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Keeping it Fresh: Maintaining a Reason to Attend a Professional Conference

There are thousands of medical professional conferences each year around the world. The cost to host and attend professional conferences continues to increase while organizations are decreasing budgets allocated for attending. Then there is a notion that the internet and social media platforms make conference information and contacts available without ever leaving the office.

Historically, success is evidenced when meetings draw crowds, sponsors and exhibitors quantify a positive return on their investment, and the content is graded as informative by attendees. But success can also breed complacency with the temptation to re-bake the same successful recipe year after year. That is a mistake.

In 2019, the AAWC began offering regional education summits. The model offers science-based deep dives into specific topics crucial to advancing wound care. At the same time, the model is responsive to reduced budgets and enables members to travel shorter distances. On the other hand, the content of each summit draws global expertise to bring best in class research and care direct to those involved in the day-to-day ministrations of wound care. The increased intimacy of the regional meetings improves face-to-face interaction and connection so it is possible to actually meet with all those on a target list.

For example, the AAWC continues to host one annual Pressure Ulcer Summit (PrU) drawing attendees from across the globe. This topic is one of daily challenge to wound care providers and staying in front of current research is crucial. The Summit is designed to be collaborative, evidence-based, interactive, scientific, open and cutting edge. One attendee reported it to be, “a learning bonanza.” Ninety-eight (98%) percent of attendees said they were satisfied or highly satisfied with the multi-disciplinary approach to wound care and 94% said the PrU Summit exceeded their expectations.

In 2019 the AAWC will be host to multiple Wound Infection Summits (WIS, pronounced WISE) and the feedback about those held to date underscore the content and operational model are highly successful. With 94% reporting WIS to be scientifically sound and 92% reporting it helpful in practice and treatment strategies. One attendee said it was, “concise, relatable, and comprehensible.” Another described it as “exciting, collaborative, cutting-edge information.”

Conversely, AAWC members report different experiences with a recent national conference. One found the agenda to be virtually identical to offerings of prior years with the same topics for the educational tracks and even some repeat speakers. One said she will have a hard time selling through to her employer a compelling reason to attend again.

As the AAWC’s national and global presence expands, its influence for advancing wound care makes the AAWC’s leadership coveted partners at meetings hosted by others. This year, the AAWC has been invited to develop multidisciplinary wound care educational tracks for several prominent national meetings including DFCon, focusing on diabetic foot wounds, Desert Foot focusing on limb salvage, and the C3 Summit focused on collaboration among cardiovascular disciplines necessary to successfully manage complex coronary, carotid, and peripheral arterial disease. As an international partner to the European Wound Management Association (EWMA), the AAWC will participate in their global Summit in June.

While AAWC is likely to host national meetings in the future, it will do so with an eye toward assuring attendees find it fresh, scientific, medically practical, collaborative and interactive. However, for 2019 the bold move to shake up its conference model has proven smart. The following is the schedule for the remaining 2019 AAWC conferences. We hope to see you there.

AAWC Regional Wound Infection Summit

Detroit Kansas City
August 16-17, 2019
Detroit, Michigan
October 5-6, 2019
Kansas City, MO

AAWC Regional Lower Extremity Summit
November 1-2, 2019
Sacramento, CA

Also look for AAWC Featured Tracks at these meetings:
Special AAWC Member Rates will apply!

***Log in to the Members Only section of the AAWC website to obtain Member Discount Codes***

Complex Cardiovascular Catheter Therapeutics: Advanced Endovascular and Coronary Intervention Global Summit (C3)
June 23-26, Orlando, FL
AAWC Members save 15% on registration!
http://www.c3conference.net/Main/Conference-Registration

DFCon – Diabetic Foot Global Conference
October 17-19, Los Angeles, CA
AAWC Members save 15% on registration!
http://dfcon.com/

Desert Foot
December 4-7, Phoenix, AZ
AAWC Members pay only $99!
https://www.desertfoot.org/

Strength and Value in Numbers!

There is knowledge in numbers – even small ones and the AAWC is making sure that wound care clinicians from facilities large and small can take part in AAWC’s valuable programming.

Most AAWC members work in institutional or clinic settings of varying sizes. Regardless of size and budget, it is important that all the wound care clinicians have access to education and resources needed to provide the best in class patient care. That is why the AAWC has established a Group Membership option. The two-tiered program enables either up to four or up to eight employees from one facility to engage with member activities and receive member benefits such as the newsletter, Journal Club and member rates on AAWC Regional Summits. As a group membership, it is interchangeable among employees. If an employee were to leave that facility, another can be added at no additional charge for the duration of that membership year.

