Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
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J Wound Ostomy Continence Nurs · Nov 2020
Prophylactic Dressings for Maintaining Skin Integrity of Healthcare Workers When Using N95 Respirators While Preventing Contamination Due to the Novel Coronavirus: A Quality Improvement Project.
Extended use of N95 respirator masks is far more prevalent during the coronavirus disease 2019 (COVID-19) pandemic. As WOC nurses, we were tasked with formulating procedures for protecting the facial skin integrity of healthcare workers (HCWs) using personal protective devices when caring for patients with suspected or active COVID-19, while avoiding contamination when the masks are donned or doffed. This quality improvement project describes how we approached this project within the limited time frame available as we cared for patients with established and suspected COVID-19. ⋯ Based on these experiences, we recommend application of an alcohol-free liquid acrylate film to prevent facial skin injury associated with friction from the extended use of an N95 respirator mask. We further recommend performing a fit test and user-performed seal check with the use of any topical dressing and especially those that add cushion. For the duration of the COVID-19 pandemic, we recommend use of protective dressings to maintain skin integrity and protection from coronavirus infection as HCWs continue to provide care to all of patients under their care.
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COVID-19 symptoms mimic many other common conditions, making it difficult to identify patients infected with COVID-19. Adult patients may exhibit what is called "COVID toes" later in their course of illness. Noteworthy is that COVID toes may be the only symptom in otherwise asymptomatic young adults and children. ⋯ Familiarity with COVID toes will help foot care providers to identify patients who may not have been diagnosed with COVID-19 but could still be infectious and need to be isolated. COVID toe signs may be subtle and often mimic other conditions such as chilblains/pernio, thus a thorough history and physical examination are required.
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J Wound Ostomy Continence Nurs · Sep 2020
Case ReportsTelehealth for Wound Management During the COVID-19 Pandemic: Case Studies.
Prior to the COVID-19 pandemic, the Cardiovascular Surgery (CV) service of an academic medical center conducted a quality improvement project to decrease readmissions to the hospital from 2 rehabilitation facilities using telehealth via video calling. This initiative became of great importance with the COVID-19 pandemic because it helped the CV service better navigate and more efficiently meet the patient care needs associated with patient care restrictions. The CV service had to quickly evaluate and implement measures to reduce the rate of transmission of the coronavirus, which included adapting the clinic workflow to comply with state and federal recommendations. To minimize the interruption of clinical services and the associated revenue, a rapid transition from outpatient clinic visits to telehealth visits was implemented. ⋯ Health care systems have had to adjust the manner in which they triage, evaluate, and care for patients using telehealth platforms that do not rely on in-person clinic visits during the COVID-19 pandemic. There are multiple telehealth platforms that require careful planning and treatment implementation. Each health care agency needs to choose the one or ones that function the best in their care setting.
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J Wound Ostomy Continence Nurs · Sep 2020
Telehealth, Telemedicine, and Related Technologic Platforms: Current Practice and Response to the COVID-19 Pandemic.
Providing health care at a distance has evolved over the past decades, resulting in a myriad of terms and styles of care delivery. Telehealth is defined as any health care service delivered at a distance. Nursing services have been delivered by a wide range of specialty nurses for many years using various technological formats. Clinical experience suggests that few WOC nurses had extensively adopted these technologies and principles into their practice as recently as 2019. However, the COVID-19 pandemic of 2020 has forced both administrators and clinicians to rapidly adapt or introduce telemedicine technologies to deliver specialty care including WOC nurse services. ⋯ The pandemic crisis has accelerated the need for health care to reimagine the delivery of care to patients. Telehealth technologies and principles have emerged as essential for WOC nurses to deliver safe and effective care.