross's picture
Unavoidable Pressure Ulcers

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

"At all times material hereto, defendant failed to develop an adequate care plan and properly monitor and supervise the care and treatment in order to prevent her from suffering the development and deterioration of bed sores."

Heidi Cross's picture
Risk Factors for Unavoidable Ulcers

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

According to the Agency for Healthcare Research and Quality, more than 17,000 lawsuits related to pressure ulcers (PUs) are filed annually in the United States, second only to wrongful death lawsuits. One of the greatest gifts to defense attorneys was when the Centers for Medicare & Medicaid Services (CMS) published F-Tag 314, finally acknowledging that some ulcers can occur despite best care. The facility essentially can maintain, “Hey, we did everything we were supposed to, and despite that, the patient developed that pressure ulcer”—that is, the ulcer was unavoidable. To prove unavoidability, proper documentation (proof) of best care needs to be in place, as well as documentation that all proper prevention and treatment measures were implemented.

WoundSource Practice Accelerator's picture
Wound Chronicity

by the WoundSource Editors

Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year. Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as intrinsic and extrinsic factors, comorbidities, and mixed etiologies—may complicate this process.

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.

Industry News's picture

by Industry News

January 15, 2019 – The Association for the Advancement of Wound Care (AAWC) will host the 2019 Pressure Ulcer Summit (PrU Summit) on February 8 and 9, 2019 at the Westin Atlanta Airport Hotel. The Summit will be preceded by the workshop, “PrU Prevention Programs: Justify, Quantify, Strategize,” on February 7.

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Industry News's picture

by Kara Couch, MS, CRNP, CWS, CWCN-AP

The Association for the Advancement of Wound Care (AAWC) is dedicated to providing forums that challenge the status quo, promote new ideas for practice and research, and, most importantly, share information that immediately enhances the care we provide to the patients who so desperately need our expertise. For wound care to advance as a specialty, our educational programs must not focus on novices and consist of redundant sanitized content; it requires open debate and critical evidence-based analysis. To achieve this, the AAWC is hosting a series of regional, single-topic meetings that are designed to bring high-level content at an affordable cost closer to our members who may not have the ability to attend a national meeting.

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