“The knowledge transfer accruing from AAWC membership is unique, valuable in routine wound care practice, and essential to advancing wound care worldwide,” said Victoria Elliott, AAWC Chief Executive Officer. “A group membership option allowing for individual interchange means that anyone from that institution or clinic can participate in a program and bring the knowledge back to be shared among colleagues. Otherwise, if the one member was unavailable for a program, the facility might miss out on the knowledge shared.”

The costs for the group membership are $480 for up to four employees and $959 for up to eight employees. Those facilities with more than eight can receive a discounted membership of $95 for each additional member, a $20 savings over individual AAWC membership. The membership for all individuals in the group option would begin and then renew at the same time.

To learn more about a group facility membership option, please contact Lyn Donze, [email protected] or visit https://aawconline.memberclicks.net/about-membership.

Wound Care Nurses: A long-standing tradition of specialized patient care.

When Florence Nightingale began nursing patients in the mid 1800’s, she was joined by a team of fewer than 40 women all of whom she had trained herself. Credited with establishing the nursing profession, the seed she planted has grown exponentially across many specialty care areas. Today it is estimated that there are about 29 million nurses across the globe, with nearly four million in the US alone.

International Nurses Week from May 6-12th is dedicated to honoring those men and women who put their patients first with International Nurses Day May 12th, Florence Nightingale’s birthday.

Nurses are caregivers, scientists, technical specialists, ministers and healers who work with their heads, hands and hearts – and they do it 24/7/365. They are special people with skills extending far beyond bedpans and blood pressure cuffs. In the course of a shift, a nurse is responsible for administering medications and managing IVs as well as observing and monitoring patients’ conditions, maintaining electronic and traditional records, and communicating with doctors, patients and patients’ families. They are the first line in the fight for healing and total health.

Wound care nurses bring specific skills to the bedside. They are responsible to assess and evaluate a patient’s complete condition and then assess and evaluate acute and chronic wounds, obtain cultures, evaluate how other presenting illnesses impact the wound. They initiate the care to manage the wound, coordinate with other caregivers, and educate and counsel the patients and their families on wound care and self-management of the wound.

Florence Nightingale’s initial nursing assignment along with her team was to provide wound care to British soldiers injured in combat during the Crimean War. She described it as the most challenging of her life. Working in horrific conditions, she treated wounds while working to improving sanitary conditions, food and nutritional needs, and establishing a library to stimulate intellect.  

It is the model of modern day nursing to treat the whole patient with nurses ministering to the mind, body and spirit of patients and their loved ones. The nursing profession continues to evolve as all nurses, including those in wound care, work to advance and improve patient care. AAWC salutes all nurses for their selfless service to their patients.

Let's Get the Patient Perspective: Join us on May 8 for Journal Club on Martorell's Ulcer

In the May 2019 Journal Club webinar, Kara Couch, MS, CRNP, CWCN-AP, Director of Inpatient Wound Care at the George Washington Hospital, will examine the Hypertensive Ischemic Leg Ulcer, also known as Martorell’s ulcer.  This is an atypical lower extremity ulcer that is likely underdiagnosed as some of its clinical features closely mimic other atypicals such as calciphylaxis and pyoderma gangrenosum.  Couch will review the pathophysiology of the Martorell's ulcer, discuss its prevalence and explain the appropriate workup and treatment options.

One of the distinguishing characteristics of Martorell’s is excruciating pain. Using a recent patient case, Ms. Couch will be joined by her patient to give both the provider and patient perspective in managing this rapidly progressive and extremely painful ulcer. In this particular case, the patient also has an unusual co-morbid condition called Liddle’s syndrome which will also be discussed.

AAWC’s monthly Journal Club is free to members. The next journal club is May 8 from 1:00 to 2:00 p.m. Eastern. CLICK HERE to sign up today!

All About that Biofilm

As Jennifer Hurlow, GNP, CWOCN, highlighted in the February Journal Club Presentation “Diabetic Foot Infection: A Critical Complication,” the science is there, but clinical practice – often – is not. Evidence suggests that approaches to treatment for chronic wounds that incorporate biofilm research, like Biofilm Based Wound Care (BWCC) can lead to significant increases in the efficacy of treatment of chronic wounds, but most traditional diagnosis and treatment methodologies overlook the importance of biofilm in wound healing. So how can YOU help make the transition and bring more of these evidence-based practices into the wound care community?

Read Up. For a start, AAWC members can review the recorded webinar and hear about some of this research from Jennifer, first hand, by logging into AAWConline.org. Or, the article was originally published by the International Wound Journal and you can access the full text there with a subscription.  Equip yourself with a thorough understanding of the research so you and your teams can better use it to inform your practice.

