IN THIS ISSUE OF JWOCN
Like so many other health care providers, WOC nurses face multiple unprecedented challenges during the COVID-19 global pandemic. These challenges include (1) providing care for patients directly affected by COVID, (2) maintaining much-needed ongoing care to our patients with WOC and foot & nail problems, (3) providing care for colleagues affected by COVID, and (4) protecting ourselves and our families and communities from the spread of this viral infection. As part of a larger strategy undertaken by the WOCN Society in response to the COVID pandemic, this issue of the Journal is a blend of best practice and expert opinion-based information related to the effect of COVID on our specialty practice combined with the latest in evidence-based and research findings related to our routine practice. This Context for Practice Editorial will summarize highlight from the platform and special feature articles you have grown to expect from JWOCN. In addition, this issue contains a separate special section, titled "Resources for Battling COVID," that includes Views From Here focusing on the challenges the pandemic has imposed on our specialty practice, a best practice statement from the WOCN Society, a special note from WOCN Society President Stephanie Yates, and a separate Editorial reflecting on our role as frontline providers during this global crisis.
Similar to prior issues, the authors in this issue of JWOCN comprise a global community reporting the latest evidence in the premiere journal for wound, ostomy, continence, and foot & nail care (Figure). This issue's Wound Care section opens with a prospective observational study of subepidermal moisture and pressure injury (PI) in a pediatric population (aged 8-16 years) authored by Barbara Bates-Jensen, Sinead Reilly, Carol Hilliard, Declan Patton, and Zena Moore. As reported in previous articles published in JWOCN, subepidermal moisture measurement is one of the most promising new technologies emerging in the ongoing mission to detect and prevent PI before it progresses to loss of skin integrity or full-thickness ulceration.1 You will want to read this article to gain insight into the potential role of subepidermal moisture measurement in the pediatric population.
Seyed Borzou, Sheller Amiri, Azim Azizi, Leili Tapak, Farshid Bashar, and Shirin Moradkhani report a single-blind study comparing almond oil, a placebo topical treatment (paraffin), and a control group receiving no topical products. You will want to read this cutting-edge research report to determine the potential of topical almond oil for prevention of PI in critically ill patients.
Xiaomei Chen, Haitao Liao, Wen Gao, Yunchao Chen, Jiegang Huang, and Yiping Wei report findings of an epidemiologic study of PI incidence among patients undergoing cardiopulmonary bypass surgery. You will want to read this insightful study of the incidence of PI in this vulnerable group along with a detailed analysis of potential risk factors.
Leena Al-Mansour, Sharon Dudley-Brown, and Abdullah Al-Shaikhi report findings from an ambitious quality improvement project that aimed to create an interdisciplinary health care team for managing patients with full-thickness pressure injuries, measure the knowledge of level of the nursing staff regarding PI management, and conduct quarterly PI prevalence surveys designed to decrease the rate of the hospital-acquired PI. You will want to read this article to determine the actions this interdisciplinary health care team took, its effects on their care outcomes, and possible lessons you can apply to your PI prevention program.
Finally, Ann Nie describes the historical process she went through to establish a PI prevention program in an acute care facility providing care to neonates and pediatric patients in a View From Here. Her challenge was complicated by the extreme paucity of evidence in the care of neonatal and pediatric patients. In addition to providing important historic insights, I suspect you will find the challenge of responding to immediate care needs in the absence of evidence or guidelines is particularly prescient of care in 2020.
This issue's Ostomy Care section comprises a timely follow up of the ADVOCATE trial published in 2018 in JWOCN.2 While the original article focused on economic outcomes, this article focuses on the clinical aspects of those data, including characteristics and severity of peristomal skin complications, time to resolution, and topical management. This article qualifies as a must read for every WOC nurse charged with managing the peristomal skin of patients with fecal or urinary ostomies.
This issue's Continence Care section opens with a systematic review of the effects of incontinence education for nurses and nursing support personnel on knowledge and attitudes toward incontinence and patient outcomes. You will want to read this lucid article authored by Joan Ostaszkiewicz, Emily Tomlinson, and Kathleen Hunter to tailor your approach to incontinence education for first-line nurse colleagues.
Andrew Gammie is a first-time author in JWOCN; he is part of the team at the Bristol Urological Institute and has considerable expertise in complex urodynamic testing. He reports a pilot study examining patient adherence to recommendations based on an evidence-based algorithm for behavioral management of lower urinary tract symptoms. This article will be of particular interest to every continence nurse (or nurse urodynamicist) who collects and reviews data from bladder diaries.
This issue's Foot & Nail Care section focuses on a particularly vulnerable group, Haitian immigrants living in batayes (rural sugarcane villages) in the Dominican Republic. The intensity and harsh conditions associated with the cultivation of sugar cane and manufacture of sugar are legendary. This article qualifies as must read for every nurse charged with providing foot and nail care for vulnerable populations with limited access to sophisticated health care resources.
Evidence-Based Report Cards are BACK!
I am personally excited and pleased to report the long-awaited return of regularly appearing Evidence Based Report Cards (EBRC) in JWOCN! Under the leadership of Section Editor Dr Carolyn Crumley, the EBRC section is undergoing several carefully planned changes to better suit your needs for various evidence-based documents including systematic reviews (the classic format for EBRC), scoping reviews, and technology reports. Expect to see this important feature regularly in every issue of JWOCN, beginning with the timely and clinically relevant scoping review of knowledge and gaps related to the etiology and pathophysiology of incontinence-associated dermatitis (IAD) appearing in this issue. Authored by Sofoklis Koudounas, Dan Bader, and Professor David Voegeli, this structured review summarizes cutting-edge knowledge of the natural history, etiology, and pathophysiology of IAD. It also points out specific gaps in our knowledge and provides recommendations for pragmatic and useful research needed to fill these clinically relevant gaps.
This issue's Clinical Challenges reports a rare case of pyoderma gangrenosum in a patient with an ileostomy created for management of rectal cancer. You will want to read this dynamic and interesting description of the multiple interventions used to effectively manage this rare but painful and destructive peristomal skin complication.
This issue's Getting Ready for Certification feature focuses on the CCCN (Certified Continence Care Nurse) examination. You will want to read this feature and answer the associated practice questions to increase your insights into this important certification credential from the WOCNCB.
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