Air-fluidized support surface therapy has many drawbacks, such as dehydration, in an already difficult recovery for those wound patients who have undergone flap and graft surgery. In addition, patient care and handling are also problematic. Patients complain of discomfort, and the instability of the surface interferes with patient stability in side lying and semi-Fowler's positions. Alternative support surfaces can be considered for postflap or postgraft patients. Such technologies as alternating pressure, low-air-loss, and therapeutic nonpowered, advanced, and lateral rotation surfaces are widely used for pressure management in high-risk patients and those with existing pressure ulcers. These surfaces must be used within a total pressure ulcer management program that includes frequent turning and repositioning, skin and ulcer care according to evidence-based protocols, patient and caregiver instruction, nutrition, and offloading and positioning. The proposed recommendations require more research on the relative effectiveness of less expensive and more user-friendly support surfaces such as low-air-loss and nonpowered advanced support surfaces and is necessary in order to conclusively recommend one type of surface over another. However, at this time the available clinical studies and opinions remain positive.
In order to address the need for a tool to support hospital-based nurses in catheter-associated urinary tract infection (CAUTI) prevention, the American Nurses Association (ANA) was asked to convene a Technical Expert Panel of stakeholders in CAUTI prevention. The Technical Expert Panel was chaired by the ANA's Senior Policy Fellow, a certified wound, ostomy and continence (WOC) nurse. The panel comprised 23 representatives, including nurses from specialty practice organizations, nursing affiliated with the ANA, infection control specialists, patient safety authorities, award-winning hospitals using the National Database of Nursing Quality Indicators, and content experts. The Wound, Ostomy and Continence Nurses Society appointed 2 representatives to this panel, a key nurse researcher with expertise in this area of care and a former Society President. The CAUTI Prevention Tool Kit, combined with supplemental guidance documents developed, supports WOC nurses and Society members in achieving quality clinical outcomes for their patients.
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