Join the Conversation at the upcoming Wound Infection Summit Atlanta. Jennifer and several other researchers and clinicians with BWCC expertise will be sharing their insights, practices and tactical approaches as a part of the program. Not only that, the summit includes additional conversation on gaps between scientific research and clinical practice, helping share practices and new ideas across disciplines. Learn more and register today for the WIS Atlanta!

Reach out. Who are the fellow healthcare professionals you interact with regularly in your community that you “only wish more fully understood and appreciated the great information that is available”? Invite them to membership and engagement with the AAWC. The more diverse healthcare providers are included in this multi-disciplinary wound care community, the better the results… if you’re not already a member, join today and invite those you work with to join!

Why Sponsors Matter

AAWC walks a careful line toward assuring balance for members. Policies have long been in place to prevent organizational endorsements of any businesses or corporations or products associated with wound care. Additional policies assure the AAWC leadership does not benefit financially from relationships with wound care businesses. The AAWC expects and offers transparency, and holds both leadership and membership accountable.

And yet at all Summits, there is an exhibition hall of sponsors members and summit attendees are asked to visit. The sponsors are there because they have been invited by the AAWC or they have asked and paid the AAWC to participate. It may seem a violation of the organization’s very tenets. But it isn’t and here is why.

On the front lines of wound care in clinical settings across the country and around the world, members need the very best tools available to successfully treat patients under care. It is not possible for individuals or even individual institutions to remain on the cutting edge of all things new in wound care. Having developers and manufacturers of tools, treatments, practices, and devices willing to participate in a Summit helps advance wound care. It enables care providers to do what they do best, confident in the knowledge they have what is new and best.

Removing vendors as sponsors and exhibitors would limit the potential of providing best in class care for patients in need of healing. These opportunities for engagement one-on-one with those most familiar with innovative healing tools are crucial to advance wound care. AAWC Summit attendees and all members can trust that policies prevent inappropriate relationships and can use the time to learn how the newest options can help in the clinic.

AAWC President Elect Ruth Bryant's Hill Day on Pressure Ulcers

On Wednesday, March 13, the Association for the Advancement of Wound Care (AAWC) President-elect Ruth Bryant, PhD, RN, CWOCN, met with a number of House and Senate offices on Capitol Hill to educate lawmakers on the need for increased prevention of pressure ulcers for our nation’s veterans. Dr. Bryant was joined by Martin Burns, CEO of Bruin Biometrics, and representatives from Arnold & Porter specializing in health care policy.

Congress is now developing the appropriations bills that will fund the federal government’s departments and programs in the 2020 fiscal year. BBI and AAWC met with House and Senate offices to discuss the need for increased funding for research on pressure ulcer prevention at the Veterans Hospital Administration (VHA), particularly with high risk populations such as veterans with spinal cord injuries, and BBI’s interest in developing a pilot program for the VHA using SEM Scanner technology*. Veterans treated in Veterans Health Administration (VHA) hospitals are 52% more likely to develop a pressure ulcer than patients in civilian hospitals. It costs the VHA between $20,900 and $151,700 to treat each individual pressure ulcer, totaling an estimated $1.3 to $3.6 billion in costs annually. Dr. Bryant discussed the importance of finding new approaches that could allow the VHA to save resources and ensure the highest quality of care for veterans.

The group met with the staff of the following members of Congress:

•    Rep. Sanford Bishop (D-GA)
•    Rep. Doug Collins (R-GA)
•    Rep. Tom Emmer (R-MN)
•    Rep. Chellie Pingree (D-ME)
•    Rep. Martha Roby (R-AL)
•    Rep. Rob Woodall (R-GA)
•    Sen. Susan Collins (R-ME)
•    Sen. Dianne Feinstein (D-CA)
•    Sen. Marco Rubio (R-FL)

The group also discussed the unique challenges facing the VHA in addressing pressure ulcers with staff members of the House and Senate Appropriations Committees, which are tasked with crafting the legislation that is ultimately approved by Congress. The day was highlighted by a meeting with Representative Debbie Wasserman Schultz (D-FL), who serves as Chairwoman of the House Appropriations Committee’s Subcommittee on Military Construction, Veterans’ Affairs, and Related Agencies, which oversees the Department of Veterans Affairs. Rep. Wasserman Schultz has been supportive of efforts to combat the threat of pressure ulcers in the past, and expressed interest in BBI’s pilot program proposal.

