AAWC Board of Directors election is right around the corner. Before voting opens on Monday, October 14, 2019, we invite you to learn about the 18 candidates who are running to help lead the future of AAWC. At its core, AAWC is a multidisciplinary organization that champions the four pillars of education, public policy, research, and infrastructure to support wound care patients, researchers, advocates, and practitioners of all specialties. The AAWC Board of Directors serves to advance the initiatives of the AAWC which are focused on the strategic plan consisting of the four pillars.

This year’s candidates have a variety of professional backgrounds and skills, reinforcing the dynamic team approach that AAWC is founded on. On the elections webpage, each nominee describes how their qualifications align with the four pillars and their plans to support the Board in its efforts to meet AAWC's strategic objectives. Candidate’s credentials, years of AAWC membership, and CV are also available.

 “2020 is going to be a pivotal year for AAWC. Strong leadership is essential to carrying out a successful strategic plan. I am confident we have a highly proactive and experienced selection of qualified candidates. In the coming weeks, I encourage everyone to take the opportunity to get familiar with the Board of Directors candidates and vote.” Victoria E. Elliott, RPh, MBA, CAE, chief executive officer, Association for the Advancement of Wound Care.

Voting for AAWC’s Board of Directors ends on Sunday, November 10, 2019. Support the success of AAWC through participation in the upcoming election. Every voice counts in the direction and leadership of AAWC, the premiere voice of wound care.

Candidates include:

• Industry
  • Matthew Davis RN, CWON, CFCN
  • William Tettelbach MD, FACP, FIDSA, FUHM, CWS

• Nurse
• Jacalyn Brace Ph.D. ANP-BC RN-BC WOCN
• Maria Luisa Faner DNP, APRN, FNP-C, CWS
• E. Lynette Gunn APRN, GCNS-BC, CWCN CFCN
• Victoria Nalls GNP-BC, CWS, ACHPN

• Physical Therapist
• Rose Hamm PT, DPT
• Marta Ostler PT, CWS, CLT, DAPWCA
• Brandy Rose PT, DPT, CWS

• Physician
• Ali Bairos MD, CWSP, FACCWS
• Jonathan Johnson MD, MBA, CWSP
• Naz Wahab, MD

• Podiatric Physician
  
• Marcela Farrer DPM, MBA, CWS
• Marc Jones DPM, FACFAOM
• Jared Shippee DPM, DWC, WCC, PCWC, FAPWCA

• Research
• Alisha Oropallo, MD
• Nicola Waters Ph.D., MSc, RN

• Secretary, Executive Committee
  
• Kara Couch MS, CRNP, CWCN-AP

Learn more about each candidate by clicking here. For more information visit AAWC.

Members of AAWC are known for top tier commitment, specialization, and passion for wound care. Yet among the greatest of challenges advanced wound care professionals face, one is how to demonstrate and communicate the impact and value provided to administrators and clinicians managing or overseeing multiple clinical services.

After all, it’s only recently that advanced wound care has begun to become recognized as a specialty and service line -- and there is still a long way to go, not only scientifically or clinically.

Getting the proper buy-in, which in turn unlocks resources for staffing, products, technologies, training, and infrastructure, requires more than the ability to deliver evidence-based, patient-centric wound care. While a short post is not enough to tackle this important subject, what follows are some actionable ways to ensure recognized value:

1. Determine baseline metrics and KPIs (key performance indicators):
   
   Tracking clinical (e.g. healing rate, healing velocity, average days to heal, etc.), operational (e.g. new patients, visits, cancellation rates, staffing ratios, etc.), and financial (e.g. revenue, expense, profit, cost per dressing change or per healed wound, etc.) metrics and KPIs makes a difference. Starting with baseline historical stats from prior to when the current wound care program (or the new investment in staff, technology, training, etc.) began is a must, though it’s never too late to start. Aside from hospital-acquired pressure ulcers (HAPUs), surgical site infections (SSIs), and a couple others which all are influenced by many factors that can be tough to control for, healthcare administrators - especially in care settings that are not hospital-based - have very little insight into the correct ways of telling whether investments are paying off (or if budget cuts are costing more than they’re saving). Part of delivering wound care is to ensure administrators have the information to make decisions and see the return on investment (ROI) for advanced wound care.
   
