Title : Untangling skin breakdown & poor wound healing outcomes
The major categories of chronic dermal ulcers are complex and difficult to prevent and treat. These are the categories of venous stasis, neuropathic (diabetic), arterial insufficiency, and pressure ulcers/injuries plaguing patients who suffer with the health conditions after which the ulcers are named. Although there are multiple etiologies of open wounds and chronic dermal ulcers, this session will focus on these major four categories and how clinicians can impact optimal patient health and healing modalities along with prevention or recurrence of these ulcers.
Pressure ulcers/injuries are a huge issue in any health care setting, including the home. Attempts to fight pressure injury formation through preventive means are met with varying levels of success. There are costly and regulatory ramifications to the development and deterioration of pressure injuries in any setting as well as the difficult issue of human suffering. Pressure injury prevention, treatment, and care rendered through clinician caring, collaboration, communication, and close engagement is also as important as best practice and evidence-based prevention and treatment measures.
Major points for discussion are:
- A brief introduction to the pathophysiology of pressure, venous, arterial, and neuropathic ulcerations
- The components of a robust wound assessment
- “T.I.M.E”, an acronym that guides best practice cares for healing modalities
- Current pressure ulcer guidelines
- How to defy recalcitrant (non-healing) chronic wounds
- Other hot topics such as prevention of hospital-acquired infections, common factors that impact wound healing, the wound microbiome, optimizing the Braden Scale for robust pressure ulcer prevention interventions, and other best practices for managing complex wounds.
Lori graduated from nursing school with her ADN in 1987 and earned a BSN in 1995. She worked in a variety of settings such as surgical orthopedics in acute care, long term, rehab, and subacute care, home health, physician practice, and nursing education at ADN and BSN levels. While working in nursing education, she earned her MS in community health and then went on to earn her certifications in wound, ostomy, continence, and foot care nursing (WOC nursing).
She has varied WOC nursing experience, with the majority of time spent in hospitals (acute care). She opened and managed an outpatient wound clinic as her first position after achieving her certifications. Other pieces of WOC nursing she has participated in were/are:
Skin/wound –related medical device in-services to nurses and patients (wound care dressings, skin care products, a fecal management system, and lymphedema medical equipment)
Instructor in a nursing assistant education program with a contribution to a nursing assistant textbook to update the pressure ulcer/skin care portion of the textbook
Legal nurse consulting for wound/pressure ulcer/medical device-related cases (expert witness)
Currently teaching a 50 hour continuing education course for WOC career-oriented nurses who are already working in the community
Volunteer for Project Medishare Haiti to work with patients and teach wound care providers and clinicians at Bernard Mevs Hospital in Port au Prince on principles and practice of wound, ostomy, and skin care
Multiple and varied speaking engagements as requested by organizations and professional associations using the Power Point presentation format
Wound care case study poster presentation for a professional association of rehab nurses
Board member of the Orlando Chapter of Legal Nurse Consultants
Preceptor for Emory WOC NEP program students
Member of the Florida Association of Enterostomal Nurses
Experienced clinical reviewer for a worker’s compensation insurance company as a clinical auditor for best practice/current appropriate wound care, and designer/management of the program that oversees the injured workers that have wounds and are at risk for pressure ulcers.