Chronic Wound Care 4th Edition Excerpts
Section 1: Foundations for Chronic Wound Caring: Evidence, Education, and Interprofessional Knowledge Transfer
Chapter 1
Interprofessional Wound Care
Diane L. Krasner, PhD, RN, CWCN, CWS, BCLNC, FAAN; George T. Rodeheaver, PhD; R. Gary Sibbald, BSc, MD, FRCPC (Med Derm), ABIM DABD, Med
In this chapter, the editors of Chronic Wound Care: A Clinical Source Book for Healthcare Professionals present The Interprofessional Wound Caring Model©. Our goal is to trigger you to think about your own work environment and to reflect on whether it enables you to practice wound care interprofessionally. We challenge you to analyze how your current practice model compares and contrasts with ours. Then ask yourself and other members of your team if you can improve your interprofessional wound caring practice model.
Chapter 2
Chronic Wound Healing and Chronic Wound Management
Dean P. Kane, MD, FACS, CWS
The most common chronic wounds include lower-extremity ulcers, diabetic ulcers, and pressure ulcers. Other types of chronic wounds include skin cancers, nonhealing surgical wounds, fistulae, dermatitis or vasculitis wounds, radiation wounds, and burns. Differentiated from acute wounds that heal in a matter of days or weeks, chronic wounds may persist for months or years and occasionally can last a lifetime. Every chronic wound drains the life and resources of the individual and our society.
Chapter 3
The Language of Wounds
Lia van Rijswijk, RN, MSN, CWCN
What is the framework of wound care and dressing changes? Most importantly, how can an understanding of the words we use contribute to improving patient care? If you have ever spent time explaining to others what a wound care professional does, you know the language we use is not well understood outside the circle of wound care practitioners. This chapter may help you understand why and may help you communicate more effectively with patients, caregivers, and others who do not have the same language framework as healthcare professionals.
Chapter 4
Effective Adult Education Principles to Improve Outcomes in Patients with Chronic Wounds
R. Gary Sibbald, BSc, MD, FRCPC (Med Derm), ABIM DABD, MEd; Afsaneh Alavi, MD; Matthew Sibbald BSc, MD; Debra Sibbald, B Pharm, PhD(c); Darlyne Rath, RN, MSE; Dave Davis, MD
Traditionally, experts have delivered wound-care education in didactic classroom settings. Facts and new knowledge have seldom been contextualized to the work place or linked to healthcare professional performance and health outcomes. Traditionally, medical teaching and continuing education are taught in the classroom, but to increase the educational relevance, a shift needs to occur to the work place with the needed fundamental changes. In this chapter, we emphasize a need to go beyond content in wound-care education to include the key elements of the educational process, including needs assessment, goals, objectives, and interactive teaching methods, evaluation of healthcare professional performance and patient outcomes.
Chapter 5
Teaching Wound Care to Patients, Families, and Healthcare Providers
Paula Erwin-Toth, MSN, RN, CWOCN, CNS, ET; Brenda Stenger, MEd, RN, CWOCN, ET
Effective patient/caregiver education is an essential component of successful wound management. In order for successful learning to take place, healthcare personnel providing patient/caregiver education must possess knowledge and skills in wound care and adult education. Decreasing lengths of stay in the acute care setting has given further impetus to healthcare personnel to provide meaningful patient/caregiver education in a variety of settings. Interventions derived from research-based outcome criteria will further standardize care.
Chapter 6
Developing Educational Programs: A Blueprint for Success
Sharon Baranoski, MSN, RN, CWOCN; Mary Brenczewski, MSN, RN
Chronic Wound Care: A Clinical Source Book for Healthcare Professionals, fourth edition, is an interprofessional book written by experts in the field of wound management. This book is filled with chapters of knowledge from which healthcare professionals can benefit. Educational needs and concerns are expressed throughout the chapters. This chapter provides the essential strategies needed to ensure successful educational programs. It is not intended to be all encompassing but is meant to be a blueprint for a strong program foundation. The discussion begins with an explanation of learning needs and program design and concludes with promotional strategies.
Chapter 7
Controlled Clinical Trials Versus Case Studies: Why Wound Care Professionals Need to Know the Difference
Laura Bolton, PhD; Peggy Dotson, RN, BS; Morris D. Kerstein, MD
In keeping with rapid changes in healthcare, wound care research has made great strides. Product availability has branched from few options to a multitude of selections now classified in product categories. Likewise, expectations regarding treatment choices have progressed from “it worked before” approaches to research-based decision making. Solid rationale for established or modified treatment plans separates a knowledgeable healthcare provider from a haphazard one. Given the abundance of published literature and sales materials, all claiming product superiority, how does one discern the legitimacy of the claims being made? It is the responsibility of the clinicians on the interprofessional team not to accept these claims at face value but to scrutinize the quality of information received and to use it properly. When they can identify the different types of research and understand what conclusions can be drawn from each, practitioners are better prepared to base care decisions solely on the accurate claims. The goal of this chapter is to provide wound care professionals the tools needed to identify the various types of clinical research that support wound care product claims and to select only the legitimate conclusions derived from each as the scientific backing for their wound care decisions.
Chapter 8
Bench Science Advances for Chronic Wound Care
Joyce Stechmiller, ARNP, PhD; Gregory Schultz, PhD
Wound healing occurs through 4 phases. These phases are sequentially regulated by the actions of chemokines, cytokines, growth factors, and proteases. If an acute wound fails to move through a phase of healing, molecular imbalances will occur, leading to a chronic wound. Chronic wounds are characterized by elevated inflammatory cytokines and proteases, low levels of mitogenic activity, and senescent cells that are unable to respond to growth factors. Healing of chronic wounds occurs as the molecular environment of the wound shifts to the environment of an acute wound. New therapies are designed to correct the molecular abnormalities of chronic wounds and correspond to the principles of wound bed preparation.