As the Fall brings cooler weather, the topics in this issue are heating up for interest and value. Wound care focuses on bariatric care challenges and pressure injury risk assessment. Beitz & Kennedy Evans discuss the multiple unique care considerations when providing interventions for Class 3 (morbid) obesity patients including visuals demonstrating skin and wound conditions. Shieh and Colleagues used a prospective cohort design to test a novel risk assessment instrument for reducing hospital-acquired pressure injuries (HAPIs). Implementation of the new scale, an early warning system, and a standing order set resulted in a 38% reduction in annual HAPI rate. Talk about knowledge and early warning being powerful!!
Ostomy care addresses a lifespan perspective. Forest-Lalande reports on a new best practice guideline for ostomy care in neonates, children, and adolescents. Based on literature review and consensus techniques, an international group of pediatric ostomy care experts developed guidance for clinical and psychological aspects of care. Ostomy adjustment in permanent ostomates was evaluated by Tirgari et al in a descriptive correlational study of 100 Turkish participants. Using questionnaires about resilience and ostomy adjustment, the researchers identified that resilience was associated with ostomy adjustment.
For continence care, researchers provided guidance on intermittent catheterization (IC). Qualilich and Colleagues reported on an expert consensus panel who conducted a scoping literature review and developed 15 consensus-based statements guiding education of patients on IC. Santos-Perez, Medina-Polo, Gonzalez-Padilla et al, examined quality of life and self-reported complications in 50 individuals using clean intermittent catheterization (CIC) in Madrid, Spain. Most patients noted preparation for CIC was simple and that catheters were easily inserted though 98% felt self-conscious about the need to use CIC. The most common complication reported was urinary tract infection. Another study by Avci and Yildirim examined instrument development related to health beliefs about urinary incontinence (UI) and Kegel exercises. Tested with 527 individuals in Turkey, the new scale had strong construct validity and reliability indices.
Zima and Jairath targeted foot care when they described use of quality improvement approach (nurse-administered foot care intervention bundle (NA-FCIB). The project incorporated 39 patients with diabetic foot ulcers (DFUs). Without hurting work low, the bundle usage resulted in significantly increased knowledge for patients' self-care and hemoglobin AIC levels dropped from 8.27 (SD 2.05) to 7.46 (SD 1.58) (p=0.002). Zhu et alprovided a visual description of 3 case patients wherein negative pressure wound therapy (NPWT) was used to treat mucocutaneous separation in ileal conduit patients.
Finally, Views From Here raise intriguing issues. Brunette suggests that surgical consent forms should contain information about the risk of pressure injury for any surgery . Kelechi looks at the big picture issue of social determinants of health and how they affect WOC patients. She makes a compelling case for the need for further research on the topic. All these articles are highly interesting, helpful for your practice, and well worth your time.
Your colleague
Janice Beitz
