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Beyond multidisciplinary. According to R. Gary Sibbald, BSc, MD, FRCPC (Med) (Derm), FAPWCA, MEd, and Elizabeth Ayello, PhD, RN, APRN,BC, CWOCN, FAPWCA, FAAN, the term multidisciplinary is passe´; today's wound care team members should be thinking transprofessional.
According to Drs Sibbald and Ayello, the concept of a transprofessional team means that team members do not think within the confines of their individual disciplines. Instead, they blur the lines to focus on what is best for the patient's care. The result, they said, is a successful wound care team.
Honored for excellence. The advanced skin and wound care nursing team at Medline Industries, Inc, Mundelein, IL, recently won the 2005 Excellence in Clinical Education Award from Advance for Nurses magazine.
Team members include: Cynthia Fleck, MBA, BSN, ET/WOCN, CWS, DAPWCA, Vice President, Clinical Marketing; Margaret Falconio-West, BSN, RN, APN/CNS, ET/CWOCN, DAPWCA, Corporate Wound Care Nurse; Elizabeth O'Connell-Gifford, MBA, BSN, RN, ET/CWOCN, DAPWCA, Clinical Education Specialist; Joyce Norman, BSN, RN, ET/CWOCN, DAPWCA, Clinical Education Specialist; Carol Paustian, BSN, RN, ET/CWOCN, DAPWCA, Clinical Education Specialist; Janet Jones, BSN, RN, ET/CWOCN, DAPWCA, Vice President, Clinical Services; and M.J. Johnson, MSN, RN, CWCN, Clinical Nurse Specialist, Support Surfaces.
Jonathon Primer, Medline Dermal Management System Division President, acknowledged the team's commitment to patients' well-being and to educating staff nurses on advanced wound and skin care. In the past year, the team has conducted more than 200 educational programs for nurses nationwide. They also operate Medline's Wound Care Hotline, answering clinical questions and helping nurses work through daily wound care challenges.
Responding to denial. Be careful about what you send to the Centers for Medicare & Medicaid Services (CMS) when appealing a denial of payment, recommends Sharon Baranoski, MSN, RN, CWOCN, APN, DAPWCA, FAAN. Speaking at the recent American Professional Wound Care Association (APWCA) annual meeting, Ms Baranoski said that you should "only send what they ask for, not 1 paper more." If you give them more documentation than requested, "they won't look at it," she said.
But it could be worse if CMS reviews the unrequested information. Your appeal process could get held up, denied because you didn't follow the request, and/or denied because what you sent conflicts with previously submitted documentation.
Diarrhea and tube feedings. Diarrhea should not be the expected outcome when a patient is receiving tube feedings, according to Evelyn Phillips, MS, RD, LDN. Also speaking at the APWCA meeting, Ms Phillips said that diarrhea in patients with pressure ulcers is an indication of loss of gut integrity, which results in malabsorption of nutrients. Diarrhea can hinder nutrient uptake, accelerate nutrient losses, excoriate and macerate skin, contaminate existing wounds, and increase nursing care needs.
She recommends using peptide-based formulas for these patients. This type of formula, she said, will improve nitrogen retention and balance, visceral protein synthesis, and absorption (which reduces diarrhea); maintain or restore gut integrity; and reduce bacterial translocation.
A true leader. Marcia Nusgart, RPh, Executive Director of the Alliance of Wound Care Stakeholders, is the first winner of the Leadership Award from the Association for the Advancement of Wound Care. The award was presented in recognition of her vision and leadership of the Alliance, which is a consortium of more than 15 physician, clinical, provider, manufacturer, and patient organizations with an interest in wound care.
The Alliance has been very active lately in educating the CMS about usual care of chronic wounds. This could have an impact on CMS's national coverage decisions for wound care devices and procedures going forward.
Ms Nusgart is primarily responsible for developing, analyzing, and carrying out the Alliance's response on legislative and regulatory issues related to wound care.
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