In This Issue of JWOCN
Support surfaces remain a mainstay of pressure ulcer prevention and management, but a validated algorithm for selecting the best support surface has been lacking. In this issue's Wound Care section, Laurie McNichol, Carolyn Watts, Dianne Mackey, Janice Beitz, and Mikel Gray summarize the process leading to an algorithm for support surface selection. You will want to read the outcome of this article and get a preview of this major WOCN-driven initiative that generated an evidence- and consensus-based algorithm that has undergone content validation by a world-class group of clinicians and researchers.
Clinical experience overwhelmingly supports the hypothesis that psychological distress slows wound healing. Sharon House provides a masterful integrative review that synthesizes evidence exploring the impact of psychological distress on wound healing. This review qualifies as a must-read for every WOC nurse striving to provide comprehensive care; are you identifying and considering the effects of depression, relational conflicts, and anxiety on that slow healing wound?
Compression therapy is a first-line intervention for treatment of prevention and treatment of venous leg ulcers, and a growing body of evidence has been published suggesting that surgical intervention also may be useful in reducing the risk of venous leg ulcer recurrence. Magali de Carvalho systematically reviewed the literature to determine whether surgery plus compression therapy was more effective for wound healing and prevention of venous leg ulcer recurrence as comapred to compression therapy alone. You will want to read this clinically relevant systematic review to determine whether surgery and compression therapy act together to promote healing and prevent recurrence more effectively than compression alone.
This issue's Wound Care section concludes with a pair of extremely important articles that examine friction, shear, and their impact on the skin. David Brienza, Steven Antokal, Laura Herbe, Susan Logan, Jeanine Maguire, Jennifer Van Ranst, and Aamir Siddiqui authored an updated NPUAP White Paper describing the relationships between friction, sharing forces, and skin damage. You will want to read this important document from the NPUAP to not only clarify your understanding of what friction is, the different actions of friction and shearing forces on the skin and underlying tissues, and the types of skin damage caused by these distinctive forces. This essential update from the NPUAP is followed by a must-read article by Christine Berke, who describes a case series and literature review focusing on the pathology and clinical presentation of friction injuries. Read these articles together; I predict they will clarify, or possibly even revolutionize, your understanding of friction as a physical force and the differential assessment and management of friction-induced injuries.
Do you teach your patients with new colostomies about irrigation? Opening this issue's Ostomy Care section, authors Martha Cobb, Marcia Grant, Nancy Tallman, Christopher Wendel, Janice Colwell, Ruth McCorkle, and Robert Krouse report findings from an important study of WOC nurses' current knowledge and practice of colostomy irrigation. Read this article to determine how your practice in this area compares to that of your colleagues and whether you should take a fresh look at this well-established self-management technique.
The Journal has published multiple articles about health-related quality of life following stoma surgery and its profound influence on multiple components of the individual's self-image, lifestyle, and important relationships. Thom Nichols next reports analysis of a large cohort of persons with fecal and urinary ostomies, using the Medical Outcomes Study Short Form 36, version 2. This first installment in a series of articles is unique because it not only provides new insights into the influence of ostomy creation on health-related quality of life based on findings from the gold standard for instruments used to measure this critical construct, it also compares these findings to those of the general population.
The WOCN(R) Society's Clinical Practice Ostomy Task Force presents a new Best Practice document for discharge planning in patients with a new ostomy. Authored by Anita Prinz, Janice Colwell, Heidi Cross, Janet Mantel, Jacqueline Perkins, and Cynthia Walker, this article deftly summarizes essential elements for discharge planning for patients with newly created ostomies as they make the transition from hospital to home care.
Forceful contraction of an ostomy can lead to powerful expulsion of effluent from an ileostomy with more than enough force to create leakage from an otherwise well-sealed pouching system. Vanessa Smith and Callum Lyon present a case series of 10 patients with hypercontractile ileostomies resulting in regular pouching system leaks who were treated by injection of botulinum toxin A. You will want to read this innovative approach to determine if botulinum injections might be worthwhile in your patients with hypercontractile ileostomies leading to frequent leakage.
This issue's Challenges in Practice feature article also focuses on ostomy management. Kosuke Ishikawa, Toshiyuki Minamimoto, Takeo Mizuki, and Hiroshi Furukawa report a case where they used split-thickness skin grafting with subsequent negative pressure wound therapy to promote graft fixation in a gentleman with severe peristomal pyoderma gangrenosum. This timely case report provides an innovative and elegant solution to the management of a painful and difficult peristomal skin problem in a frail patient with advanced stage colorectal cancer.
This issue's Continence Care section begins with a landmark study of the prevalence of fecal and double fecal and urinary incontinence in hospitalized patients in Austria. It was authored by Erman Shahin and Christa Lohrmann. You will want to read this study involving more than 9000 patients in 227 Austrian hospitals to learn more about the prevalence of fecal incontinence in the hospital setting and to identify risk factors in the acutely ill patient.
Percutaneous tibial nerve stimulation has reinvigorated interest in neuromodulation in patients with urge urinary incontinence. M. Perissinotto, C. D'Ancona, A. Lucio, R. Campos, and A. Abreu present findings from a randomized controlled trial evaluating the efficacy or transcutaneous tibial nerve stimulation in a group of patients with Parkinson disease and neurogenic detrusor overactivity leading to cure incontinence. You will want to read this article to determine whether neuromodulation might play a role in this challenging patient group.
Evidence-Based Practice has evolved from a novel idea to a fundamental element of WOC nursing practice. Based on reader demand, the Journal is pleased to announce that we are working closely with Society leadership and the Center for Clinical Investigation to resume publication of the Evidence Based Report Card articles that were so popular in recent years. This issue of the Journal also includes a professional practice article giving you an update of the newest techniques that will be employed in authoring this revitalized resource for your practice.
In this issue's CAET Feature article, Catherine Harley describes CAET's transition to compliance with the new Canada Not-for-Profit Corporations Act (CNCA). This is a top priority for the CAET and an ideal opportunity to reexamine the society's purpose and bylaws.