Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Wound Care Coordinator
Department of Veterans Affairs Medical Center
Holly is a Wound Care Coordinator at The Department of Veterans Affairs Medical Center in Cleveland, Ohio. She has a passion for education, teaching, and our Veterans. Holly has been practicing in wound care nursing for approximately six years. She has much experience with the long-term care population and chronic wounds as well as pressure injuries, diabetic ulcers, venous and arterial wounds, surgical wounds, radiation dermatitis, and wounds requiring advanced wound therapy for healing.
Holly enjoys teaching new nurses about wound care and most importantly, pressure injury prevention. She enjoys working with each patient to come up with an individualized plan of care based on their needs and overall medical situation. She values the importance of taking an inter-professional approach with wound care and prevention overall, and involves each member of the healthcare team as much as possible. She also values the significance of the support of leadership within her facility and the overall impact of great teamwork for positive outcomes.
By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Pressure injuries (PIs) typically are the result of unrelieved pressure, shear, or force. In an inpatient or hospital setting, interventions are put into place to prevent pressure injuries based on evidence and patient risk. However,...
by Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
The literature suggests that patients with a high degree of adiposity are more at risk for inflammatory conditions, and the numbers of these patients continue to rise. Increased adipose tissue may impact activities of daily living,...
Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Standards of care and evidence-based guidelines should lead our wound care practice to ensure the best possible outcomes for our patients. There are often prewritten algorithms or first- and second-line therapies, along with outlined...
Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
Pain has been a prevalent health care challenge in the United States for some time, with data from the Centers for Disease Control and Prevention showing that approximately 16% of men and 20% of women experience pain on most days or even...
Holly Hovan MSN, GERO-BC, APRN, CWOCN-A
Predominant pain pattern, ulcer location, ulcer appearance, type and amount of wound exudate, and vascular and sensorimotor assessment are some key factors used to determine the primary etiology of lower extremity ulcers.
By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
Lower extremity wounds manifest in a multitude of ways, with numerous causative or trigger factors. These types of wounds are often costly to treat, are frequently refractory, and have a high risk for recurrence. A comprehensive...
By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
Intertriginous dermatitis (ITD), also referred to as intertrigo, is an inflammatory condition that affects opposing skin surfaces and can occur anywhere on the body where two surfaces are in contact. For example, the pannus or abdominal...
By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Peripheral artery disease (PAD) is also known as lower extremity arterial disease (LEAD), peripheral arterial occlusive disease (PAOD), or arteriosclerosis obliterans. LEAD is a disease that impacts the circulatory system, specifically...
By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in previous blogs. Wounds that fail to heal not only impact quality of life, but also...
Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Refractory wounds are a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in previous blogs. Wounds that fail to heal not only impact quality of life, but also impose a...
By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
Refractory wounds are a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in a prior blog. Wounds that fail to heal not only impact quality of life, but also impose a...
By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone. Wounds that fail to heal not only impact quality of life but also impose a significant physical,...
By Holly Hovan MSN, APRN, GERO-BC, CWOCN-AP
Wound care and healing require an evidenced-based, interprofessional approach, following standards of care, and treating the whole patient, not just the hole in the patient. Often, wound care clinicians are consulted for recommendations...
When assessing and documenting a wound, it is important to note the amount and type of wound exudate (drainage). Using our senses is a large part of the initial wound assessment, followed by accurate documentation. Wound exudate or drainage gives us significant information about what is going on...
By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
“Top-down skin injuries” is an increasingly common term used to describe superficial cutaneous injuries. Top-down injuries result from damage beginning at the skin’s surface or the soft tissue. In contrast, “bottom-up injuries” are...
By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP
We have all heard the saying: a dry cell is a dead cell… we know that a moist wound bed is most conducive to healing. If a wound is too dry, we add moisture… and if a wound is too wet, we try to absorb the drainage. There must be a...
By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Wound assessment is one of the initial steps in determining the plan of care, changes in treatment, and the choice of key players in wound management. However, wound assessment needs to be accurately understood and documented by...
By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Most of us are familiar with the terms "prednisone skin," "thin skin," "fragile skin," or "easily bruises." One or all of these phrases are commonly used to describe our geriatric population's aging skin. As we age, so does our skin...
