Objectives. Why is this important? 5/1/2012. By: Rhonda Trexler, BS RN COS-C CCP
|
|
- Todd Cook
- 7 years ago
- Views:
Transcription
1 By: Rhonda Trexler, BS RN COS-C CCP Objectives Verbalize the ability to determine if a surgical wound exists when documenting in OASIS-C Describe would healing phases related to wounds healing by primary intention and secondary intention Discuss the completion of OASIS C items related to surgical wounds in home health patients Why is this important? Accurate Assessments lead to appropriate interventions for the patient and accurate data collection for OASIS-C -----leads to accurate payment and accurate measuring of outcomes 1
2 Home Health Compare Improvement in Surgical Wounds is a publically reported outcome on the home health compare website How often wounds improved or healed after an operation Surgical Procedure/Surgical Wound The Center for Medicare and Medicaid Services provides guidance to Home Health regarding scoring for OASIS-C OASIS-C Guidance Manual Chapter 3 Assessment- Instruments/HomeHealthQualityInits/HHQIOASISUserM anual.html CMS Q&As link for OASIS Q&As will take you to the OASIS Answers Website Can also access the user manual from this site 2
3 M1340 Does this patient have a Surgical Wound? Integumentary System Skin, hair, nails and sweat glands Excludes mucous membranes, cataract surgery of the eye, surgeries via a vaginal approach Centers for Medicare and Medicaid Services. (2010). OASIS C guidnace manual. Consider the Etiology Surgical interventions to treat already existing wounds do not change the classification of the wound as surgical Suture of laceration from trauma Debridement of existing wound Simple I&D of abscess/cyst Skin graft over existing wound Full thickness Partial thickness Suture of Laceration from Trauma Classified as a trauma wound Debridement of a traumatic wound to remove debris or a foreign matter Traumatic wound requiring surgery to repair an internal organ or other internal structure is a surgical wound Repair of a torn tendon or a ruptured internal organ 3
4 Pressure Ulcer with Sharp Debridement remains a pressure ulcer Incision and Drainage Simple Incision and Drainage Incision and drainage with removal of tissue or other structures Drain placement = surgical wound Wound remains surgical even after drain removal Excision of an abscess or cyst Skin Grafts Skin grafting is a treatment of an existing wound Donor site is considered a surgical wound Full thickness Partial thickness 4
5 Muscle Flap/Skin Advancement Flap/Rotational Flap Creates a surgical wound Pressure ulcer that is muscle flapped will be classified as a surgical wound If area breaks down again due to pressure becomes a pressure ulcer Skin Flap of a Pressure Ulcer becomes a Surgical Wound Biopsy Sites Any wound created by needle puncture only is not a surgical wound Needle biopsy Paracentesis with needle puncture only Cardiac catheterization sites (even if stent placed) Cut-Down procedure 5
6 Biopsy Sites Excisional biopsy Shave biopsy Punch biopsy Surgical Wound for OASIS-C Vascular Access Devices Central line sites Implanted vascular access devices Arterio-venous shunts PICC lines Peripheral IV sites Ostomies All ostomies are excluded from consideration as surgical wounds Chest Tube sites Take down procedure vs. Ostomy closing on own 6
7 Sutures Sutures and Surgical Wounds Peripheral IV sutured in place ON-Q Pump ON-Q C-bloc is a continuous peripheral nerve block system that slowly infuses local anesthetic near a nerve for effective pain relief Considered an implanted infusion device Surgical wound if inserted separate from wound What is Not a Surgical Wound? VP shunt Pacemaker Toenail removed Callous removed Subcutaneous infusion Enterocutaneous fistula 7
8 What is a Surgical Wound? Orthopedic pin sites Peritoneal dialysis catheter site LVAD cannula exit site When is a Surgical Wound No Longer Reported on OASIS-C? 30 Days After Epithelialization Wound is considered a scar and no longer included in M1340 Does this patient have a surgical wound? 8
9 What is Epithelialization? National Institute of Health. (2010). Skin layers. Retrieved from ages/8912.htm. OASIS-C M1340: Does this patient have a surgical wound? M1342: Status of the Most Problematic (Observable) Surgical Wound: Outcome Based Quality Improvement Outcome Based Quality Monitoring Home Health Prospective Payment System Risk Adjustment Phases of Wound Healing Hemostasis Inflammation Proliferation Maturation 9
10 Hemostasis Clotting cascade begins Fibrinogen Clot formation Fibrinolysis Inflammation Inflammation WBCs enter the wound Redness, swelling, warmth, and discomfort Proliferation Granulation tissue New blood supply develops Epithelialization 10