Throughout the day, Dr. Bryant provided valuable insight into the challenges of identifying and treating pressure ulcers, and the harm they cause to patients. Her perspective as an expert on the subject provided valuable information for Congressional staff, who have been concerned about higher pressure ulcer rates at the VA. Dr. Bryant’s efforts ensured that Congressional leaders are aware of new developments in the science and technology to alleviate the burden of pressure ulcers, setting a strong base for progress on this issue down the road. The AAWC is committed to continuing to work with Congress to improve the identification and care of patients with pressure ulcers and to improve prevention strategies for those at risk.


* Bruin Biometrics (BBI) is a medical device company that has developed innovative technology called the “SEM Scanner,” for early detection and prevention of pressure ulcers. The hand-held, portable wound assessment device can alert caregivers and providers to increased risk 5 days (median) before ulceration or visual signs of skin damage. The SEM Scanner, currently deployed across the UK and Canada, has seen success in reducing facility-acquired pressure ulcers (FAPUs). The SEM Scanner has been used in Europe since 2014 to prevent pressure ulcers, with up to 100% reductions in PU incidents across all care settings. In December of this past year, the U.S. Food and Drug Administration granted marketing authorization for the SEM Scanner, as an adjunct to the standard of care when assessing patients in the U.S. who are at increased risk for pressure ulcers. BBI is interested in partnering with the VA to pilot the technology.

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John F. Kennedy was Correct!

At a White House dinner for Nobel Prize recipients, President Kennedy said, “I think this is the most extraordinary collection of talent, of human knowledge, that has ever been gathered at the White House - with the possible exception of when Thomas Jefferson dined alone.”
A more than appropriate reference to President Jefferson, a man who was a statesman, a visionary, an inventor, an educator, a lawyer, a farmer – and many other things.

And on April 26-27th at the AAWC Wound Infection Summit, the same concept is likely to apply. On those days in Atlanta, some of the brightest minds and advanced care givers in wound care will gather to share expertise on a range of topics as vast as Mr. Jefferson’s accomplishments.
It is there when attendees will learn about the cost of wound care, the gaps in research and practice, how to bring research to the bedside, various approaches to wound care, how radiology is used in wound care, the impact of topical treatments on wounds, and the necessity of a systemic approach to wound treatment, among many other topics.

Like the Nobel recipients listening to Mr. Kennedy, the Summit attendees will hear from those most connected with advancing these matters in a practical environment. Registration is open at WoundInfectionSummit.com. Don’t miss your chance to join the best thinkers and practitioners in wound care.

In coming weeks, the AAWC will share speaker highlights and new research findings of the Wound Infection Summit – Atlanta. Stay tuned!

Medical Stewardshp in the Wound Care World

The principle of stewardship centers on an individual’s responsibility to use resources in a responsible manner. In medicine the emergence of resistant organisms has given rise to the concept of antibiotic stewardship.

Initial efforts, focused primarily on inpatient antibiotic use, led to the development of hospital stewardship committees monitoring patterns of resistance and antibiotic utilization.  But what about outpatient wound care centers? Antibiotic and antiseptic use follows no prescribed guidelines and varies drastically between centers.

Recent evidence suggests patients on antibiotics heal faster. However, in the absence of reliable diagnostic tools and the inaccuracy of clinical examination in making the diagnosis of infection in chronic wounds, clinicians prescribe antiseptics and antibiotics in a random fashion.

The AAWC Wound Infection Summit will face head on antibiotic stewardship in the wound center, presenting evidence and suggesting practical approaches. Join us in Atlanta April 26th and 27th to become a better steward. Click here to learn more or to register for the Wound Infection Summit – Atlanta.

Meeting Makes a Difference

When it comes to treating wounds and providing best in class care for patients with wounds, none can go it alone. And with the numerous and different medical professionals typically involved in the care of any one individual, unique perspectives come to the bedside to develop a comprehensive treatment plan. Best outcomes result from cross-professional collaboration.

This is one of the many reasons why the AAWC Summits are crucial to advancing wound care. Those attending find an emphasis on audience interaction during the educational sessions, in the exhibit halls, and at the breaks. Speaker presentations are interesting and professional, engaging with the audience, sharing their experiences, and inviting the audience to do the same.

Professionals in all segments and levels of wound care gather to think, to listen, to share, to learn. A recent AAWC Summit focused on care and treatment of pressure ulcers. There was increased attendance from the previous year, with feedback indicating nearly all respondents found the sessions met or exceeded their expectations. Participant evaluations referred to the meeting as “thought provoking”, “interactive”, “evidence-based”, “cutting edge”, “relevant” and “practical”.