By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
The third Thursday in November is a highly recognized day within many hospital systems and wound care programs. This day is recognized nationally as World Wide Pressure Injury Prevention Day, highlighted by the National Pressure...
By: Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
Every year, on the first Saturday of October, we celebrate ostomy awareness day. This is a significant day. Ostomies truly are lifesavers for so many people, and it is important that we bring awareness, education, and support to...
By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP
As wound care professionals, the Braden Scale for Predicting Pressure Sore Risk® is near and dear to our hearts. With that in mind, our evidence-based tool needs to be used correctly to yield accurate results. Working with long-term...
Holly Hovan MSN, RN-BC, APRN, CWOCN-AP
Diabetes is extremely prevalent in the United States. The Centers for Disease Control and Prevention (CDC) report that over 10% of the US population has this chronic disease, and 26.8% of older adults (65 and over) are impacted by diabetes,...
Holly Hovan MSN, APRN, RN-BC, CWOCN-AP
Identifying wound etiology before initiating topical treatment is important. Additionally, correctly documenting wound etiology is significant in health care settings for many reasons. Accurate documentation and appropriate topical treatment...
Holly M. Hovan MSN, RN-BC, APRN, CWOCN-AP
Negative pressure wound therapy (NPWT) is an advanced wound care modality using a sponge with an occlusive dressing connected to a pump that creates a negative pressure environment to promote wound healing. NPWT has many indications and...
Holly M. Hovan MSN, RN-BC, APRN, CWOCN-AP
An abdominoperineal resection (APR) is an operation in which a surgeon removes the anus, rectum, and sigmoid colon, usually to treat low rectal cancers.
By Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP
The novel coronavirus, responsible for the COVID-19 disease, has certainly impacted us all somehow. Whether you work in a hospital setting, an outpatient clinic, a doctor's office, or a specialty setting, this pandemic has...
By Holly M. Hovan MSN, RN-BC, APRN, CWOCN-AP
With National Nurses Week approaching, we will once again be seeing the work of Florence Nightingale highlighted, along with the concepts and values that have built the nursing profession. As we've heard many times, nursing is an art...
By Holly M. Hovan, MSN, RN-BC, APRN, CWOCN-AP
A new ostomy can be intimidating and life-changing, but also lifesaving. Many people experience a new degree of independence after ostomy surgery and often become advocates and support people for other people with ostomies. However,...
Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP
As you may have already heard, the World Health Organization (WHO) has designated 2020 as the year of the nurse and midwife. The WHO has informed us that in order to achieve universal health coverage by 2030, we need 9...
By Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP
Education is key in sustained positive outcomes and it is the first step in understanding pressure injury prevention, for both patients and staff. It's very difficult to hold people accountable for something that they did not...
Holly M. Hovan MSN, RN-BC, APRN, CWOCN-AP
You might notice the hospital halls seem a little quieter around the holidays, the unit census may be down, and patients may be asking about their discharge plans. The holidays can be a time when patients want to be home (when they're...
By Holly M. Hovan MSN, RN-BC, APRN.ACNS-BC, CWOCN-AP
Often when we hear the words "pressure injury," our brains are trained to think about staging the wound, considering treatment options, and obtaining a provider's order for care. Ideally, when we hear the words "pressure injury...
By Holly M. Hovan MSN, RN-BC, APRN.ACNS-BC, CWOCN-AP
Documentation is a huge part of our practice as wound care nurses. It is how we take credit for the care we provide to our patients and how we explain things so that other providers can understand what is going on with the...
By Holly M. Hovan, MSN, RN-BC, APRN-CNS, CWOCN-AP
As wound, ostomy, and continence (WOC) nurses, and nurses in general, we are often so busy taking care of others that sometimes we forget to take care of ourselves. A wise instructor in nursing school once told me, "If you don't...
By Holly M. Hovan, MSN, RN-BC, APRN, CWOCN-AP
As someone who holds tricertification, I often feel as though my ostomy patients are the ones in whose lives I am making the biggest difference. Watching them progress, gain confidence in independent ostomy management, and enjoy their...
Holly M. Hovan MSN, RN-BC, APRN-CNS, CWOCN-AP
Not many people wake up one day and say, "Wow, I really want to be a continence nurse!" In fact, sometimes people don't even really understand what a continence nurse is, their role, or the specialty in general. I often tell nurses...