11 Epithelialization Healthy Wound Edges Moist wound environment Closed Wound Edges Epibole Calloused Hyperkeratonic Maturation Day 7 up to 1 year Contraction Increased tensile strength 11
12 Primary Intention Primary Intention Surgically closed Completely approximated Less tissue loss Do not granulate Secondary Intention Open surgical wounds Wound edges are open Requires granulation tissue Intentional and dehisced Approximated Incisions Heal by Primary Intention Any dehiscence of separation results in healing by Secondary Intention 12
13 Terminology Avascular Tissue Eschar Slough Dead Space Granulation Tissue Hyperkeratotic Closed Wound Edges M1342 Status of the Most Problematic Surgical Wound Newly Epithelialized Fully Granulating Early/Partial Granulation Not Healing WOCN Guidance on OASIS-C Items: Newly Epithelialized Wound Bed completely covered with new epithelium No exudate No avascular tissue No signs or symptoms of infection Peirce, B., Mackey, D., & McNichol, L. (2009). Wound ostomy continence nurses society guidance on OASIS-C integumentary items. Retrieved from 13
14 Fully Granulating Wound bed filled with granulation tissue to the level of the surrounding skin No dead space No avascular tissue No signs or symptoms of infection Early/Partial Granulation > 25% of the wound bed is covered with granulation tissue < 25% of the wound bed is covered with avascular tissue (eschar and/or slough) No signs or symptoms of infection Wound edges are open Not Healing Wound with > 25% avascular tissue (eschar and/or slough) OR Signs/symptoms of infection OR Clean but nongranulating wound bed OR Closed/hyperkeratotic wound edges OR Persistent failure to improve despite appropriate comprehensive wound management 14
15 Primary Intention vs. Secondary Intention Do not granulate Newly Epithelialized Not healing Granulation tissue Newly Epithelialized Fully Granulating Early/Partial Granulation Not Healing Sutures / Staples Not considered part of the surgical wound when determining the healing status Include status of sites in comprehensive assessment documentation 15
16 10 Days Post-Op Scabs Presence of a scab is not automatically non-healing Determine first is the wound is healing by Primary Intention or Secondary Intention Primary Intention healing with scab = Not healing Secondary Intention = Consider all 4 healing status choices Implanted Port - Accessed Some sites, because they are being held open by a line or needle, cannot fully granulate and may remain non-healing while the line or needle is in place CMS OOCS 04/10 Q&A #14 16
17 Approximated Incision Separates in Several Areas If the wound is not completely epithelialized for 30 days openings are considered part of the original surgical wound Assess all areas following WOCN Guideline If one area is not healing, report the status as Not Healing for M1342 Healing Status of the Most Problematic Surgical Wound Improvement in Surgical Wounds Assessment Accuracy Dehiscence Infection Delayed wound healing Systemic Factors Education Prevention of Complications Dehiscence Day 7 Drainage Signs or symptoms of infection Mechanical stress 17
18 Infection Increased mortality Longer hospitalizations Higher healthcare costs Drainage > 48 hours Systemic Factors Circulatory Disorders Diabetes Malnutrition Patient Education Prevent Dehiscence Splint incisions Prevent strain Monitor for and report signs of complications Prevent Infection Educate patients Hand hygiene Wound care Promote Healing 18
19 References Baranoski, S., & Ayello, E. (2008). Wound care essentials: Practice principles (2 nd ed.). Philadelphia: Lippincott Williams & Wilkins. Benbow, M. (2005). Evidence-based wound management. London: Whurr Publishing. Benbow, M. (2007). Healing and wound classification. Journal of Community Nursing, 21(9), Centers for Disease Control and Prevention. (2009). Centers for disease control and prevention: Your online source for credible health information. Retrieved from Centers for Medicare & Medicaid Services. (2007). CMS OCCB Q&As May Retrieved from Centers for Medicare & Medicaid Services. (2007). CMS OCCB Q&As October Retrieved from Centers for Medicare & Medicaid Services. (2010). OASIS-C guidance manual. Retrieved from Centers for Medicare & Medicaid Services. (2010). CMS OCCB Q&As April Retrieved from 0_508c.pdf Centers for Medicare & Medicaid Services. (2010). CMS OCCB Q&As July Retrieved from References Continued Centers for Medicare & Medicaid Services. (2010). CMS OCCB Q&As October Retrieved from Centers for Medicare & Medicaid Services. (2011). CMS OCCB Q&As January Retrieved from Doughty, D. B. (2005). Preventing and managing surgical wound dehiscence. Advances in Skin and Wound Care. 18(6), Hampton, S. (2007). Bacteria and wound healing. Journal of Community Nursing, 21(10), Hunter, S., Thompson, P., Langemo, D., Hanson, D., & Anderson, J. (2007). Wound & skin care. Understanding wound dehiscence. Nursing, 37(9), Kaye, K., Anderson, D., Sloane, R., Chen, L., Choi, Y., Link, K., Sexton, D., & Schmader, K.