From the Deputy Editor
The May/June issue contains articles with timely, clinically helpful, and pragmatically useful information supporting your practice. Edsberg, Cox, Koloms, and VanGilder examined pressure injury (PI) prevention strategies in over 1,800 acute care settings in the United States. The study identified substantial compliance with PI prevention strategies, but there was need for improvement. Ironically, some of the most basic prevention strategies like heel elevation, nutritional support, moisture management, and repositioning were lacking. An international study from Turkey examined a similar phenomenon. Yilmazer and Tuzer demonstrated the effectiveness of a PI prevention care bundle in critical care patients. Incorporating similar care foci, they found that the bundle had best effects in prevention of Stage I PIs thereby supporting the importance of “basic" interventions. The “little things" do matter in PI prevention.
In an interesting technological analysis, JWOCN Section Editor Crumley conducted a literature review examining devices (usually placed in the bladder or stomach) for measuring intra-abdominal pressure including safety information. She reminds clinicians that intra-abdominal hypertension is often unrecognized due to lack of overt symptoms and there is a need for research for the benefits of routine screening via these devices.
Ostomy articles in this issue target pragmatic issues like coding and clinical care topics like convexity use. McNichol, Bliss, and Gray describe the success of WOCN Society in obtaining ICD 10-CM coding for moisture-associated skin damage (MASD), specifically irritant contact dermatitis (ICD). This is the second of two follow-up articles that reviews clinical manifestations, pathophysiology, epidemiology, and management of ICD. The coding aspect may help your financial bottom line and provide data for future research like true incidence and prevalence of ICD while the clinical description is a powerful reminder of critical components.
The prohibition against using convexity immediately postoperative is examined in two highly important articles. Stoia-Davis, Sims, Colwell, and colleagues surveyed over 300 ostomy care specialists in the US and identified that convexity is routinely and safely used in the postoperative period including the first 30 days. Colwell, Stoia-Davis, Emodi et al conducted a scoping review and consensus panel to develop care statements related to convexity use. Clinicians should note both articles support the priority of care as the maintaining of intact peristomal skin including the early use of convexity to achieve this goal.
Ostomy patients' perspectives are represented in the validation of standards of care for ostomy and continent diversion patients in a Patient Bill of Rights (PBOR) study by Burgess-Stocks, Gleba, Lawrence, and Mueller. The authors support that adoption of these PBOR best practices can drive health care quality improvement.
WOC clinicians will find interesting information in the continence and foot/nail care sections. Tuzer, Gezginci, and Yilmazer evaluated the effects of an information, motivation, and behavioral skills model on male urinary incontinence. The structured, bundled approach significantly improved lower urinary tract symptoms.
The executive summary of the newly updated Lower Extremity Wounds Related to Diabetes Mellitus and/or Neuropathic Disease by Bonham, Brunette, Crestodina, Droste, et al, is a must read for WOC clinicians who want to use evidence-based approaches for patients with these kinds of wounds. Again, JWOCN is a wonderful resource for busy clinicians searching for the best guidance in clinical care.
Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, CRNP, ANEF, FNAP, FAAN