IN THIS ISSUE OF JWOCN
Given its importance to WOC practice, it is not surprising that our understanding of the relationship between pressure and shearing forces and the integrity of the skin remains a source of ongoing scrutiny and frequent controversy. Our struggle to understand the causes of the skin damage and associated ulcers produced by immobility can be traced back all the way to the third to fourth century BCE.1 In 1975, Shea proposed a staging system that underwent modification by the International Association of Enterostomal Therapy and National Pressure Ulcer Advisory Panel (NPUAP).2 The concept of a staging system is advocated on a global basis, as reflected in the most recent International Pressure Ulcer Guidelines from the NPUAP, European Pressure Ulcer Advisory Panel, and the Pan Pacific Pressure injury Alliance, published in 2014.3 In this issue of the Journal, the NPUAP provides the official report of the 2016 update to the staging system, including a change in nomenclature from pressure ulcer to pressure injury. This article, authored by Laura Edsberg, Joyce Black, Margaret Goldberg, Laurie McNichol, Lynn Moore, and Mary Sieggreen, goes beyond must read for WOC nurses; rather, it qualifies as must read for all clinicians and any stakeholder interested in pressure injury and how it is staged.
Radiation dermatitis is a prevalent and challenging sequela of radiotherapy. Its prevention and treatment relies on self-management, but adherence can be lacking. Carole Bauer, Morris Magnan, and Pamela Laszewski report outcomes of a quality improvement project that used a 4MAT theoretical framework to improve adherence to a skin care program for patients receiving external beam radiation. You will want to read this article to improve your understanding of this theoretical framework for adult education and evaluate the success of their efforts when applying it to improve self-management for prevention of radiation dermatitis.
The fetid odors associated with many chronic, nonhealing wounds may impair health-related quality of life (HRQOL), intensify isolation, and reduce contact with family, significant others, and care givers. Alma Akhmetova, Tumir Saliev, Iain Allan, Matthew Illsely, Talgat Nurgozhin, and Sergey Mikhalovsky review the effectiveness of topical interventions for managing wound malodor. Maintaining personal dignity and HRQOL are core values for WOC nursing; you will want to read this article to review current options for reducing wound odor and consider how your insights and clinical expertise might add to the sparse evidence base needed to improve our management of this psychosocial crisis.
This issue's Ostomy Care Section opens with the fourth in a series of articles from Thom Nichols concerning the impact of fecal and urinary ostomies on community-dwelling adults in the United States. You will want to read this article not only to improve you knowledge of HRQOL domains vitality, social function, role-emotional and mental health in persons with ostomies, but also to compare HRQOL in persons with ostomies to that of age-matched adults without a stoma. Xi Su, Fang Qin, Li Zhen, Xinmei Ye, Yinyi Kuang, Mulan Zhu, and Xuexia Yin report a study of stoma self-efficacy (the ability to manage one's ostomy without dependence on family members or lay caregivers) in patients with temporary fecal ostomies. You will want to read this article to identify factors associated with this critical skill and how you might strengthen these factors in your patients struggling to manage a temporary stoma.
This issue's Continence Care Section opens with a research report from Xavier Boronat-Garrido, Jan Kottner, Gabriela Schmitz, and Nils Lahmann on the prevalence and severity of incontinence-associated dermatitis using the Incontinence-Associated Dermatitis Intervention Tool-D (IADIT-D). This article is a must read that further extends the already extensive evidence base for incontinence-associated dermatitis in the Journal.
Two articles in the Continence Care Section focus on one aspect of continence management characteristic of WOC nursing practice in this area, management of intermittent and indwelling catheterization. F. Falieros, C. Kappler, J. N. Costa, N. Faverreto, and F. Pontes report findings from a study to identify predictors of self-intermittent catheterization in persons with myelodysplasia and neurogenic bladder residing in Brazil and Germany. This article is must read because it provides novel knowledge into our limited understanding of long-term adherence to intermittent catheterization.
Every WOC nurse practicing in the United States is aware that Dorothy Doughty has been leading a Task Force for the WOCN Society formed to redefine our understanding of continence care within the larger umbrella WOC specialty nursing practice. Janice Paterson, Joan Ostaszkiewicz, I. Suyasa, Jennifer Skelley, and Lesley Bellefeuille report on the end result of a 6-year project to identify the role of the nurse continence specialist on a global basis. You will want to read this well-written article to see how the practice of the nurse continence specialist compares and contrasts to your experiences with continence care. As you read this article, bear in mind that whether you are evaluating moisture management as part of a pressure injury prevention program, managing peristomal moisture-associated skin damage in a patient with a new ostomy, or participating in a catheter management program for prevention of hospital-acquired catheter-associated urinary tract infection, it is true, "You are a Continence Nurse." As Editor of the Journal and a shameless cheerleader for our specialty, I urge you to wear this moniker with pride!
This issue's Challenges in Practice focuses on epidermal necrolysis using a silicone foam dressing. You will want to read this cutting-edge article to determine whether the strategies described by Kimberly McCarthy and Rachel Donovan may be applied to your practice when managing patients with this devastating cutaneous response.
Finally, in this issue's Getting Ready for Certification, Michael Kingan briefly reviews and provides practice questions focusing on lower extremity venous disease. This regularly appearing feature is essential for any WOC nurse preparing for a first-time examination for certification or seeking recertification using the examination route.
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