(2009). The effect of surgical site infection on older operative patients. Journal of American Geriatrics Society, 57(1), Lee, S. K., (2006). The role of nutrition in treating and healing wounds. Nursing Homes: Long Term Care Management, 55(11), National Institute of Health. (2010). Skin layers. Retrieved from Peirce, B., Mackey, D., & McNichol, L. (2009). Wound ostomy continence nurses society guidance on OASIS-C integumentary items. Retrieved from Schwien, T., & Lang, C. (2008). Changes in wound care outcomes analysis: New home health compare measures. Retrieved from Vuolo, J. C., (2006). Assessment and management of surgical wounds in clinical practice. Nursing Standard, 20(52),
OASIS-C Integument Assessment: Not for Wimps! Part II: Stasis Ulcers and Surgical Wounds
OASIS-C Integument Assessment: Not for Wimps! Part II: Stasis Ulcers and Surgical Wounds Presented by: Rhonda Will, RN, BS, COS-C, HCS-D Assistant Director, OASIS Competency Institute 243 King Street,
More informationWOUND OSTOMY CONTINENCE NURSES SOCIETY GUIDANCE ON OASIS-C INTEGUMENTARY ITEMS
Wound Ostomy Continence Nurses Society Guidance on OASIS-C Integumentary Items WOCN OASIS Taskforce Members: Ben Peirce (Chairperson), RN, BA, CWOCN, COS-C Dianne Mackey, BSN, RN, PHN, CWOCN Laurie McNichol,
More informationOASIS-C Integument Assessment: Not for Wimps! Part I: Pressure Ulcers
OASIS-C Integument Assessment: Not for Wimps! Part I: Pressure Ulcers Presented by: Rhonda Will, RN, BS, COS-C, HCS-D Assistant Director, OASIS Competency Institute 243 King Street, Suite 246 Northampton,
More informationWound, Ostomy and Continence Nurses Society s Guidance on OASIS-C1 Integumentary Items: Best Practice for Clinicians
Wound, Ostomy and Continence Nurses Society s Guidance on OASIS-C1 Integumentary Items: Best Practice for Clinicians Acknowledgments Wound, Ostomy and Continence Nurses Society s Guidance on OASIS-C1 Integumentary
More informationUnraveling the Pressure Ulcer and Wound Care Sections of OASIS-C
Special Feature Unraveling the Pressure Ulcer and Wound Care Sections of OASIS-C by Clay E. Collins, RN, BSN, CWOCN, CFCN, CWS It s finally here! The long-awaited OASIS-C data collection tool for home
More informationIntegumentary System Individual Exercises
Integumentary System Individual Exercises 1. A physician performs an incision and drainage of a subcutaneous abscess in his office for a particularly uncooperative established patient. How should this
More informationWound Healing. Healing is a matter of time, but it is sometimes also a matter of opportunity. Hippocrates
C HAPTER 9 Wound Healing Healing is a matter of time, but it is sometimes also a matter of opportunity. Hippocrates As the above quote suggests, conduct regular and systematic wound assessments, and seize
More informationPosition Statement: Pressure Ulcer Staging
Position Statement: Pressure Ulcer Staging Statement of Position The Wound, Ostomy and Continence Nurses (WOCN) Society supports the use of the National Pressure Ulcer Advisory Panel Staging System (NPUAP).
More informationPlantar Fascia Release
Plantar Fascia Release Introduction Plantar fasciitis is a common condition that causes pain around the heel. It may be severe enough to affect regular activities. If other treatments are unsuccessful,
More informationManaging cavity wounds Journal of Community Nursing March 1998 Author: Rosemary Pudner
Managing cavity wounds Journal of Community Nursing March 1998 Author: Rosemary Pudner It has been seen in recent years, that an increasing number of patients are being discharged early into the community,
More informationTraumatic Primary Eyelid and Facial Laceration Repair. Riva Lee Asbell Philadelphia, PA
Traumatic Primary Eyelid and Facial Laceration Repair Riva Lee Asbell Philadelphia, PA I INTRODUCTION I always have to work a little harder when coding for traumatic eyelid and facial repairs. There is
More informationChapter 11. Everting skin edges
Chapter 11 PRIMARY WOUND CLOSURE KEY FIGURE: Everting skin edges In primary wound closure, the skin edges of the wound are sutured together to close the defect. Whenever possible and practical, primary
More informationPrerequisites: None. Course Description: Studies principles and procedures essential to the basic nursing care of patients.
