Risk Factors

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.

By Mary Ellen Posthauer RDN, CD, LD, FAND

For many years clinicians have relied on serum proteins, such as albumin and pre-albumin, as markers of nutritional status. However, current research indicates that there is little data to support this practice. Albumin and pre-albumin (transthyretin) are acute phase proteins. The advent of the inflammatory process - including infection, trauma, surgery, burns, and other wounds - elicits the acute phase response. During this acute phase response, these proteins decline and are called negative acute phase reactants.

By Laurie Swezey RN, BSN, CWOCN, FACCWS

Heels are particularly vulnerable to skin breakdown. The posterior heel is only covered by a thin layer of skin and fat, and that makes breakdown a very real risk. When patients lie supine, all of the pressure of their lower legs and feet rest on the heels, which have relatively poor skin perfusion and a paucity of muscle tissue to absorb stress.