As I read over this issue's articles, I was particularly struck by the number of authors who addressed persistent gaps in evidence supporting our specialty practice. These persistent gaps are partially fulfilled by interim strategies such as consensus-based best practice, application of well-accepted clinical principles to decision-making, or expert opinion of one or more individuals. While these are invaluable in sustaining current practice, the ultimate goal is to identify gaps in practice and produce the strongest possible evidence to replace best practice with evidence-based practice. Read on in this issue (2022; volume 50, issue 1-more on this landmark achievement later in 2023) to see how your colleagues from around the world are striving to fill gaps in evidence supporting our caring community.
This issue's Wound Care Section leads off with Tonya Moyse, Jacqueline Bates, James F. Bena, Shannon L. Morrison, and Nancy M. Albert, who report on the validity and responsiveness of a Hospital-Acquired Pressure Injury Risk Scale on nearly 3000 participants admitted to hospital for management of various vascular diseases. This article extends the efforts of Barbara Braden and Nancy Bergstrom, who developed and validated a robust pressure injury (PI) risk assessment tool in 1988. I well remember Braden speaking at a meeting in Canada. She was asked when she planned to develop and validate an instrument for PI risk in the critical care unit. Her answer was both understandable and insightful. She responded that the Braden Scale for Pressure Sore Risk was not intended for use in all health care settings and it is the challenge of current clinicians and researchers to develop instruments for the continuously evolving care settings in the 21st-century health care setting. I am confident that Drs Braden and Bergstrom would be pleased with the efforts of Moyse and colleagues and I encourage you to read this valuable evidence designed to sharpen our ability to identify PI risk by developing updated instruments designed to use in specific vulnerable populations when cared for in various care settings.
Vita Boyar (a frequent contributor to the Journal of Wound, Ostomy and Continence Nursing [JWOCN]) and Tuisha Desai also address a massive gap in our knowledge of skin care in neonates and premature neonates, the effects and safety profiles of various leave-on skin products. Boyar and Desai evaluated the effects of an acrylate-based skin protectant on 33 infants who were 23 to 32 weeks of gestational age on skin condition and maturation of the stratum corneum. This original research report is simply a must read for every WOC nurse caring for neonates and infants.
Tuhina Banerjee, Aradhana Singh, Anurag, Sourav Pal, and Somprakas Basu recognized changes in the microbiology of persons experiencing pilonidal sinuses and report on their latest research into the microbiology or pilonidal sinuses. Their multiple case study series not only recognized a trend toward a higher prevalence of anaerobic species and atypical pathogens such as Kocuria flava. You will also want to read this cutting-edge article to identify potential risk factors for pilonidal sinuses and determine which are potentially modifiable.
Your Ostomy Care Section opens with an original research report from Kimberly LeBlanc, Stephanie Furtado, Deborah Mings, Melanie Martin, Michele Evans, Deanna Eaves, and George Skountrianos that focuses on a cost-effectiveness analysis of ostomy-related costs of a ceramide-infused skin barrier versus a conventional skin barrier in 2 provinces in Canada (Ontario and Alberta). This work is a direct extension of 2 earlier studies published in the JWOCN1,2 and it extends our knowledge of the cost implications of this modified skin barrier for protection of peristomal skin health.3
Sevcan Avci Isik, Berrak Balanuey, Elif Budak Erturk, Azize Karahan, Cigdem Ustundag, Ziyafet Ugurlu, Aysel Oren Hin, Durucan Aydin, Zehra Gocmen Baykara, Hulya Acarlar, Emine Akar, Yasemin Kosker, and Mehmet Ali Koc report findings from a study of sleep problems in a group of individuals living with intestinal ostomies (colostomy and ileostomy). Findings from this multisite study extend our knowledge of sleep quality, daytime sleepiness, and how living with an ostomy specifically influences these essential indicators of health.
The first article in your Continence Care Section was authored by Saima N. Rajabali, Kathleen F. Hunter, Prosper Asaana, Megan L. McCreary, Sahar Nazari, and Adrian S. Wagg. They report on the effectiveness of a smart urinary care continence system for nursing home residents. This is the latest in a series of original research published in the JWOCN examining the use of technologies to aid WOC and other nurses caring for patients with chronic urinary incontinence. Use of this system allows for individualized continence care planning-you will want to read this article whether your role includes direct patient visits or consultations in a long-term term or postacute care facility.
Lindsay Allen, Chelsea Nalley, Allison Devries, and Steve R. Fisher also evaluated patients residing in nursing homes. They report outcomes of a systematic review of behavioral interventions (and physical therapy-related interventions in particular) in female nursing home residents. This article also extends our knowledge of the effect of single or bundled nonpharmacologic/nonsurgical interventions in elder females with and without cognitive impairment.
Sema Dereli Yilmaz and Yasemin Erkal Aksoy report findings of a study of the influence of urinary incontinence on sexual health and daily life of adult females residing in Turkey. Among other findings, their study extends prior research exploring the impact of religious practices on individuals living with incontinence or a urinary or fecal ostomy when carrying out daily religious practice central to the Muslim faith.
This issue's Foot & Nail Care Section reports a qualitative study of the impact of a diabetic foot ulcer on the daily lives of person also living with diabetes mellitus. Authored by Idevania G. Costa and Pilar Camargo-Plazas, you will want to read this article to learn more about the wide-ranging impact of a diabetic foot ulcer on these individuals, including basic activities such as driving a vehicle or other components of their daily diabetic care.
Evidence informing care of individuals with category 3 obesity (also referred to as morbid obesity) remains very sparse. Matthew Ciabattoni, Amanda C. Ward, and Ave Maria Preston report 3 case studies of individuals with atypical wounds initially classified as pressure injuries. Research focusing on preventive skin care and management of wounds in this vulnerable population is urgently needed, and this multiple case series supports the need for additional research while reinforcing the multiple care needs associated with patients with a body mass index of 35 or higher.
Finally, I urge you to go to our webpage (https://journals.lww.com/jwocnonline/pages/default.aspx) and explore the exciting new video summaries. These, along with our exciting new infographics, are just one more way the WOCN Society and the JWOCN are distinguishing themselves as the preferred source for all things related to caring for patients with wound, ostomy, continence, and foot and nail needs!
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