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2022 Wound Care & Prevention

Kindred Hospital Louisville at Jewish Hospital

Objectives

Discuss management & nursing implication in care of EC Fistula.

Agenda

Demonstrate appropriate turning & offloading practices.

Identify appropriate use of Skin IQ devices.

EC Fistula

Abnormal tract communicating between the gut and skin surface.

EC Fistula

Anatomy

Risks Factors

Foreign Body

Radiation

Risks

IBS / Iatrogenic / Infection

F

R

I

E

N

D

S

Epithelialization of tract

Neoplasm

Distal Obstruction / Diverticula

Sepsis

Nursing Care

Nursing Implications

Recognize

Intervene

Monitor

Pressure Reduction

Pressure & shearing force creates iatrogenic wounds and adds to patient suffering and healthcare workload.

Pressure Reduction

Intentional Rounding

Intentional Rounding

Monitor patient for safety risks:

- Bed: HOB, wheel lock, height

- Pressure: turning / offloading, devices

- Therapeutics: IV, feeding, NPWT, brace/splints.

- Environment: lighting, personal belongings, clutter, fall mats

Common Pressure Points

Click to edit text

Common Pressure Points

1

2

3

Pressure Injury

5

6

4

Only WCN to document new pressure injury!!!!

Pressure Reduction Devices

Misc:

- Line management

- Turning

- Biatain

- Early mobility

- Specialty beds

- Citadel

- Bariatric

- Envella

Offloading:

- Wedge

- Cushion

- Boots

Reduce pressure:

- Ear Pillow

- Duoderm

- Pillows

Pressure Reduction Devices

Reduce Shearing

Shearing Injuries

Shearing = Pressure + Friction

Reduce pressure.

Reduce friction.

- Skin IQ

- Sheets

- Air cushion movers

Maintain HOB at minimum required to prevent aspiration.

Arjo Skin IQ

How do you turn it on?

Skin IQ Device

How many times can you reuse it?

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