In This Issue of JWOCN
As I reviewed the articles in this issue, I was sharply reminded of the significant scope of WOC nursing and how well this issue reflects the breadth of our specialty practice. Topics in the current issue include pressure ulcers, skin tears, neuropathic pain in patients with burn injuries, stoma site marking, peristomal skin complications, and relationships between Parkinsonism, alcohol, caffeine, and artificial sweeteners and lower urinary tract symptoms. Read on and learn more about the efficacy of specific interventions, instrument development, pathophysiology, informatics, cost analysis, evidence-based practice, and credentialing.
This issue's Wound Care section opens with the latest Evidence-Based Report Card from Kimberly LeBlanc, Kathryn Kozell, Lina Martins, Louise Forest-Lalande, Marilyn Langolis, and Mary Hill. It focuses on enhancement of the skin's moisture barrier via application of moisturizers for prevention of skin tears. This Evidence-Based Report Card can only be described as must read for any WOC nurse who cares for frail or aged patients at risk for such injuries. Phyllis Bonham, Bonny Flemister, Linda Droste, Jan Johnson, Teresa Kelechi, Catherine Ratliff, Myra Varnado, and Ronald Palmer provide an Executive Summary of the 2014 WOCN Guideline for Management of Wounds in Lower-Extremity Arterial Disease (LEAD). The clinical practice guidelines from the Society are widely known because they provide a comprehensive and cogent synthesis of evidence and best practice for this patient group. The latest LEAD guideline is must read for every WOC nurse managing patients with lower-extremity ulcers and endothelial disease.
Issues surrounding unavoidable pressure ulcers continue to challenge our evolving understanding of pressure ulcer prevention.1 Joyce Pittman, Terrie Beeson, Colin Terry, Jill Dillon, Charity Hampton, Denise Kerley, Judith Mosier, Ellen Gumiela, and Jessica Tucker describe development of an operational definition for unavoidable pressure ulcers in the acute care setting, along with construction and initial validation of an important new instrument for identification of unavoidable pressure ulcers. You will want to read this article that extends our ongoing commitment to providing a broad evidence base for pressure ulcer prevention in all care settings.
William Padula, Leon Blackshaw, Tod Brindle, and Samuel Volchenboum describe an informatics-based approach for managing pressure ulcer data contained within electronic medical records. This article qualifies as must read for all Journal readers not only because it provides essential tips for facility-wide data use but also because it describes a realistic and achievable means for constructing a national database essential for increasing our understanding of the epidemiology for pressure ulcers and their effective prevention.
Patient turning and repositioning has long been recognized as an essential component of an intervention bundle for pressure ulcer prevention. Jan Powers reports results of a comparison cohort study that examined 2 methods for turning and repositioning, traditional practice using pillows versus a manufactured turning and positioning system. You will want to read this cutting-edge research report to update your knowledge of the evidence underlying this novel approach for pressure ulcer prevention.
Tarnia Taverner and Jennifer Prince examine the pathophysiology of pain in patients with acute burn injuries. Their research report raises the question of whether neuropathic pain is a component of the pain experienced by persons with acute burn injuries, an essential component of the nursing care of all patients with moderate to severe burn injuries.
The paucity of evidence concerning stoma site marking and its impact on multiple outcomes including health-related quality of life remains a central challenge for evidence-based ostomy care in the 21st century. Linda McKenna, Elizabeth Taggart, Joyce Stoelting, Geri Kirkbride, and Gordon Forbes compare health-related quality of life in patients who received stoma site marking by a certified WOC nurse versus patients who did not. This article qualifies as must read for every nurse who cares for persons living with an ostomy.
Nancy Neil, Gary Inglese, Andera Manson, and Arden Townshend provide a cost-utility analysis of how the use of ostomy accessory products impacts the cost of peristomal skin complications. This article qualifies as must read because it provides new knowledge about use of these products from an economic perspective.
Lower urinary tract symptoms (LUTS) are a set of subjective reports arising from dysfunction of the bladder, urethra, and pelvic floor muscles.2 Janis Miller, Caroline Garcia, Sarah Hortsch, Ying Guo, and Megan Schimpf report findings from a multiphase study that examined the relationship between LUTS and multiple beverages containing potential bladder irritants. This article raises several clinically relevant issues including the elusive definition of what comprises a bladder irritant, what components of certain beverages influence LUTS, and the effectiveness of advice about reducing versus eliminating these beverages in the presence of symptoms. Helene Moriarity, Joanne Robinson, Lisette Bunting-Perry, and Christine Broadway report findings from a study of cognitive, affective, and behavioral components of LUTS in men with Parkinsonism. You will want to read this article to improve your knowledge of the impact of LUTS and opportunities for nursing interventions to alleviate symptoms and improve health-related quality of life.
The CAET Feature in this issue also addresses a hot topic in continence nursing care, intermittent catheterization. Jean Brown, Gail Creelman, Donna Fossum, Maria Jones, Sandra Roberts, and Teri Anne Schroeder describe development of a decision aid for patients who are candidates for intermittent self-catheterization.
The first Challenges in Practice feature article of 2016 describes a gentleman with impaired healing of a donor site following bone harvest for reconstruction of the jaw. You will want to read this complex case study and see how Lauren Wolfe managed both systemic and local factors to enhance wound healing in an aged, community-dwelling patient.
Finally, you will want to read the Getting Ready for Certification feature article. It not only provides 3 practice questions for the CFCN certification examination, it also provides an important announcement concerning credentialing for this integral component of our specialty practice.
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