Cath Lab Digest

  This year in particular, as the National Pressure Ulcer Advisory Panel (NPUAP) celebrates its 25th anniversary, there are many reasons to be proud about the journey to awareness and best practice related to pressure ulcers. No longer do we find ourselves “ringing the bell” to alert clinicians, administrators, policy makers, and family caregivers to this pervasive problem among immobile and debilitated patients. Examples of a changed culture include assessing a patient’s risk for pressure ulcer formation using a valid and reliable tool in all care settings, widespread acceptance of nutritional screening and support for people with healing pressure ulcers, and the expanding use of pressure redistribution products beneath all persons at risk. Today, pressure ulcer prevention is a topic on the tip of everyone’s tongue.

  As wound care providers, taking care of our patients should be our priority. Many of them have no place else to turn, and to provide less than the best care is not acceptable. I am reminded of a story about other professionals who could choose to provide less than the best.

  In times past, the apothecary was charged with making perfume. Using a mortar and pestle, he would grind and mix the best, most fragrant spices and resins to ensure the most outstanding fragrance possible. The sweet aroma of the mixture would permeate the shop, attracting flies and gnats through the screenless windows. Occasionally, one of the winged visitors would get too close to the mixture and become trapped, so the apothecary would stop and remove the insect, along with some of the mixture. The time and perfume money lost was a great frustration to the apothecary. If he wasn’t paying attention or chose to ignore the gnats, one or some of them could be mixed into the fragrant mixture. If the apothecary’s laziness and insect infestation persisted, the mixture’s sweet scent soon was diminished; over time, the once-fragrant mixture began to stink from the dead insects. Soon it was worthless and the entire mixture had to be discarded at great expense to the apothecary.¹

Life is about learning; when you stop learning, you die. — Tom Clancy, author

  Clinicians in the UK and much of Europe have enjoyed ready access to the wide spectrum of available wound dressings for many years. However, economic pressures and lack of evidence have been cited as the reasons for recent restrictions on modern wound dressings — notably, those containing the antimicrobial silver — particularly in the UK. This has created frustration and confusion among clinicians and manufacturers, the former forced to vigorously defend clinical practices.

  What precipitated the change? Importantly, the available evidence supporting silver dress

  In October 2009, the Robert Wood Johnson Foundation and the Institute of Medicine¹ hosted a public forum on the future of nursing, targeting nursing in the acute care setting. The timing could not have been more fortuitous, given recent legislation aimed at reforming the healthcare system. The point of the forum was to present best practices and successes in innovative nursing care projects as well as to collect data about the status quo (the “dark side”). Although the direction of the forum’s outcomes is still unclear, the message is that acute care, in many ways