   
2. Ensuring a proper organizational and financial structure:
   
   What is the chain of command for wound care services in each care setting? Is it seen as a function of clinical education? Quality and compliance? A revenue stream? A way to attract patients to the facility? This affects alignment (or lack thereof) with senior administration, key executive goals, and ultimately impacts the availability of resources. Likewise, the smaller the wound care team, the less likely there is to be a separate budget. Tracking an individual and separate budget for wound care apart from ancillary services, nursing administration, education, or other umbrella departments avoids unnecessary politicization and more difficulty/time spent to obtain unique resources necessary for wound care.
   
   
3. Use a dashboard report to regularly share (in person) with institutional administration:
   
   Once items one and two are in place, it’s important to distill them into a concise dashboard which can be used as a framework for discussions with administration and clinical leadership. Today, there are more tools than ever for tracking and visualizing changes in your data and outcomes over time.

As with many industries, the more senior the executive or administrator, the less familiar management will be with specific challenges and needs. At the same time, they tend to rely more on data (clinical + operational + financial) to gauge whether investments are being deployed in an impactful manner. Whether part of a large clinic or hospital team, or the sole specialist in an SNF or home care agency, the ability to regularly articulate a wound care program’s needs and performance to administration, using real-world metrics, in a relatable and useable form is a key component of ensuring wound care efforts are properly resourced.

About the Author
Rafael Mazuz is the managing director of Diligence Wound Care Global. To contact, email: [email protected].

As the premier voice of wound care, AAWC offers the hands-on education that elevates a practitioner’s wound care knowledge and skills. Most recently, AAWC held Wound Care Tricks of the Trade on September 11, 2019. This Wild on Wounds pre-conference workshop gave nurses and physicians insider wound care tricks and expert training. View photos here!

The workshop was a day-long educational session lead by seasoned wound care practitioners, Catherine T. Milne MSN, APRN, ANP/ACNS, CWOCN-AP, Kara S. Couch, MS, CRNP, CWCN-AP, and Marta Ostler, PT, CWS, CLT. During the workshop, attendees benefitted from educational sessions and hands-on training that covered:

• Selecting topical dressings
• Basic Negative Pressure Wound Therapy
• Advanced Negative Pressure Wound Therapy
• Choosing and applying compression
• Managing Lymphedema
• Clinical management of diabetic foot ulcers and Total Contact Casting

Each session provided unique “tricks of the trade” including useful tips on how to identify, dress, manage, and treat wounds both quickly and effectively. Throughout the day, seasoned instructors helped attendees navigate difficult wound care choices and learn how to adapt without specific wound care supplies. Towards the end of the program, attendees had the opportunity to learn about Total Contact Casting (TCC). Many nurses performed TCC casting for the first time with guidance on proper procedure and application from AAWC instructors.

Wound Care Tricks of the Trade educational sessions reinforced the idea of creativity. The premise that if a practitioner doesn’t have all the tools, then the solution relies on creativity. Hands-on sessions encouraged attendees to be creative and get in the habit of choosing the best course of action given select resources when practicing wound care.

In addition to hands-on, expert-led training, attendees benefitted from:

• Registration that included a one-year AAWC membership
• AAWC members have access to the monthly Journal Club, Trip Database, event discounts, and more
• The opportunity to earn up to 6.75 ongoing education credits
• $100 off Wild on Wounds Conference, an exclusive offer for AAWC members 

AAWC has many educational opportunities throughout the year. Near or far, join us for our September Journal Club "A Standardized Approach to Evaluating Lower Extremity Wounds" tomorrow evening, 8:00-9:00 p.m. EST, presented by Marta Ostler CWS, CLT, PT, and Mary Haddow, RN, CWCN. Register to get a unique preview of the topics that will be covered at AAWC’s Lower Extremity Summit (LEx), November 2-3, in Sacramento California.