Revised: Fall 2015 22TPNE 142 22TNursing Skills II Prerequisites: None Course Description: Studies principles and procedures essential to the basic nursing care of patients. Semester Credits: 3 Lecture
More informationHow To Stage A Pressure Ulcer
WOCN Society Position Statement: Pressure Ulcer Staging Originated By: Wound Committee Date Completed: 1996 Reviewed/Revised: July 2006 Revised: August 2007 Reviewed/Revised: April 2011 Definition of Pressure
More informationDescemet s Stripping Endothelial Keratoplasty (DSEK)
Descemet s Stripping Endothelial Keratoplasty (DSEK) Your doctor has decided that you will benefit from a corneal transplant operation. This handout will explain your options to you. It explains the differences
More informationFUNCTIONS OF THE SKIN
FUNCTIONS OF THE SKIN Skin is the largest organ of the body. The average adult has 18 square feet of skin which account for 16% of the total body weight. Skin acts as a physical barrier for you to the
More informationWound Classification Name That Wound Sheridan, WY June 8 th 2013
Initial Wound Care Consult Sheridan, WY June 8 th, 2013 History Physical Examination Detailed examination of the wound Photographs Cultures Procedures TCOM ABI Debridement Management Decisions A Detailed
More informationLymph Node Dissection for Penile Cancer
Lymph Node Dissection for Penile Cancer Exceptional healthcare, personally delivered Removal of Lymph Nodes Why are the Lymph Nodes so important when I have penile cancer? Lymph nodes are small bean shaped
More informationInflammation and Healing. Review of Normal Defenses. Review of Normal Capillary Exchange. BIO 375 Pathophysiology
Inflammation and Healing BIO 375 Pathophysiology Review of Normal Defenses Review of Normal Capillary Exchange 1 Inflammation Inflammation is a biochemical and cellular process that occurs in vascularized
More informationSection 4: Your Vascular Access. What is vascular access?
Section 4: Your Vascular Access What is vascular access? What is a fistula? Taking care of a new fistula What is a graft? Taking care of a new graft What is a hemodialysis catheter? Taking care of a hemodialysis
More information41 Assisting with Minor Surgery
Learning Outcomes 41.1 Define the medical assistant s role in minor surgical procedures. 41-2 CHAPTER 41 Assisting with Minor Surgery 41.2 Describe types of wounds and explain how they heal. 41.3 Describe
More informationAPPLICATION OF DRY DRESSING
G-100 APPLICATION OF DRY DRESSING PURPOSE To aid in the management of a wound with minimal drainage. To protect the wound from injury, prevent introduction of bacteria, reduce discomfort, and assist with
More informationEndoscopic Plantar Fasciotomy
Endoscopic Plantar Fasciotomy Introduction Plantar fasciitis is a common condition that causes pain centralized around the heel. It may be severe enough to affect regular activities. Health care providers
More informationY O U R S U R G E O N S. choice of. implants F O R Y O U R S U R G E R Y
Y O U R S U R G E O N S choice of implants F O R Y O U R S U R G E R Y Y O U R S U R G E O N S choice of implants F O R Y O U R S U R G E R Y Your Surgeon Has Chosen the C 2 a-taper Acetabular System The
More information7/11/2011. Pressure Ulcers. Moisture-NOT Pressure. Wounds NOT Caused by Pressure
Assessment and Documentation of Pressure Ulcers Jeri Ann Lundgren, RN, BSN, PHN, CWS, CWCN Pathway Health Services July 19, 2011 Training Objectives Describe etiologies of pressure ulcers Discuss how to
More informationShoulder Arthroscopy
Copyright 2011 American Academy of Orthopaedic Surgeons Shoulder Arthroscopy Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint. The word
More informationX-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary
X-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary Introduction A Subclavian Inserted Central Catheter, or subclavian line, is a long thin hollow tube inserted in a vein under the
More informationDiabetic Foot Ulcers and Pressure Ulcers. Laurie Duckett D.O. Plastic and Reconstructive Surgeon Oklahoma State University Center for Health Sciences
Diabetic Foot Ulcers and Pressure Ulcers Laurie Duckett D.O. Plastic and Reconstructive Surgeon Oklahoma State University Center for Health Sciences Lecture Objectives Identify risk factors Initiate appropriate
More informationSome of the ophthalmic surgeries performed at the DMV Center.
