In This Issue of JWOCN

In 1983, International Association for Enterostomal Therapy President Dr Debbie Broadwell (Jackson) wrote a prescient Editorial that outlined her vision for specialty practice nursing in general and WOC specialty practice in particular.1 In addition to clearly articulating the difference between advanced and specialty practices, she also outlined several key expectations for specialty practice nursing in the 20th century. One of these expectations was setting standards of care within the group's specialty practice and the expectation that these standards should influence nursing care across specialties. Her message, which preceded our current ideas of evidence-based practice and best practice by more than 30 years, nevertheless spoke to one of our greatest ongoing missions: setting standards for care within our specialty that are evidence-based whenever possible, and reflective of current best practices when this higher standard cannot be met. This issue of the Journal contains several articles that address this ongoing mission. Read on and challenge your own practice by asking yourself, "How has my practice influenced WOC nursing in my facility, health system, community, region, and country?"

This issue's "Continence Care" section opens with an article focusing on current best evidence, best practices, and their application to a skin care algorithm that can be used in multiple health care settings. Andrea Lichterfeld, Armin Hauss, Christian Surber, Tina Peters, Ulrike-Blume-Peytavi, and Jan Kottner summarize the research base for their algorithm for providing basic skin care in adults in acute and long-term care settings. This article is a must read for any WOC nurse seeking to elevate skin care from a basic hygienic task to a preventive intervention essential for care in our increasingly prevention-driven health care system. Donna Bliss, Taylor Funk, Megan Jacobsen, and Kay Savik report on their latest study of incontinence-associated dermatitis (IAD) in community-dwelling adults. You will want to read this article to find out more about both the incidence and characteristics in this understudied group.

Vidya Seshan and Joshua Muliira report findings from their study that evaluated the effect of a video-assisted teaching program designed to educate community-dwelling women about pelvic floor muscle exercises. This article is a must read for any WOC nurse seeking to determine effective methods for reaching multiple women in a community-based setting. Mary H. Palmer, Celine Siewe Marquez, Yin Li, Shelley Yerger Hawkins, Fay Smith, and Jan Busby-Whitehead describe a feasibility study for an intervention for managing lower urinary tract symptoms in adults with heart failure. You will want to read this article to improve your insights into the relationship between urinary symptoms and heart failure, and the challenges associated with its management. This issue's Getting Ready for Certification focuses on fecal incontinence. I encourage you to regularly read this useful feature of the Journal, authored by Donna L. Thompson, especially if you are contemplating sitting for the WOCNCB's new and exciting examination for advanced practice continence nurses.

This issue's "Ostomy Care" section opens with a report of a study of one of the most important issues facing WOC nursing today; should we routinely teach colostomy irrigation to indicated patients? Authored by Nancy Tallman, Martha Cobb, Marcia Grant, Christopher Wendel, Janice Colwell, Elizabeth Ercolano, and Robert Krouse, this article is essential reading for every WOC nurse who wishes to understand the factors that influence our decisions about teaching colostomy irrigation. You will also want to read this article to determine whether you should reconsider your current approach to this important aspect of ostomy nursing. Raymond Oliphant, Alex Czerniewski, Isabell Robertson, Clare McNulty, Ashita Waterston, and Angus Macdonald report findings from their retrospective review of ostomy function in patients undergoing surgery alone versus patients managed by surgery and chemotherapy. You will want to read this study to determine the impact of chemotherapy on stoma function in this important patient population.

This issue's "Wound Care" section includes 3 articles and a View From Here commentary focusing on pressure ulcer management, a central focus of WOC nursing practice in the 21st century. The first is a report on standardizing support surface testing and reporting from the National Pressure Advisory Panel authored by Arthur Stone, David Birenza, Evan Call, Rock Fontaine, Margaret Goldberg, K. Z. Hong, Rosalyn Jordan, Charlie Lachenbruch, Patrick LaFleche, and Cindy Sylvia. Every WOC nurse involved in pressure ulcer prevention has by now heard about the NPUAP's S3I committee and its goals of establishing a common language for support surfaces, standardized tests for evaluating characteristics and features of these surfaces, and methods for evaluating their effective life. Read on in this issue of your Journal to learn about the outcomes of this ground-breaking task. Petra Lawrence, Paul Fulbrook, and Sandra Miles report their survey of Australian nurses' knowledge of pressure ulcers and their management. This article is must-read for any WOC nurse involved in educating colleagues concerning prevention, assessment, and care of pressure injuries. Tracy Yap, Mary Rapp, Susal Kennerly, Stanley Cron, and Nancy Bergstrom report their study of the use of time-to-erythema as a component of a pressure ulcer prevention program. You will want to read this retrospective review of the performance of time-to-ischemia as an assessment for pressure ulcer risk as compared to its evaluation using a validated instrument such as the Braden Scale for Pressure Sore Risk. Susan M. Scott, a well-known expert in preoperative pressure ulcer prevention, summarizes her view of progress and challenges associated with current efforts to ensure perioperative pressure ulcer prevention. Her commentary provides a thoughtful consideration of the most pressing questions and needs we face as we continue to grapple with this unique challenge in our prevention efforts.

Harvey N. Mayrovitz, Hugo Partsch, and Wolfgang Vanscheidt report their study of the pressure delivery characteristics of a 4-layer bandage system versus an adaptive compression device for venous leg compression. You will want to read this article to determine the effect of these devices on tissue interface pressures in healthy volunteers. Finally, this issue's "Wound Care" section includes a timely article from Jill Monfre, Teresa Kelechi, Gayenell Magwood, and Martina Meuller, who report on the development and psychometric evaluation of a new instrument for evaluating symptom bother in persons experiencing pain associated with chronic wounds. You will want to read this article to determine the role of this novel instrument and its potential application for your practice.

This issue's "Challenges in Practice" column focuses on one of the greatest challenges facing WOC nursing practice in the 21st century, ensuring adequate nourishment to a person with a devastating injury to the gastrointestinal tract. Kate Willcutts, David Mercer, and Jane Ziegler describe a case of nutritional management of a patient with an enteroatmospheric fistula using fistuloclysis. You will want to read this cutting-edge case study, typical of the Journal's Clinical Challenges feature, to increase your knowledge of this approach to meeting the nutritional needs of this vulnerable patient population.

Kathy Mutch and Dorothy Dewar provide this issue's CAET Feature describing implementation of a provincial diabetic foot screening program. This article is essential reading for every WOC nurse seeking to move prevention back to its earliest moment, before we are forced to provide care for an existing wound and work with the patient on prevention of recurrence.

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