This year’s Wound Care Tricks of the Trade would not be possible without the generous support from its sponsors.

Thank you, Wound Care Tricks of the Trade Sponsors!
KCI An Acelity Company
Integra Life Sciences
Tissue Analytics
Molnlycke
Prism
Medline

For more information visit AAWC.

The Association for the Advancement of Wound Care (AAWC) is focused on success and stepping boldly into the future. AAWC held a Town Hall live webinar on Thursday, September 5th at 7:30 p.m., eastern time, led by AAWC’s Chief Executive Officer, Victoria E. Elliott, RPh, MBA, CAE. This interactive Town Hall provided a review of the association’s 2019 accomplishments, and a preview into the upcoming initiatives that will enable AAWC to reach its full potential as the leading voice in wound care.

Over the course of an hour, Victoria revealed new meeting opportunities, research initiatives, plans for a robust public policy agenda, and a new program to be launched this fall. Lead by AAWC’s core strategic pillars: Education, Public Policy, Infrastructure, and Research, Victoria discussed how each pillar will be strengthened moving forward.

Last fall, AAWC members indicated they desired more initiatives in education, impact on legislation, research to improve the patient care, and an increased AAWC presence. Victoria spoke to the programs and opportunities that will fulfill the needs of our association’s members.

In terms of education, AAWC offers a monthly Journal Club and regional educational programming. This year, AAWC offered a Pressure Ulcer Summit, two Wound Infection Summits, and has scheduled a Lower Extremity Summit that will take place November 2-3, in Sacramento, California. Looking ahead, AAWC will host its 3rd Annual Pressure Ulcer Summit tentatively scheduled for early February, introduce new Summits in 2020, have new journal club offerings, and provide more online professional development opportunities.

AAWC members received additional educational benefits this year, including:

• A complimentary copy of the WoundSourceTM 2019 publication
• Member-only access to Trip Database, an online clinical search engine 
• The opportunity for cross-certification in wound care through an ABWH certification conferment

The association is also involved in an international capacity as well. This year, AAWC had its first-ever exhibit booth at the European Wound Management Association’s annual meeting in Gothenburg, Sweden. AAWC is also a supporting society of the World Union of Wound Healing Societies and will be supplementing next year’s WUWHS conference in Abu Dhabi with a panel of AAWC wound care experts and a pre-conference workshop.

AAWC is passionate about its public policy pillar. In 2019 AAWC meet with former representative Jack Kingston, and his staff at Squire Patton Boggs, to discuss how to leverage its position in the wound care arena and mobilize a public policy agenda, especially as it relates to pressure ulcers. Additionally, President-Elect Ruth Bryant met with a number of House and Senate offices to educate lawmakers on the need for increased prevention of pressure ulcers for our nation’s veterans. As a commitment to making meaningful change, AAWC continues to be an active member of the Alliance of Wound Care Stakeholders.

This year, AAWC has strengthened its infrastructure by partnering with MCI USA. The new management partner brings over 30 years of experience to AAWC with expertise in the medical sector. MCI USA will assist AAWC staff and leadership in efforts to improve member engagement, expand educational initiatives, and strengthen AAWC’s position as the premier voice for wound care professionals. AAWC has also redesigned the board-approved nominations process, yielding numerous new candidates for the 2020 Board of Directors. Elections are scheduled to open on Monday, October 14, 2019.

As science and technology rapidly evolve, AAWC is committed to investing in research initiatives that will benefit members. AAWC is working to create a research agenda based on identified gaps in summits, a toolkit for developing a clinical question, a three-part education series on research project development and a task force to solidify a global common data set. Research work will also continue on the development of the Pressure Ulcer Description Tool.

