In This Issue of JWOCN

WOC nurses face multiple challenges in their practices, and this issue of the Journal is ready to provide research-based answers to several of the most pressing clinical issues we face today. Your Wound Care section opens with an integrative review of the effects of smoking on wound healing. Authored by Jodi C. McDaniel and Kristine Browning, this CE article qualifies as must read for every wound care nurse who manages patients who smoke cigarettes. Kyung Hee Park reports results of a study comparing standard pressure ulcer prevention care to standard plus use of a silicone border foam dressing in 50 critically ill patients. You will want to read this lucid article that adds to existing evidence published in the Journal about the effects of these dressings on sacral pressure ulcers1-3 as well as original data about their effect on incontinence-associated dermatitis.

Ye-Na Lee, Hyon-Surk Kim, Jeong-A Kang, and Seung-Kyu Han report findings from a study that evaluated the association between macrocirculation and TcpO₂ in persons with diabetes mellitus. You will want to read this clinically relevant article to find out whether Doppler ultrasound or computed tomographic guided angiography are accurate enough to replace TcpO₂ measurement for determining management of patients with diabetic foot ulcers. Leticia Faria Serpa and Vera L. C. G. Santos coauthored an article for this issue that evaluated the ability of the Nutrition subscale of the Braden Scale for Pressure Sore Risk, when considered in isolation from other subscores, to predict pressure ulcer formation in hospitalized patients. This article qualifies as must read for any WOC nurse seeking to maximize the utility of this widely used instrument for prevention of pressure ulcers.

Your Ostomy Care section for this issue opens with an article by Janice M. Beitz and Janice C. Colwell that describes outcomes of a validation study of interventions for stomal and peristomal complications. This timely and clinically relevant article qualifies as must read for every WOC nurse who manages patients with fecal or urinary ostomies. Ailing Hu, Yunfeng Pan, Meifen Zhang, June Zhang, Meichun Zheng, Manrong Huang, Xinmei Ye, and Xianrong Wu report results of a study that evaluated the influence of confidence in self-care and social support on adjustment to a colostomy. You will want to read this cogent article that provides important insights into this complex but essential process following creation of a colostomy.

Your Continence Care section opens with a research report by Kelly Yamasato, Bliss Kaneshiro, and Ian A. Oyama, who describe their evaluation of a preclinical measure of efficacy and cost-effectiveness of commercially available absorptive incontinence pads or wrap around briefs. Any clinician who educates patients or families or who guides facility determination of policies and protocols for the use of absorptive products will want to read this compelling article to learn how to measure the leak point of an absorptive pad or brief and its relationship to product cost. Next, James W. Lederer, William R. Jarvis, Lendon Thomas, and Jaime Ritter report on their multicenter, before-after nonrandomized cohort study evaluating the impact of introducing a silver alloy hydrogel indwelling urinary catheter for use in the acute care setting. This article qualifies as must read for every WOC nurse who shares an interest in or responsibility for reduction of catheter-associated urinary tract infections (CAUTIs) in the hospital setting. This article also provides clinically relevant data because it challenges prevailing recommendations about the use of these catheters as a strategy for reducing symptomatic CAUTIs based on commonly used clinical criteria for this difficult diagnosis and the most recent definition promulgated by the National Healthcare Safety Network.

This issue also includes a Professional Practice article that reports results of a laboratory-based study comparing 2 stool management systems. You have heard of the effect of indwelling fecal management devices on prevention of IAD or sacral pressure ulcers4,5 but this article focuses on another marker of effectiveness, their ability to prevent environmental spread of Clostridium difficile. You will want to read this article to determine whether differences in the designs of these devices influence their ability to prevent the spread of this virulent and prevalent pathogen.

This issue's Clinical Challenges feature article is authored by Kristen Kalkbrenner, Kyle Sanniec, Lyndsey Bryant, Jacques Heppell, Heather Mc Entarffer, and Alanna Rebecca. They describe the case of a patient with an ileostomy and hyperhydrosis of the peristomal skin, resulting in significant difficulties with her pouching system. You will want to read this case study to determine whether injection of botulinum toxin-A should be added to the options for treatment that you recommend to patients suffering from this clinically relevant disorder of the peristomal skin.

This issue's Getting Ready for Certification feature explores the definition of Care Bundles and their incorporation in current certification examinations offered by the WOCNCB. You will want to read this feature and answer the accompanying practice questions in order to increase your understanding of this increasingly popular tool for clustering interventions in a manner that renders them more effective for prevention or treatment than their use in isolation.

Finally, this issue includes an important View From Here feature authored by Mary Arnold Long, which discusses the impact of the Affordable Care Act on WOC nursing practice. This feature is valuable because it not only dispels common myths about this important change in the US health care system but also projects its probable influence on multiple aspects of our specialty practice.

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