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1. Demonstrate and discuss strategies to minimize damage to high risk skin.
2. Differentiate between skin care products and optimal use of options available.
3. Identify and distinguish factors likely to stall wound healing.
4. Analyze leg and foot wound characteristics of: neuropathic, arterial, and venous wounds.
5. Identify characteristics of 6 categories of wound dressings.
6. Compare and contrast 5 types of wound debridement.
7. Outline goals for wound care in hospice and palliative care settings.
8. Explain evidence-based pressure ulcer prevention practices and tools.

Keeping skin in balance: adding that ‘ounce of prevention’

• Moisture, oil, bacteria, and acid balance
• review of epidermal and dermal differences
• Skin - first line of defense; how our skin manages to protect us and how we can help it succeed

Preventing traumatic skin injury

• Skin tears, abrasions, tape burns
• Simple methods of reducing friction between skin and other surfaces

Incontinence associated dermatitis

• Prevention and treatment - evidenceinformed international guidelines
• Frequent incontinence needs high intensity prevention
• Acidic skin cleanser and protectant necessary
• Incontinence cloths can reduce friction, have acidic cleansers and built-in protectants
• Under pads/protective garments

Accurately assessing the buttocks - pressure ulcers vs other common buttock ulcers

• Location, shape, color, depth
• Case studies using a systematic assessment method

Fecal incontinence

• Steps to improve stool consistency
• Collection devices pros and cons

Fungal rashes

• Options of what to use and when to treat fungus
• Natural ways to control and prevent re-infection

Wound healing essentials

• Phases of healing a full-thickness ulcer
• Wound assessment techniques
• Team approach to wound healing, including the patient/family
• Making use of nutrition and endorphins to speed healing

Wound bed preparation to assure best possible healing

• Best cleansing - takes more than saline
• Aggressive antiseptic cleansers
• Biofilm - invisible shield for bacteria
• Gentle and effective antiseptic wound cleansers

Debridement of non-viable tissues - an important part of infection control

• Compare methods - each has pros and cons
• Discuss new soft pad for mechanical debridement (breaks biofilm too)

Dressings help with moisture and bacterial balance in wounds

• Many antiseptic dressings available - new category is germ traps
• Super-absorbent options - not just foam and alginate any more
• How to choose a dressing based on wound characteristics
• How to decrease costs using products included on your buying contract

Modalities - physical science can be used to speed healing

• Surgical wounds
• Keeping incisions clean and dry to decrease dehiscence and infection
• Negative pressure wound therapybedside and single patient use models

Pressure Ulcers - 2014 international guidelines

• Identify risks - how to intervene
• Tools to use and prevention options
• Pressure mapping and therapists who specialize in fitting for optimal cushion
• Foam mattresses, air mattresses, chair cushions, foot protection boots - what options may be best for your facility’s situation/budget

Diabetic foot ulcers

• Depression, vitamin D deficiency, neuropathy - how limbs and lives are lost
• Off-loading methods
• Utilizing written contracts

Advanced therapies - skin grafts, hyperbarics, autologous platelet concentrate

• Arterial ulcers
• Comparison of diagnostic methods
• Re-vascularize if possible
• Keep dry if not able to restore the flow

Edema related ulcers

• Compression and elevation - tips to help them succeed
• Infection control methods to prevent frequent stasis dermatitis and infections
• Managing fibrin slough without causing trauma to legs

Lipedema and lymphedema

• Assessment tips
• Lymphedema therapy

Joan Junkin, RN, MSN, was introduced to wound care as a research analyst for the AHCPR (now AHRQ) panel that created the first ever pressure ulcer treatment guideline. After wound education and certification, she was the wound clinical nurse specialist for a 500-bed hospital and spent 10 years building an outpatient and inpatient program to improve wound outcomes. She conducted and published the first research documenting incontinence associated dermatitis prevalence in acute care and has published in several nursing and wound journals. Since 2008 she has devoted her time to teaching in 49 states and 5 provinces in Canada. This, along with her wound consulting business gives her a broad perspective. Joan is passionate about sharing essential information for healthcare providers with just enough humor to help navigate this challenging topic. Speaker Disclosures:
Financial: Joan Junkin is an independent contractor and has an employment relationship with UNMC College of Nursing. She receives a speaking honorarium from Sage, a Stryker company. Joan Junkin receives a speaking honorarium and recording royalties from PESI, Inc. All relevant financial relationships with ineligible organizations have been mitigated.
Non-financial: Joan Junkin is a member of the Association for Advancement of Wound Care.

For U.S. and Canadian customers, a CE test is available for $9.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 4/13/2019
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Occupational Therapists & Occupational Therapy Assistant: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.3 continuing education credits.

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Physical Therapists & Physical Therapist Assistants
This self-study course consists of 6.25 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

California Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.25 continuing competency hours.

Illinois Physical Therapists & Physical Therapist Assistants: PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.6 contact hours.

Texas Physical Therapists & Physical Therapist Assistants: This self-study activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2106032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. This activity will provide 6.25 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses, Clinical Nurse Specialists, Nurse Practitioners, Physician Assistants, Registered Dietitians & Dietetic Technicians, Athletic Trainers, Physical Therapists, Physical Therapist Assistants, Nursing Home Administrators, Occupational Therapists, Occupational Therapy Assistants