Some of the ophthalmic surgeries performed at the DMV Center. This document presents some types of the surgeries performed by the ophthalmology service at the DMV veterinary center as well as the equipment
More informationWound Care on the Field. Objectives
Wound Care on the Field Brittany Witte, PT, DPT Cook Children s Medical Center Objectives Name 3 different types of wounds commonly seen in sports and how to emergently provide care for them. Name all
More informationDERMABOND Portfolio 2012 LACERATION REPAIR REIMBURSEMENT GUIDE
2012 LACERATION REPAIR REIMBURSEMENT GUIDE ETHICON, INC. IS PLEASED TO PROVIDE THIS LACERATION REPAIR REIMBURSEMENT GUIDE AS A RESOURCE FOR HEALTHCARE PROVIDERS. This guide is intended for informational
More informationInservice: Wound Care and Dressings. Friday, June 26, 2009. A. Closed Wounds tissue is injured but skin is not BROKEN
f Inservice: Wound Care and Dressings Friday, June 26, 2009 WOUNDS: Are injuries of the skin and underlying subcutaneous tissues and muscles (Nursing Manual by Lippincott) Are disruptions in the integrity
More informationWound management can be exciting and
P r o c e d u r e s P r o Peer Reviewed S U R G E R Y / W O U N D M A N A G E M E N T Karen M. Tobias, DVM, MS, DACVS, & John Ayers, DVM University of Tennessee THE ESSENTIAL WOUND CARE SERIES Wound Management
More informationDEPARTMENT OF FAMILY MEDICINE Delineation of Privileges. Name: Date:
Page 1 of 5 DEPARTMENT OF FAMILY MEDICINE Delineation of Name: Date: Types of Category I in this category include those procedures and cognitive skills involving serious medical problems that are normally
More informationPressure Ulcers: Facility Assessment Checklists
Pressure Ulcers: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to managing pressure ulcers in the facility, in
More informationWound Care Management
Rule Category: Billing ` Ref: No: 2012-BR-0007 Version Control: Version No. 3.0 Effective Date: 08 December 2012 Revision Date: August 2015 Wound Care Management Adjudication Rule Table of content Abstract
More informationPeripherally Inserted Central Catheter (PICC) for Outpatient
Peripherally Inserted Central Catheter (PICC) for Outpatient Introduction A Peripherally Inserted Central Catheter, or PICC line, is a thin, long, soft plastic tube inserted into a vein of the arm. It
More informationWound Care: The Basics
Wound Care: The Basics Suzann Williams-Rosenthal, RN, MSN, WOC, GNP Norma Branham, RN, MSN, WOC, GNP University of Virginia May, 2010 What Type of Wound is it? How long has it been there? Acute-generally
More informationSurgical Coding Errors & English 101. Riva Lee Asbell. Fort Lauderdale, FL
Surgical Coding Errors & English 101 Riva Lee Asbell Fort Lauderdale, FL INTRODUCTION Many surgical coding mistakes result from misinterpretation of CPT (Current Procedural Terminology) wording. When the
More informationPICC & Midline Catheters Patient Information Guide
PICC & Midline Catheters Patient Information Guide medcompnet.com 1 table of contents Introduction 4 What is a PICC or Midline Catheter? 4 How is the PICC or Midline Catheter Inserted? 6 Catheter Care
More informationCoding & Reimbursement
2013 Coding & Reimbursement 2013 Coding and Reimbursement MatriStem is a unique extracellular matrix derived from a porcine urinary bladder. It has been shown to be effective in the treatment of acute
More informationPHaSES: Practical Hands-on Surgical Education System
U.S. Toll Free 866-GOLIMBS PHaSES Range PHaSES: Practical Hands-on Surgical Education System Limbs & Things is pleased to introduce the PHaSES Range. The range is based upon our well known basic & general
More informationPatient and Family Guide to Vascular Access
Patient and Family Guide to Vascular Access IMPORTANT INFORMATION YOU NEED TO KNOW! Vascular Access Choosing the One that is Right for You! There are 3 kinds of vascular access for hemodialysis: AV fistula,
More informationTotal Abdominal Hysterectomy
What is a total abdominal hysterectomy? Is the removal of the uterus and cervix through an abdominal incision (either an up and down or bikini cut). Removal of the ovaries and tubes depends on the patient.
More informationContents. Overview. Removing the womb (hysterectomy) Overview
This information is an extract from the booklet Understanding womb (endometrial) cancer. You may find the full booklet helpful. We can send you a free copy see page 9. Overview Contents Overview Removing
More informationNurse Week materials produced through the support of
Nurse Week materials produced through the support of There is a difference... Not all nurses caring for patients with wounds, ostomies, or incontinence are the same. Wound, ostomy and continence (WOC)
More informationWound and Skin Assessment. Mary Carvalho RN, BSN, MBA Clinical Coordinator Johnson Creek Wound and Edema Center
Wound and Skin Assessment Mary Carvalho RN, BSN, MBA Clinical Coordinator Johnson Creek Wound and Edema Center Skin The largest Organ Weighs between 6 and 8 pounds Covers over 20 square feet Thickness
More informationUPMC For Reference Only PHYSICIAN ASSISTANT 2014
Summary of Services and Availability (by location) UPMC Each location has sufficient space, equipment, staffing and financial resources in place or available in sufficient time as required to support each
More informationPressure Ulcer Passport
Pressure Ulcer Passport Information for patients This is a record of the treatment you are receiving for your pressure ulcer injury. Please bring it with you to all your healthcare appointments. This will
More informationOpen Ventral Hernia Repair
Ventral Hernias Open Ventral Hernia Repair UCSF Postgraduate Course in General Surgery Maui, HI March 21, 2011 Hobart W. Harris, MD, MPH Ventral Hernias: National Experience Occur following 11-23% of laparotomies,
More informationHome Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes
Home Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E99) ICD-10-CM diabetes mellitus
More informationState of Kuwait Ministry of Health Infection Control Directorate. Guidelines for Prevention of Surgical Site Infection (SSI)
State of Kuwait Ministry of Health Infection Control Directorate Guidelines for Prevention of Surgical Site Infection (SSI) September 1999 Updated 2007 Surgical Wound: According to 1998 Kuwait National
More informationBachelor s degree in Nursing
Tbilisi State Medical University Faculty of Physical Medicine and Rehabilitation The first level of academic higher education Bachelor s degree in Nursing Tbilisi 2012 Name of program Nursing Name of qualification
More informationPressure Ulcers Risk Management and Treatment
Pressure Ulcers Risk Management and Treatment Objectives State reasons why individuals initiate lawsuits. Define strategies to reduce the risk of litigation. Determine appropriate treatment for the patient.