Towards the conclusion of the meeting, Victoria announced plans for a new membership recognition opportunity: the AAWC Fellowship Program. This unique designation will be of great value for AAWC members where credentialing holds specific importance in career work.

AAWC’s future is brighter than ever before. The Town Hall confirms that plans are set in motion to have a strong finish to 2019 and an even brighter beginning to 2020. An AAWC membership holds incredible power, value, and commitment to outstanding patient care and best practices in the wound care space. The coming months and years are only the beginning of the incredible difference AAWC will make as the premiere voice of wound care. 

AAWC members can access the full September 11, 2019, Virtual Town Hall recording by clicking here. 

When fans take the stands and players take the field at sporting events, the focus tends to be on the pitcher, the quarterback or the goalie. A win or a loss begins with these positions. The arena for wound treatment is not very different. The eyes of the care providers tend to go direct to the center of the wound, the wound bed. But the action on the periwound or the wound sidelines can make a difference in how rapidly the patient may heal.

The periwound offers key information crucial to overall wound healing. Following these recommendations can make the wound care team take home a win.

Maintaining the moisture balance of the periwound is essential to wound contraction and epithelialization. If the skin around the wound is too wet, the epithelium cannot crawl across the wound bed and the wound cannot contract appropriately. 

Heavy moisture is an indicator of other issues such as venous insufficiency in a leg wound, an unaddressed bioburden causing heavy exudate, systemic fluid overload, or a primary dressing that is perhaps creating an inappropriate moisture balance for the wound.

Once adequate arterial flow to lower extremities is confirmed, compression can be utilized to help with edema to periwound skin. A liquid adhesive can be applied to protect the periwound skin and will control maceration. Removal of the callus ring enables visualization of the real periwound and minimizes pressure, and using a dressing with more moisture helps wounds that are dryer.

Bioburden is a factor in any wound healing, particularly in the perineal areas or the feet. A foul odor from the wound is a hint of a bioburden. Sharp debridement and physically breaking the biofilm then dressing the wound with an antimicrobial dressing can help optimize wound healing after the biofilm is broken.

If bioburden has been ruled out and the periwound is red, other factors are at play. Offloading pressure and reducing friction even when it is not the primary etiology can help. 

Necrotic tissue in the periwound or wound bed that is resistant to treatment may indicate cancer or autoimmune disease. Though rare, these should not be discounted. A biopsy can provide answers.

Necrosis also can be caused by arterial insufficiency from large or small vessel disease. A toe brachial index in addition to an ankle brachial index can reveal the problem and potential for healing.  Particularly with foot wounds, small vessel disease requires a lower level of negative wound pressure therapy so there is no clamping of the periwound small vessels.

Edema is another consideration. Localized edema treatment is more effective once the patient is euvolemic. With lymphedema, specialists are required to assure the proper treatment.

Crunchy sounds caused when there is gas under the skin is called crepitus, and it is an emergent condition. It can indicate gas gangrene, requiring systematic antimicrobial therapy and possibly surgery. Fluctuance, or sensation of a pocket of fluid trapped in the tissues in either the periwound or under the wound itself, with or without erythema, may require surgical intervention.

Epibole Is when the periwound curls in. In a healthy periwound, epithelial cells should be observed as moving across the wound bed. If they have stopped or the periwound is curled in, something is preventing normal contraction and epithelialization from happening. Scraping the curled area with a curette and then treating with an advanced dressing and an antimicrobial component will disrupt the potential biofilm as well as help correct the defect.

Like other players on a sports team, the periwound may not be the central attraction. But what it does and how it plays impacts the healing of a wound as much as the other players impact the outcome of the game. The periwound needs to be evaluated with the wound bed, treated at different stages of healing, and supported as it plays its crucial role in the wound healing challenge.

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