Among the most well-received program elements was the newly included patient success stories. Several patients benefiting from wound care specialists shared the challenges and triumphs of their wound healing journeys. In this video, wound care patient Tom Barnard shares his experience with the complications of paraplegia and how the support of a caring wound care clinician and family helped him overcome the associated pressure ulcer challenges.

The AAWC plans four additional regional Summits for 2019: three comprehensive wound infection summits and one lower extremity summit. In addition, the AAWC has been invited to develop a specialty advanced wound care track at the global summit for Complex Cardiovascular Catheter Therapeutics (C3), and others at DFCon 2019 and Desert Foot conferences focusing on wounds to the feet. You may view the full line up of AAWC Summits and Invited Tracks online.

There is no profession which benefits more than medicine from collaboration and sharing best practices and lessons learned. The AAWC Summits create professional forums for these exchanges. Participating is crucial to advancing wound care and advancing our collective roles in improved patient outcomes. February’s Pressure Ulcer Summit reached maximum enrollment and the upcoming summits are sure to fill quickly. Registration for the April Wound Infection Summit is now open. Make plans now to join us! Click here to register.

More than Calor, Dolor, Rubor and Tumor

The classic signs of infection first recorded by Celsus in the first century A.D. (warmth, pain, redness and swelling) fail the wound clinician. Infected chronic wounds do not exhibit the classic signs and symptoms known since antiquity. As a result, clinical examination detects only a percentage of infections. Unseen biofilms mature in the non-healing ulcers open for weeks to months. Scientific research on infection in chronic wounds is expanding rapidly; however, a gap in knowledge exists between the bench and the bedside. 

The AAWC plans to convene three Wound Infection Summits this year focusing on infection in chronic wounds. These inter-professional conferences will examine the scope of the problem, present the latest evidence from the lab to recently completed clinical trials, and provide attendees with practical information that will have an immediate impact on their practices. The meeting format encourages discussion and debate.

Registration is open for the AAWC’s First Wound Infection Summit of 2019 in Atlanta from April 26-27th. Join us to advance the practice of wound care and learn from one another how we can improve our practices on behalf of our patients.

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Price is Right

The AAWC welcomed Former Secretary of Health and Human Services director, Tom Price, MD, to the Pressure Ulcer Summit to address whether the problem of pressure ulcers and chronic wounds has finally grabbed Washington’s attention? After speaking with the Secretary and listening to his lecture, it is clear that it has.

In his address, Secretary Price emphasized that politics are all about relationships. If the AAWC wants to influence policy, the AAWC must get to know key elected officials, especially members of their staff. In return, when a matter develops or counsel is needed on a wound related issue, Congress will turn for guidance to the society with whom they are most familiar: The AAWC.

Secretary Price outlined a plan. First, meet your regional representative, preferably in his or her home district. Share success stories about healing patients and the challenges in the wound care profession. Consider what is known in Washington as a “fly-in,” where select AAWC members come together in Washington to educate their congressional representatives on the issues facing the profession and patients. Make the fly-in a regular event. He recommended forging relationships with staffers as well as the legislators themselves. The representatives rely heavily on their staffs and when informed on matters, they can serve as advocates for the AAWC. Finally, keep in mind that if the AAWC is not present in Washington, DC and does not engage and inform Congressional representatives, another organization will fill the void.

To the applause of the members of the eight societies that joined together in support of the Pressure Ulcer Summit, Secretary Price stressed the importance of speaking with one voice. Disagreement between societies, he said, will not be mediated by Congress. On the contrary, they will find a united group and engage with them.

The AAWC must speak with one voice! Our plans for 2019 include engaging as much as Secretary Price recommended. On the ground in DC is are partner organizations willing to help the AAWC approach those on the Hill most influential on matters important in wound care. The AAWC is listening to its membership to bring together with one voice the issues which need to be before Congress. The AAWC is grateful to Secretary Price for recognizing the leadership role the organization plays in the wound care community. We look forward to seeing him and others in DC.


The Value of Coming Together - Part 2

Last week I told you how fortunate I was to attend the AAWC’s 2nd Pressure Ulcer Summit (PrU Summit) in Atlanta. Along with three colleagues and nearly 200 others, we learned about the latest research, thinking, and best in class approaches to the challenges of managing pressure ulcers. Today I wish to share a few of the key learnings I took away from the Summit.
 