More informationClean Technique vs. Sterile Technique for Nurses
Clean Technique vs. Sterile Technique for Nurses Dressing changes and other nursing procedures Jen Agosti RN, CWCA, FACCWS, CFCN, DAPWCA Accredita8on Nurse Sharks, Inc. is an approved provider of Continuing
More informationAbdominal Pedicle Flaps To The Hand And Forearm John C. Kelleher M.D., F.A.C.S.
Abdominal Pedicle Flaps To The Hand And Forearm John C. Kelleher M.D., F.A.C.S. Global-HELP Publications Chapter Eight: TECHNICAL REQUIREMENTS FOR FORMATION OF A TUBED PEDICLE FLAP Creating a tube pedicle
More informationPage 1 of 10 MC1482 Peripherally-Inserted Central Catheter. Peripherally-Inserted Central Catheter (PICC)
Page 1 of 10 MC1482 Peripherally-Inserted Central Catheter Peripherally-Inserted Central Catheter (PICC) Page 2 of 10 MC1482 Peripherally-Inserted Central Catheter Introduction A peripherally-inserted
More informationHip Replacement Surgery Understanding the Risks
Hip Replacement Surgery Understanding the Risks Understanding the Risks of Hip Replacement Surgery Introduction This booklet is designed to help your doctor talk to you about the most common risks you
More informationRecurrent Varicose Veins
Information for patients Recurrent Varicose Veins Sheffield Vascular Institute Northern General Hospital You have been diagnosed as having Varicose Veins that have recurred (come back). This leaflet explains
More informationLOSS OF BLADDER CONTROL IS TREATABLE TAKE CONTROL AND RESTORE YOUR LIFESTYLE
LOSS OF BLADDER CONTROL IS TREATABLE TAKE CONTROL AND RESTORE YOUR LIFESTYLE TALKING ABOUT STRESS INCONTINENCE (SUI) Millions of women suffer from stress incontinence (SUI). This condition results in accidental
More informationHCPCS AMERIGEL HYDROGEL DRESSINGS CODING GUIDANCE FOR:
HCPCS CODING GUIDANCE FOR: AMERIGEL HYDROGEL DRESSINGS FORM 1500 MUST HAVE THE FOLLOWING: APPROPRIATE HCPCS CODE APPROPRIATE A MODIFIER ACCURATE POS = 12 The Centers for Medicare and Medicaid Services
More informationChapter 29. Initial Care
Chapter 29 FINGERTIP AND NAIL BED INJURIES KEY FIGURES: Digital tourniquet Bone rongeur Fingernail with hematoma Thenar flap Repair of nail bed Hand injuries are commonly encountered by health care providers
More informationSurgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place.
