Cath Lab Digest

Laura Bolton, PhD
Adjunct Associate Professor
Department of Surgery, Bioengineering Section
University of Medicine and Dentistry of New Jersey

Retired after 32 years in wound care science, I am devoted to ensuring patients receive care based on the best available evidence. As so many OWM readers have taught me, we all are responsible for helping patients. During my post-retirement years, I plan to summarize wound care evidence to make it simple and easy for busy professionals to apply and use to improve patient outcomes. This is why I agreed to serve on the OWM Editorial Board and to co-chair the AAWC Guideline Department with Sue Girolami, RN, BSN, CWOCN.

Which brings us to PUCI (rhymes with “Gucci”), our “designer” pressure ulcer guideline. Our hard-working team developed PUCI as an “open source” initiative by compiling simplified recommendations from all of the pressure ulcer guidelines we could find1 after completing a similar VUCI initiative for venous ulcers.2 Please let me know if you would like to help me update VUCI evidence this winter. You can find VUCI at www.guideline.gov and www.aawconline.org.

Many thanks to those of you who helped us content validate PUCI’s 380 recommendations. Results of your PUCI content validation are available at the “News Stand” on the AAWC website at www.aawconline.org with best evidence we’ve found so far for you to “beta test”. If you know of better evidence, please send it to us per directions at the website before October 30!

You’ll notice that many content-validated opinions need more evidence (opportunities for research or for you to provide better references) and that a few recommendations supported by A-level evidence lacked content validity (opportunities for education). Some basic pressure ulcer care still needs clarification. For example, we found no clear operational definition of a “high specification foam” support surface or of “Group 1, 2, or 3” support surfaces. Without this information, how can a bedside professional recognize effective pressure redistribution devices, verify whether they are functioning properly, or document and apply “the right stuff” for each patient? We all need to use the same language and procedures to provide consistent bedside care.

This fall, while you’re reviewing the pioneering content-validity results many of you helped create, please help us solve these remaining mysteries and improve our PUCI evidence base. Pressure ulcer care should be crystal clear for the sake of both professionals and patients. We all help each other.

References
1. Bolton LL, Girolami S, Slayton S, et al. Assessing the need for developing a comprehensive content-validated pressure ulcer guideline. Ostomy Wound Manage. 2008;54(11):22–30.
2. Bolton LL, Corbett L, Bernato DL, et al. Development of a content-validated venous ulcer guideline. Ostomy Wound Manage. 2006;52(11):32–48.