Day one of the conference brought a lot of excitement about the topic of pressure ulcers.  In the room were researchers, physical therapists, physicians, surgeons, nurses, nurse practitioners, product specialists, and administrators from across the world.  The first presentation gave us a patient’s perspective on the issue of pressure ulcers. That set the stage for the remainder of the conference.  An important feature of the PrU Summit was learning how to make pressure ulcer prevention and treatment meaningful to the patient and individualizing care plans and treatment modalities. The remainder of the day was filled with research information on pressure-induced tissue damage both at the micro and macro level.  Most compelling was the research on offloading, including important patient considerations when determining how to offload and the choice of an offloading device to best fit the clinical situation.  
 
I also enjoyed being able to spend time with the pharmaceutical and wound care product vendors during the exhibit hours. It is important to nurture positive collaboration with corporate supporters and vendors. These interactions provide a mutual benefit. Companies can learn more about the challenges we face in wound care practice, taking this information to their teams to improve and advance product development in support of clinical practice and patient needs. In turn, these companies provide clinicians with important research and data to help drive evidence-based practice.  
 
Using the detailed research information from Day 1, the second day brought it all to a practical level.  One of my favorite sessions was the Topical and First Line Treatment program with Kelly Jaszarowski, MSN, RN, CNS, ANP, CWOCN & Stephanie Yates, MSN, RN, ANP-BC, CWOCN, which included ample audience participation. It is so good to hear from a room of clinicians what their practice, experience and opinions are, and then to have that conversation brought back to where the evidence is for those interventions. This interactive program also spawned a great conversation on wound cleansing, wound infection and biofilms, providing AAWC President Tom Serena the opportunity to remind attendees there is more to be learned at the Wound Infection Summit planned for April 26-27, 2019 back here in Atlanta.
 
There were many other take home points and practical applications offered including when surgical interventions for pressure ulcers are warranted; post-acute care considerations including choice of facility; the role of the outpatient wound center in navigating the treatment plan; and tips to secure insurance coverage for durable medical equipment. And that is where the information learned and experiences shared during the PrU Summit take us from here.  Participants left armed with new ideas and strategies to apply in their practices when they return to work. The PrU Summit also spawned research ideas to address new treatment and patient care questions that arose from the presentations and conversations. Wound care requires good research and guidelines that enable us to prevent and treat pressure ulcers while individualizing the plan to each patient, our staff, and our institution.  I invite all of us to come together to take a place at the table at future AAWC summits to discuss the questions, challenges, and research surrounding pressure ulcers.

The Value of Coming Together - Part 1

This past weekend I was lucky enough to have my hospital (Reading Hospital, part of Tower Health System) support the attendance of not only myself, but of three additional nurses from my institution at the AAWC Pressure Ulcer (PrU) Summit. Amy, the nursing quality coordinator, Sylvia, a surgical Intensive Care Clinical Nurse Specialist, and Eileen, the medical intensive care unit clinical nurse specialist are NOT wound care specialists.  The vision of our institution is that engaging the entire team will help us drive change that is meaningful, hence my decision to have our team join me at the AAWC PrU Summit.  

My team and I found ourselves in the company of more than 200 clinicians representing institutions across the U.S., including individuals and teams from many practice areas and professional levels. In addition to attending the conference, we also attended the Pre-Summit Workshop titled PrU Prevention Programs: Justify, Quantify, Strategize.  There we heard from an international team that practices in a variety of settings that face challenges very similar to ours in the states. 

One of the greatest things about this conference is that we are not here to complain about the problems of our specialties.  We all know the challenges of patient care and of our practices.  Everyone in the room is here for solutions and to discover what other colleagues are doing that works well.  We learn about how external factors such as regulatory bodies, scientific studies and other published works can augment or hinder our practices.  As a wound care specialist, I was concerned whether my Tower Health colleagues would find the Summit beneficial. My passion for wound, ostomy, and continence care drive my desire to learn more. I should not have worried. Each reported learning something different but applicable from the Summit and agreed they would bring back learnings which would help in their day to day practice areas.  

There is extraordinary value in coming together. In listening to the challenges of others and learning how they have persevered through them and how our contributions and experiences can help others. Joining with researchers, physical therapists, physicians, surgeons, nurses, nurse practitioners, product specialists, and administrators, among others, we continue to drive the ever-changing and ever-improving specialty of wound care. And that is what I appreciated most about this conference.  You don’t know what you don’t know until you know what you don’t know.  

There is more to share about the take-aways from the Summit. Read more in next week’s blog!

The Things We Don't Know

Donald Rumsfeld famously said, “There are things we don’t know we don’t know.” From the depths of this ignorance come the most astonishing surprises and devastating disasters. In the wound care world, the unknown dangers lurk in halls of Medicare and in the sprawling, luxuriously appointed offices of private insurance companies.

