IN THIS ISSUE OF JWOCN
Following Journal of Wound, Ostomy and Continence Nursing (JWOCN) tradition, this issue covers all major areas of our specialty practice, from continence care, to foot and nail care, ostomy management, and prevention of chronic wounds. Combine this with essential resource documents from the Wound, Ostomy and Continence Nurses (WOCN) Society, and you have an issue that demands to be read cover to cover. Contributing authors continue to reflect the global readership of the JWOCN; they practice in Brazil, Canada, Germany, South Korea, Spain, and the United States.
Our newest platform Section, Foot and Nail Care, has an article by Drs Teresa Kelechi and Tara Beuscher that reviews clinical characteristics, evaluation, and treatment of nail infection with dermatophytes (onychomycosis). This article is another addition to the growing library for foot and nail recourses available to CFCN and every WOC nurse who cares for individuals with conditions affecting the feet and nails.
This issue's Ostomy Care Section contains a must-read article from Toni McTigue, Jason Lei, Mildred Kowalski, Susan Prestera, Stephanie Chiu, and Josef Shehebar that not only describes use of ostomy bridges in patients undergoing loop ostomy diversions at a single facility in the United States, but also summarizes cross-sectional data from colorectal and oncologic surgeons in 30 countries concerning this controversial practice.
The Journal continues to benefit from our special relationship with our neighbors to the North. Read the Executive Summary by Jillian Brooke, Amanda El-Ghaname, Karen Napier, and Laureen Sommerey that provides best practice recommendations when caring for patients with enterocutaneous and enteroatmospheric fistulas. Want to read even more about this timely and challenging aspect of WOC specialty nursing? Read the detailed and incredibly complex case presented by Jose Gonzalez, Cristina Sanchez, and Francisca Rodriguez who describe the case of a frail elderly woman who developed both of these fistulas following abdominal surgery.
Your Wound Care Section opens with an especially robust epidemiologic study authored by Susan Kayser, LeeAnn Phipps, Catherine VanGilder, and Charlie Lachenbruch who evaluate the prevalence and risk factors of incontinence-associated dermatitis (IAD). This study represents yet another substantial contribution from the International Pressure Ulcer Prevalence Survey database, a large and robust source for expanding both the science and clinical evidence for prevention and management of patients with pressure injury and IAD. LeeAnn Phipps, a co-author of the IAD epidemiologic study, also led a group of 3 investigators, including Evan Call and myself, who evaluated the effect of exposure time on impaired epithelial/moisture barrier skin function in healthy, elder adult women aged 65 years or older. You will want to read this article to gain insights to the pathophysiology and probable natural history of IAD. Are you thinking days to a week or more from exposure to inflammation in vulnerable patients? Read this study and judge the findings yourself!
This issue also contains a clinically relevant and timely description of a quality improvement project that evaluated the effect of a unit-based algorithm for management of fecal and urinary incontinence in patients at risk for or experiencing IAD receiving care in a surgical intensive care unit. Authored by Brandon Gates, Joy Vess, Mary Arnold-Long, and Emily Johnson, this article is a must-read for every WOC nurse contemplating a similar bundle in their facility or health system.
Two articles in this issue focus on prevention of pressure injuries. Your CE article, authored by Dr Joyce Black, presents a timely review of principles of root cause analysis, a valuable methodology for designing quality improvement for any pressure injury prevention program. You will want to read this timely article to determine the application of this utilitarian approach to determining root causes of and solutions for pressure injuries in your facility or health system. Seul Park, Hyeoun-Ae Park, and Hee Hwang report a case-control study evaluating 3 models for predicting perioperative pressure injury risk factors in an acute care facility. Perioperative pressure injury is a hot topic and this well-designed and well-written research report provides important new knowledge in this area of WOC specialty nursing practice.
Authored by the frequent JWOCN contributor, Dr Vita Boyar, the second article in this issue's Clinical Challenges Section focuses on an uncommon, but potentially devastating, congenital cutaneous defect affecting neonates, aplasia cutis congenita (ACC). You will want to read this fascinating and clinically relevant case report of a newborn with a large ACC defect managed with topical therapy including leptospermum honey.
In addition to articles related to IAD pathophysiology and management, this issue contains the latest contribution from Fabiana Faleiros, Seth Warschausky, Christoph Kappler, William Schutt, Michel Cintra, Soraia Rabeh, and Fernanda Gimenes describing a study of the transition from assisted to self-catheterization among patients with myelodysplasia and neurogenic bladder dysfunction. Intermittent and indwelling catheterization are part of the WOC-centric focused practice described in the WOCN Society's recently updated white paper on the role of the WOC nurse in continence care.1 Faleiros' group has published multiple articles in the JWOCN on this topic,2,3 and this latest contribution is essential to the small but growing evidence base for ongoing management of patients with spina bifida and neurogenic bladder dysfunction via long-term indwelling catheterization.
This issue's Getting Ready for Certification, authored by Jessica Simmons and Chenel Trevellini, focuses on implementation principles of wound management across 3 levels of certification. Whether you are preparing for your initial certification as a CWOCN, CWON or CWCN, or testing for recertification, this article is a must-read insight into the WOCNCB's rigorous testing process.
Finally, this issue provides not 1 but 2 bonus features essential to the professional practice of WOCN Society members. The first is a fact sheet outlining reimbursement opportunities for WOC nursing services under the Medicare Part B "incident to" services and the second is a fact sheet describing Medicare payment for WOC Advanced Practice Registered Nurse Services. Both are essential components of your professional practice portfolio and both are a must-read for any WOC nurse practicing in the United States.
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