Can We Talk?

Can We Talk?: Prevention Intervention Problems

     Experts agree that prevention measures are essential to reducing the occurrence of pressure ulcers. Still, the literature suggests that implementation of prevention interventions is not always what it should be,1 is sometimes unrelated to risk assessment data,2 and at times is haphazard and erratic.3 Although somewhat loosely described, prevention intervention problems (PIPs) are obvious.

     The Institute of Medicine Report on Keeping Patients Safe4 suggests that preventable conditions such as pressure ulcers might occur as a result of errors of planning (not knowing what to do) or errors of execution (knowing but not implementing a plan of action). Whether PIPs occur as a consequence of errors of planning, errors of execution, or some combination of both is not entirely clear. Moreover, little is known about PIPs beyond the fact that they continue to occur despite widespread (and often creative) efforts to introduce pressure ulcer prevention protocols and educate caregivers in their use....

Can We Talk?: Has Anyone Seen My Data?

  I have been teaching undergraduate research and supervising student nurses in clinical settings for more years than I care to think about – years in which advancing technology has changed practice. To facilitate more accurate record-keeping (and in keeping with increasing regulatory oversight), we have evolved from paper charting to computer programs. However, the quality of what we chart has not improved. This is discouraging, particularly to this professor. I have spent many hours and much effort lecturing students on the why’s and how to’s of assessment and corresponding documentation, only to discover that examples in practice are difficult to come by....

Can We Talk?: Lessons Learned by Communicating

On August 23, our local newspaper, Commercial Appeal, published an article that caught my eye. The article, “Bedsore Know-How is Lacking,” briefly summarized an article published on the same day in the Journal of the American Medical Association (Reddy M, Gill, S, Rochon P. Preventing pressure ulcers: a systematic review. JAMA. 2006;296:974–984). The JAMA article presented evidence that American medicine knows very little about how best to prevent pressure ulcers. As a nursing professional who has encountered medical professionals with a le...

Can We Talk?: Look Before You Label: Chronic versus Acute

  Many months ago, Morris Kerstein provided to Ostomy Wound Management a Guest Editorial entitled, “The Wounds of War.”1 Although my response to his article is severely belated, I am grateful for the opportunity to comment. Having been an army nurse in Vietnam, I salute Dr. Kerstein from the soles of my feet to the soul of my being for reminding us to treat the whole patient and not just the hole in the patient....

Can We Talk?: Pass It On: The Power of Mentors

    The Person Who Changed My Life by Matilda Raffa Cuomo (Barnes & Noble Books; 2002), reminded me of the importance of mentors, advisors, teachers, and coaches in our lives. An educator, a manager, a relative, a random member of your community, church, or synagogue — regardless of title, the influence of that special person has far-reaching effects....

Can We Talk?: Thoughts on the Demise of the UOA

    As of September 30, 2005, the United Ostomy Association (UOA) is closing its doors. Financial factors have driven this decision by the Board of Directors and it appears that no last minute heroics will be able to forestall this fateful outcome. I won’t countenance the wisdom of this decision; however, I will suggest that if any other entity attempts to fill the national shoes, it would be wise to take a long, hard look at how the current situation evolved. Some readers may be familiar with the UOA through its many local chapter activities and publications, its regional programs, or even its annual conference but I suspect that others I may not understand the history or present problems of this organization....

Can We Talk?: Embrace the Future

    Skin fails like any other organ system when stressed beyond its ability to endure. The question is, how much stress is required? Human beings are dynamic organisms. In situations such as critical care and end-of-life, very little tissue/surface interface pressure is required to produce tissue ischemia and ultimate ulceration....

Can We Talk?: Pressure Ulcers — A National Embarrassment

    One particular aspect of the Terri Schiavo case struck a chord....