The unsung heroes of the AAWC Health and Public Policy committee continuously monitor and rapidly respond to the endless policy publications of our bureaucratic overseers. Without their tireless efforts, wound care practitioners would never know the regulations that directly impact them and their patients. Recently, a physician asked me why joining the AAWC was important. I replied, “Among the many things AAWC does is protect your practice from payers and regulators because we don’t know what we don’t know.”

The AAWC has designated Public Policy as one of its three strategic pillars. We focus on the rules and restrictions that hamper our practice. In addition, we are expanding our Public Policy efforts. This month we are meeting with a member of Congress at our Pressure Ulcer Summit to discuss the challenge of pressure ulcers in the United States and the impact they have on cost and outcomes. We are expanding our initiatives to be more proactive rather than simply reactive in our advocacy on regulation and reimbursement. 
 
Strong positions on Public Policy require a committed membership speaking with one voice. Your participation and input help shape that voice and are vital to our success. Join us in protecting patients, ensuring access to care and making wound care a priority in Washington so there will be fewer things we don’t know.

Infectious Thoughts

Infectious Thoughts

    The patient seated on the exam table surprised me. I had seen him many times at hospital meetings and charity events. I quickly double checked the cover sheet on the chart to confirm his high-level connection to the institution. He presented to the wound clinic with a venous leg ulcer and wanted to enroll in one of our clinical trials. He appeared to be a candidate: My examination determined that the wound was not clinically infected, documenting a complete absence of signs and symptoms in the source documents.  The trial required a quantitative tissue culture biopsy, which I performed before placing him in compression. The following week the culture report revealed infection with a high bacterial load. Treating him with topical antimicrobials sped up his healing and he went on to complete closure in 6 weeks.

    Reflecting on the shortcomings of my clinical examination in this case led me on a career-long interest in improving lessons learned from a case such as this: the clinical signs and symptoms of infection in chronic wounds are unreliable, critical colonization is an ill-defined term, and bacterial counts may not tell the whole picture in chronic wounds. The journey continues, promising many more twists and turns as we gather more information.

    The AAWC leadership and membership agrees that this is an area that deserves focused attention. In response, we have planned a series of Wound Infection Summits for 2019. The summits will examine the current state of the art diagnostics, antibiotic stewardship and opportunities for future research. The first Summit is planned for April 26th and 27th in Atlanta and will be hosted by the Piedmont Atlanta Hospital. If you have an interest in this rapidly changing area of wound care, join us. Stay tuned to the AAWC website for program and registration information coming soon.

Advancing the Specialty

I challenge any nursing, medical or other specialty to surpass Wound Care providers in passion for their work or dedication to their patients. We are a special breed of clinicians with a unique passion for our work and dedication to our patients. However, uniqueness comes with a price: an obligation to advance wound care beyond its rudimentary beginnings. The AAWC has dedicated itself to providing forums that challenge the status quo, promote new ideas for practice and research and, most importantly, share information that immediately enhances the care we provide to the patients that so desperately need our expertise. To advance as a specialty our educational programs must not focus on novices and consist of redundant sanitized content; it requires open debate and critical evidence-based analysis. AAWC education is the best investment of your 2019 CME/CE time and money.

AAWC’s Pressure Ulcer Summit in Atlanta February 8-9 will take a deep dive into the evidence for the treatment of pressure ulcers. There are new confusing and frustrating changes in staging for pressure ulcer treatment. And it is controversial. We will debate it, review the evidence, and discuss alternative approaches. We need your perspective and want your opinion. Join us.

In April AAWC will hold its first Wound Infection Summit examining the problem of bacterial bioburden in chronic wounds. New evidence will challenge long held beliefs on the role of bacteria in healing chronic wounds. We will debate the importance of biofilms, challenge the ability of clinical examination to diagnose infection in chronic wounds. Also, we will take a hard look at diagnostics and discuss antibiotic stewardship for the wound care clinician.

As the 2019 AAWC educational program evolves, there are several more Summits across the country in development. In addition, there are new tracks in collaborating society events such as the Cardiovascular Catheter Therapeutics: Advanced Endovascular and Coronary Intervention Global Summit (C3). The AAWC will host an education track focused on a multidisciplinary approach to wound care issues such as chronic infection, pain management, edema/lymphedema treatment, use of advance wound care products, developing a clinical research program.
These AAWC 2019 educational seminars are the places where passion for our practice expands. We look forward to hearing from you, learning from one another, and sharing our skill set for the advancement of wound care.

