Faculty Bibliography

GENERAL PURPOSE/OBJECTIVE:To present a study that investigated sacrococcygeal skeletal structure as a possible nonmodifiable intrinsic risk factor for pressure injury and identify possible issues caused by its morphology. TARGET AUDIENCE/BACKGROUND:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES/OBJECTIVE:After participating in this educational activity, the participant will:1. Recognize the background information the authors considered when planning and conducting their study of sacrococcygeal skeletal structure as a possible pressure injury risk factor.2. Identify the characteristics of the two groups of study participants.3. Choose the results of the study clinicians may consider when implementing evidence-based practice.

ABSTRACT/UNASSIGNED:Nutrition plays a vital role in promoting skin integrity and supporting tissue repair in the presence of chronic wounds such as pressure injuries (PIs). Individuals who are malnourished are at greater risk of polymorbid conditions, adverse clinical outcomes, longer hospital lengths of stay, PI development, and mortality, and incur increased healthcare costs compared with patients who are adequately nourished. In addition, some patient populations tend to be more vulnerable to PI formation, such as neonates, patients with obesity, older adults, and individuals who are critically ill. Accordingly, this article aims to review the latest nutrition care recommendations for the prevention and treatment of PIs, including those recommendations tailored to special populations. A secondary objective is to translate nutrition recommendations into actionable steps for the healthcare professional to implement as part of a patient plan of care.Implementing an evidence-based plan of care built around individualized nutrition interventions is an essential step supporting skin integrity for these populations. The 2019 Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline (CPG) affirms that meeting nutrient requirements is essential for growth, development, maintenance, and repair of body tissues. Many macronutrients and micronutrients work synergistically to heal PIs. Registered dietitian nutritionists play an important role in helping patients identify the most nutrient dense foods, protein supplements, and oral nutrition supplements to meet their unique requirements.

GENERAL PURPOSE/UNASSIGNED:To provide information about arginine, its metabolism, and its role in acute and chronic wound healing, to assist providers in understanding the recommendations for arginine supplementation. TARGET AUDIENCE/BACKGROUND:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES/UNASSIGNED:After participating in this educational activity, the participant will:1. Describe the characteristics of arginine.2. Choose the metabolic processes that define arginine's role in wound healing.3. Identify the average daily intake of arginine in an American diet.4. Select the evidence that demonstrates the effectiveness of arginine supplementation for wound healing. ABSTRACT/UNASSIGNED:Nutrition has an important and integral role in wound healing. Arginine, a type of indispensable amino acid, has long been thought to have wound healing properties. The 2019 international guideline by the European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance recommends use of a high-protein, high-calorie oral nutrition supplement fortified with arginine and other antioxidants to treat adults with stage 2 or greater pressure injury and who are malnourished or at risk of malnutrition to foster healing. This article provides necessary background on this conditionally indispensable amino acid, its metabolism, and its role in acute and chronic wound healing to assist providers in understanding the recommendation for arginine supplementation.

GENERAL PURPOSE/UNASSIGNED:To present the 2021 update of the Wound Bed Preparation paradigm. TARGET AUDIENCE/BACKGROUND:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES/UNASSIGNED:After participating in this educational activity, the participant will: 1. Apply wound assessment strategies. 2. Identify patient concerns about wound care. 3. Select management options for healable, nonhealable, and maintenance wounds.

Patients in critical care units have a multitude of diseases and conditions that contribute to their illness and as such are susceptible to comorbid conditions such as heel pressure injuries. Prevention is a key strategy to avoid heel pressure injury occurrence. Risk factor identification can help a clinician identify those patients at risk for a heel pressure injury requiring timely prevention strategies. The purpose of this article is to raise awareness regarding the critical care patient's vulnerability to heel pressure injuries and strategies that can help avoid their occurrence or expedite their healing if occur.

Pediatric pressure injuries continue to be a worldwide healthcare problem. Studying pediatric pressure injury point prevalence may provide more insight into the problem and drive prevention strategies for at-risk pediatric patients, a truly vulnerable population. This article reports 10 years of longitudinal pediatric pressure injury prevalence data and demographics from around the world.

OBJECTIVE:To assess pressure injury knowledge of Skin Care Council nursing members using the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT), to design an educational intervention informed by the results of the baseline assessment, and to evaluate the effect of the intervention. METHODS:This was a single-group pretest-posttest project conducted in an urban, academic, tertiary medical center from January to August 2017. Participants were measured on the pretest, received the intervention, and then were reevaluated on the posttest 3 months later. Pretest results informed the design of the intervention, which was a 1-day interactive, targeted educational program referred to as the "Skin Care Council Boot Camp." Paired-samples t tests were conducted to examine differences between pretest and posttest scores on the PZ-PUKT overall and in each test section. RESULTS:Seventy-seven participants enrolled in the project and completed the pretest. Of those, 58 (75.3%) were retained through the intervention and the posttest evaluation. Participants had a mean pretest score of 78.9 and a mean posttest score of 85.3. There were significant mean differences among pretest and posttest PZ-PUKT scores: 6.4 (t = 9.419, P < .001) overall; 4.6 (t = 5.356, P < .001) in the Prevention/Risk category; 4.1 (t = 3.668, P < .001) in the Staging category; and 10.5 (t = 7.938, P < .001) in the Wound Description category. CONCLUSIONS:By testing pressure injury knowledge before developing a program, investigators created a tailored, education program that addressed knowledge gaps. Posttest results provided insight into the program's success and opportunities for future improvement.