By Holly M. Hovan, MSN, RN-BC, APRN-CNS, CWOCN-AP
As discussed in a prior blog, reflecting on why you want to become certified and how to begin the process are some important initial steps when considering certification. Understanding certification, how it relates to or...
By Holly Hovan, MSN, RN-BC, APRN-CNS, CWOCN-AP
What is mobility? Typically, when we hear the word mobility, we think about our ability to move, with or without assistance. In a long-term care setting, we often hear the words, "mobility aids," which are typically pieces of medical...
by Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP
As discussed in a prior blog, stoma location is certainly one of the key factors in successful ostomy management and independence with care at home. However, even with proper stoma siting, peristomal skin complications may occur...
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...
Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP
Payne and Martin brought skin tears to the attention of wound and skin specialists and to the wound care community when they reported an incidence rate of 2.23% in individuals aged 55 years and older, living in a long-term care...
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...
By Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP
Wound, ostomy, continence (WOC) nurses wear many hats. A significant role that we play is that of an educator, both with our patients and with our staff. I'm sure we've all heard "How on earth did you ever get interested in wounds?...
by Holly M. Hovan, MSN, APRN, ACNS-BC, CWOCN-AP
by Holly M. Hovan, MSN, APRN, ACNS-BC, CWOCN-AP
With a growing population of Americans aged 65 or older, it is important to know what skin changes are normal and abnormal and what we can do in terms of treatment, education, and prevention of skin injuries.
by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP
by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP
With World Continence Week upon us, it is an appropriate time to discuss some types and causes along with treatment of urinary...
by Holly M. Hovan MSN, APRN-ACNS-BC, CWOCN-AP
By Holly M. Hovan MSN, APRN-ACNS-BC, CWOCN-AP
After determining our goals of wound treatment (healing, maintaining, or comfort/palliative), we need to choose a treatment that meets the needs of the...
By Holly Hovan MSN, APRN, CWOCN-AP
A fistula is an abnormal opening between two areas that typically shouldn't be connected, or with an epithelialized tract. An example is an opening from the bowel to the abdominal wall, termed enteroatmospheric or enterocutaneous (the terms are...
By Holly Hovan MSN, APRN, CWOCN-AP
Friction and shear… what’s the difference and how do they cause pressure injuries? Are wounds caused by friction and shear classified as pressure injuries? What’s the easiest way to explain the differences between these critical components of...
By Holly Hovan MSN, APRN, CWOCN-AP
The Braden Scale for Predicting Pressure Sore Risk® category of activity focuses on how much (or how little) the resident can move independently. A resident can score from 1 to 4 in this category, 1 being bedfast and 4 being no real limitations...
By Holly Hovan MSN, APRN, CWOCN-AP
A common misconception by nurses is sometimes predicting nutritional status based on a resident's weight. Weight is not always a good predictor of nutritional status. Nutritional status is determined by many factors and by looking at the big...
By Holly Hovan MSN, APRN, CWOCN-AP
When nurses hear the term moisture, they usually almost always think of urinary or fecal incontinence, or both. There are actually several other reasons why a patient could be moist. Continued moisture breaks down the skin, especially when the...
By Holly Hovan MSN, APRN, CWOCN-AP
When marking a patient for a stoma, it is important to consider the practice based on evidence acquired by the wound, ostomy and continence (WOC) nurse during training and experience. Stoma siting procedures are based on evidence-based practices...
By Holly Hovan MSN, APRN, CWOCN-AP
As wound care clinicians, we are aware that part of the process of consulting requires a comprehensive wound assessment, looking at wound characteristics, causative factors, and drainage. As I've previously mentioned, we've all heard the term, "...
By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP
In patients with end stage renal disease (ESRD), there is a decreased renal clearance that causes an increase in phosphorus, then calcium, in the body. Elevation of these two electrolytes causes the parathyroid gland to secrete...
By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP
As I am sure we are all well aware, not everyone loves wounds, ostomies, and continence as much as we do. Some nurses just do not have the passion (or desire) to perform wound care and learn about different modalities. On the other hand...
By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP
As a wound, ostomy, and continence nurse in long-term care, education is a huge part of my role working in our Community Living Center (CLC), Hospice, and Transitional Care Unit (TCU). Unit specific, evidence-based training and continued...