AAWC: Your Voice on Public Policy

My end of the year blogs continue to focus on the accomplishments of our amazing AAWC volunteers. The AAWC’S Healthcare Public Policy Committee (HPPC) faced several challenges this year and the efforts of our volunteers deserves acknowledgement. When CMS proposed reducing Evaluation and Management codes from five to two categories, the change threatened a substantial reduction in physician fees, endangering the specialty of wound care. Collaborating with numerous other societies to defeat the proposal, the HPPC successfully overturned the decision thereby preserving the current payment scheme. In addition, United Healthcare (UHC) issued a problematic coverage policy during the summer limiting choices of cellular and/ or tissue-based products available to clinicians. With cooperation and assistance from the Alliance of Wound Care Stake Holders, the AAWC prepared and submitted comments to UHC to request policy changes. Finally, the HPPC evaluated and responded to numerous CMS coverage determinations and policy proposals.


On behalf of the wound care community, the HPPC remains the watch dog of the AAWC. Our volunteers continuously survey the reimbursement and regulatory landscape, responding rapidly to protect the interest of our members, allowing patients to receive best in class care. The 2018 membership survey identified public policy as one of the top priorities for the AAWC. We listened. The Committee will continue to monitor the ever-changing policies and coverage determinations with the full support of the AAWC.


A special thanks to the current HPPC members: Peggy Dotson, RN BS, Chair, Ali Baros, MD, Kara Couch, MS, CRNP, CWS, CWCN-AP, MS, Gary Gibbons, MD, FACS, Mary Haddow, RN, CWCN, Eric Lullove, DPM and Kathy Schaum, MS.

Our Future Is Bright

Que Future Mas Bello

“The future is bright,” to quote  Spanish crooner Pablo Alboran. And so it is, especially for members of the AAWC. In the next series of weekly Presidential addresses, I want to share how the accomplishments of 2018 have set the platform for a successful 2019 and beyond.
 
     Strategic Partnerships: Among the AAWC’s strongest initiatives is the Wound-Care Experts FDA-Clinical Endpoints Project (WEF-CEP). This collaborative project with the Wound Healing Society focuses on clinically relevant endpoints for wound-healing clinical trials. The result is advanced wound care products will have a smoother FDA approval pathway providing cutting edge solutions for our patients.
 
     Influential Leadership: A recently accepted article to be published in Wound Repair and Regeneration entitled “Evidence Supporting Wound Care Endpoints Relevant to Clinical Practice and Patients' Lives. Part 2. Literature Survey” was written by members of the WEF-CEP Committee. The compelling findings enabled Peggy Dotson, Marissa Carter, Vickie Driver and Gary Gibbons to appear before the FDA to discuss the details.
    
    Patient Participation: The WEF-CEP Committee reached out to those beneficiaries of our care to ask patients for their perspective on wound care products. The findings from over 400 patients are currently under review and will be published once available.  As a next step, the committee will recommend up to four scientifically achievable, clinically relevant, & patient-centered wound endpoints to serve as primary wound care outcome to the FDA.

    Your AAWC is engaged, influencing policy, and is being heard by the FDA to advocate for patients and clinicians. These are meritable achievements and a credit to your leadership and membership engagement. These accomplishments are the basis of the AAWC’s commitment to speak as one voice for the wound community.

To learn more about the WEF-CEP Project you may access the November AAWC Journal Club Webinar presented by Drs. Lisa Gould and Vickie Driver on the subject.

AAWC Launches 2019 Regional Education Series

President’s Message: The AAWC Launches 2019 Regional Education Series

    The AAWC speaks as the voice for the entire wound healing community. And we also listen to our members. More than 80 percent of members have asked for regional education events with single topic symposia.

    Tired of hearing a sanitized and simplified overview on a topic at conferences, you asked for a deep dive presented by investigators themselves. Coming in 2019 is a second annual Pressure Ulcer Summit, critically analyzing and dissecting evidence for the prevention and treatment of pressure ulcers.

A Spring regional meeting to focus on the problem of bacteria in chronic wounds is planned. Currently called W.I.S.E., Wound Infection Summit and Education, the first conference is scheduled for Atlanta in April. It will focus on the diagnosis and treatment of infection in chronic wounds. Experts will debate the latest research in wound infection. We are convinced that focused meetings such as these enable  thorough examination of topics pertinent to our membership.  

    In addition, the AAWC is bringing the meetings to you and increasing the availability of educational opportunities for everyone. We remain dedicated to our focus of being accessible, connected to our membership and collaborative, drawing on the knowledge of our interprofessional members.

    As we plan for 2019, I am reaching out personally to every member for guidance and assistance. Together we can advance the specialty of “woundology.”

    I look forward to hearing from you: [email protected]