What is an abdominal myomectomy? Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place. When is this surgery used? Treatment
More informationwww.backandspinefl.com Back and Spine Center 509 Riverside Dr., Suite 203 Stuart, FL 34994 Phone: (772) 288-5862
Non-Profit ORG. U.S. Postage PAID West Palm BCH. FL. PERMIT NO. 4709 www.backandspinefl.com Back and Spine Center 509 Riverside Dr., Suite 203 Stuart, FL 34994 Phone: (772) 288-5862 The evolution of neurosurgery
More informationEpidural Continuous Infusion. Patient information Leaflet
Epidural Continuous Infusion Patient information Leaflet April 2015 Introduction You may already know that epidural s are often used to treat pain during childbirth. This same technique can also used as
More informationCUESTA COLLEGE REGISTERED NURSING PROGRAM CRITICAL ELEMENTS
CUESTA COLLEGE REGISTERED NURSING PROGRAM CRITICAL ELEMENTS LEVELS I through IV A. OVERRIDING CRITICAL ELEMENTS Violation of an overriding area will result in termination and failure of the particular
More informationSummary of Recommendations
Summary of Recommendations *LEVEL OF EVIDENCE Practice Recommendations Assessment 1.1 Conduct a history and focused physical assessment. IV 1.2 Conduct a psychosocial assessment to determine the client
More informationPeripherally Inserted Central Catheter
Peripherally Inserted Central Catheter (PICC) by Patricia Griffin Kellicker, BSN En Español (Spanish Version) Definition A peripherally inserted central catheter is a long, thin tube that is inserted through
More informationVaxcel PICCs Valved and Non-Valved. A Patient s Guide
Vaxcel PICCs Valved and Non-Valved A Patient s Guide Information about your Vaxcel PICC is available by calling the Navilyst Medical Vascular Access Information Line 800.513.6876 Vaxcel Peripherally Inserted
More informationCollege of Applied Medical Sciences\ Department of Nursing
2 nd Edition 2014/2015 College of Applied Medical Sciences\ Department of Nursing CAMS/ Department of Nursing/ Internship Training Logbook 2 nd Edition 1 INTERNSHIP TRAINING LOGBOOK Nurse Intern Name:
More informationTotal Vaginal Hysterectomy
What is a total vaginal hysterectomy? Is the removal of the uterus and cervix through the vagina. Removal of the ovaries and tubes depends on the patient. Why is this surgery used? To treat disease of
More informationLong-term urinary catheters: prevention and control of healthcare-associated infections in primary and community care
Long-term urinary catheters: prevention and control of healthcare-associated infections in primary and community care A NICE pathway brings together all NICE guidance, quality standards and materials to
More informationClaims submission simplified for emergency dental procedure codes
January 2002 No. 2002-02 PHC 1844 To: Dentists HMOs and Other Managed Care Programs Claims submission simplified for emergency dental procedure codes Effective immediately, both electronic and paper claims
More information2015 SUMMER STUDENT NURSE EXTERNSHIP PROGRAM SKILLS CHECK LIST
2015 SUMMER STUDENT NURSE EXTERNSHIP PROGRAM SKILLS CHECK LIST STUDENT NURSE EXTERNNAME SCHOOL OF NURSING STUDENT AGREEMENT: I request the Clinical Skills Check list be released to (hospital/agency). I
More informationRenal Vascular Access Having a Fistula For Haemodialysis
Renal Vascular Access Having a Fistula For Haemodialysis Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationINTERNATIONAL MEDICAL COLLEGE
INTERNATIONAL MEDICAL COLLEGE Joint Degree Master Program: Implantology and Dental Surgery (M.Sc.) Basic modules: List of individual modules Basic Module 1 Basic principles of general and dental medicine
More informationAtrioventricular (AV) node ablation
Patient information factsheet Atrioventricular (AV) node ablation The normal electrical system of the heart The heart has its own electrical conduction system. The conduction system sends signals throughout
More informationSUPRAPUBIC CATHETER INSERTION INFORMATION FOR PATIENTS
The British Association of Urological Surgeons 35-43 Lincoln s Inn Fields London WC2A 3PE Phone: Fax: Website: E-mail: +44 (0)20 7869 6950 +44 (0)20 7404 5048 www.baus.org.uk admin@baus.org.uk INFORMATION
More information.org. Rotator Cuff Tears: Surgical Treatment Options. When Rotator Cuff Surgery is Recommended. Surgical Repair Options
Rotator Cuff Tears: Surgical Treatment Options Page ( 1 ) The following article provides in-depth information about surgical treatment for rotator cuff injuries, and is a continuation of the article Rotator
More informationSaint Francis Kidney Transplant Program Issue Date: 6/9/15
Kidney Transplant Candidate Informed Consent Education Here are educational materials about Kidney Transplant. Please review and read these before your evaluation visit. The RN Transplant Coordinator will
More informationPeripherally Inserted Central Catheter (PICC)
Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Peripherally Inserted Central Catheter (PICC) Intravenous Therapy What is a PICC? A PICC is a very fine flexible tube measuring
More informationWound Healing Community Outreach Service
Wound Healing Community Outreach Service Wound Management Education Plan January 2012 December 2012 Author: Michelle Gibb Nurse Practitioner Wound Management Wound Healing Community Outreach Service Institute
