Risk Assessment

Cheryl Carver's picture
long-term care wound education


I tell everyone that long-term care is the toughest arena for a wound consultant. However, it can also be the most rewarding. The focus of this month's blog is to give you an inside look of what really goes on in nursing homes versus other health care settings.

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Margaret Heale's picture
delivery of high quality bedside care

By Margaret Heale, RN, MSc, CWOCN

Stepping forward into a model of care that is quantitative and objective is essential and most definitely the way we are headed in wound care and beyond. Using the word "care" in the same sentence with "quantitative" and "objective" may sound like an oxymoron, but care does not have to be fluffy and old-fashioned. What it must be is kind, gentle and authentic. My question is: how can the care we provide be kind, gentle, and authentic when the emphasis is so obviously on cold, hard measures and stark black and white comparisons with little value placed on the people who are the care providers?

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Cheryl Carver's picture
medical documentation


In my role as a consultant and educator, I thought it would be interesting to acquire a handful of perspectives from wound care providers who work in the long-term care arena, and explore their responses.

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Michel Hermans's picture

By Michel H.E. Hermans, MD

Undertreatment of medical issues is not necessarily bad: palliative care usually only treats symptoms but not the underlying cause of the symptoms which, if the patient wants this, is very appropriate. Remember, Hippocrates said something about suffering and while a disease may be not curable, suffering quite often may be treated with proper medication or other interventions (though, unfortunately, this is not always the case). We should not be worried to give somebody with terminal illness and in serious pain the proper type and amount of medication, even if there is a chance the patient would get addicted.

Bruce Ruben's picture
doctor and patient

By Bruce E. Ruben MD

Life is a bunch of pivotal moments that move you on to the next phase. Like the moment you realize you're no longer a child. Or the moment it becomes clear that you have to change jobs. Later on, it's when you admit you can no longer maintain your home. And for many of us, there will be the moment you come to grips with the fact that you can no longer care for yourself without help.

Cheryl Carver's picture


As a traveling wound care educator for physicians, I am observing many changes within the state survey process for long-term care. Wound care physicians working in long-term care are feeling the same anxiety that facility leaders and staff members are, as the time nears the window for an annual state survey.

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Janis Harrison's picture

By Janis E. Harrison, RN, BSN, CWOCN, CFCN

Monday came with expectations of fixing the problem. It wasn't to be. Daryl was weak and hated the NG tube in his nose and throat. I arrived early at his bedside and waited for the doctor to let us know what the plan of action would be for the blockage problem. I left to use the public restroom and missed the doctor's visit. No one quite new what the plan was when I questioned the staff. So I created my own plan. I made Daryl get out of bed and started walking him in the halls throughout the entire hospital. I did not want him to get any weaker and I wanted to see if the mobility would increase the gastrointestinal motility. He was not happy with me at first but with education and the explanation of why, he was more than willing to try.

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Diana Gallagher's picture

By Diana L. Gallagher MS, RN, CWOCN, CFCN

I frequently write about the value and rewards of being a WOCNCB® certified nurse. It is an amazing job that allows me to save limbs and change lives on a daily basis. After decades of working in acute and outpatient care, I now work as an independent consultant. I teach, I write, and I see patients on a daily basis. Where I live, we currently do not have a single home health agency that employs a Certified Wound and Ostomy Nurse (CWOCN®). Routine wound and ostomy care can be easily managed but when there are those challenging patients with difficult wounds or unusual ostomies, there is a clear need for the care of a CWOCN.

Mark Hinkes's picture

By Dr. Mark Hinkes, DPM

I recently read a synopsis about how Obamacare will affect the type of health care services that will be available in the marketplace and the age groups that will be helped and hurt the most by this new law.1 Not really knowing much about Obamacare, I read the article and ended up feeling deeply disturbed and shocked at what Mr. Obama and the Congress have unleashed upon us. The news is not good for patients with wounds and for those who practice wound care.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Pressure ulcer risk assessment is crucial to the prevention of pressure ulcers. There are many factors which put certain patients at higher risk of developing these painful injuries that increase health care costs and lead to prolonged hospitalization, and sometimes death.

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