More information3M Steri-Strip S Surgical Skin Closure. Commonly Asked Questions
3M Steri-Strip S Surgical Skin Closure Commonly Asked Questions What are the indications for use of 3M Steri-Strip S Surgical Skin Closure? Steri-Strip S Surgical Skin Closures are indicated as a primary
More informationSkin & Wound Care Prevention & Treatment. By Candy Houk, RN Skin & Wound Program Manager
Skin & Wound Care Prevention & Treatment By Candy Houk, RN Skin & Wound Program Manager OBJECTIVES Classify Stage 1 and 2 pressure ulcers Recognize suspected Stage 3, 4, DTI, and unstageable pressure ulcers
More informationTibial Intramedullary Nailing
Tibial Intramedullary Nailing Turnberg Building Orthopaedics 0161 206 4898 All Rights Reserved 2015. Document for issue as handout. Procedure The tibia is the long shin bone in the lower leg. It is a weight
More informationGoals and Objectives for the General Surgery Rotation Resident PGY1 Hamilton Health Sciences or St. Joseph Healthcare (2 four-week rotational blocks)
Goals and Objectives for the General Surgery Rotation Resident PGY1 Hamilton Health Sciences or St. Joseph Healthcare (2 four-week rotational blocks) Overview During the first year of their residency training
More informationWound Management and Basic Suturing Techniques. Disclosures
Wound Management and Basic Suturing Techniques 10 July 2016 Douglas Winstanley, DO FAAD FACMS West Michigan Dermatology Grand Rapids MI Hugh Greenway s 33 nd Annual Cutaneous Anatomy and Surgery Course
More informationPatient Information Booklet. Endovascular Stent Grafts: A Treatment for Abdominal Aortic Aneurysms
Patient Information Booklet Endovascular Stent Grafts: A Treatment for Abdominal Aortic Aneurysms TABLE OF CONTENTS Introduction 1 Glossary 2 Abdominal Aorta 4 Abdominal Aortic Aneurysm 5 Causes 6 Symptoms
More informationPhysicians as Assistants at Surgery: 2013 Study Participating Organizations:
Physicians as Assistants at Surgery: 2013 Study Participating Organizations: American College of Surgeons American Academy of Ophthalmology American Academy of Orthopaedic Surgeons American Academy of
More informationOrthopaedic Spine Center. Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs
Orthopaedic Spine Center Graham Calvert MD James Woodall MD PhD Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs The cervical spine consists of the bony vertebrae, discs, nerves and other structures.
More informationPICC Catheter for IV Therapy
PICC Catheter for IV Therapy A Patient Guide for: PATIENT PICC A PICC is defined as a Peripherally Inserted Central Catheter. A PICC is a special IV Catheter. It is put in an arm vein and ends in a large
More informationChapter 12. Anatomy of Skin. Epidermis. Dermis
Chapter 12 SKIN GRAFTS KEY FIGURES: Skin anatomy with graft thickness Humby knife Using the dermatome Using the Humby knife Mesher Skin graft Tying the dressing in place Defatting the FTSG A skin graft
More informationDiseases of the middle ear
Diseases of the middle ear Acute Suppurative Otitis Media: Acute suppurative otitis media may be viral or bacterial and is accompanied by signs of pain, pressure sensation, diminished hearing and occasional
More informationPolicies & Procedures. Title: I.D. Number: 1160
Policies & Procedures Title: NEGATIVE PRESSURE WOUND THERAPY (NPWT) I.D. Number: 1160 Authorization: [X] SHR Nursing Practice Committee Source: Nursing Date Revised: March, 2010 Date Effective: November,
More informationCare of Gastrostomy Tubes for Adults with IDD in Community Settings: The Nurse s Role. Lillian Khalil, BSN, RN Volunteers of America, Chesapeake
Care of Gastrostomy Tubes for Adults with IDD in Community Settings: The Nurse s Role Lillian Khalil, BSN, RN Volunteers of America, Chesapeake Objectives The participants will be able to identify the
More informationLiau DW : Injuries and Liability Related to Peripheral Catheters: A Closed Claims Analysis. ASA Newsletter 70(6): 11-13 & 16, 2006.
Citation Liau DW : Injuries and Liability Related to Peripheral Catheters: A Closed Claims Analysis. ASA Newsletter 70(6): 11-13 & 16, 2006. Full Text An anesthesiologist inserted a 14-gauge peripheral
More informationA Patient s Guide to Post-Operative Physiotherapy. Following Anterior Cruciate Ligament Reconstruction of the Knee
A Patient s Guide to Post-Operative Physiotherapy Following Anterior Cruciate Ligament Reconstruction of the Knee Introduction The anterior cruciate ligament (ACL) is one of the main supporting ligaments
More informationProcedure Information Guide
Procedure Information Guide Surgery to remove the pancreas (whipple's procedure) Brought to you in association with EIDO and endorsed by the The Royal College of Surgeons of England Discovery has made
More informationArterio-Venous Fistula or Arterio-Venous Graft for Haemodialysis
Department of Nephrology Care of your Fistula Nephrology Department Lower Lane Liverpool L9 7AL Tel:0151-525-5980 Arterio-Venous Fistula or Arterio-Venous Graft for Haemodialysis Haemodialysis access In
More informationWhat should I expect before the procedure?
The British Association of Urological Surgeons 35-43 Lincoln s Inn Fields London WC2A 3PE Phone: Fax: Website: E- mail: +44 (0)20 7869 6950 +44 (0)20 7404 5048 www.baus.org.uk admin@baus.org.uk PROCEDURE-
More information