Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - News on Dr. Levine's medical and consulting practice, and reflections on our healthcare system.

Category: Pressure Ulcers & Wound Care

Pressure Ulcer Care in Hospitals: What We Can Learn from the Texas Ebola Debacle

A simple lapse in communication in a Texas hospital resulted in a patient with a deadly contagious disease being discharged home. The information regarding the patient’s travel history was recorded into the electronic medical record (EMR) by a nurse but not transmitted to the doctor who made the decision to discharge him. Such an error seems difficult to comprehend, but this type of communication mishap …Read More

Pressure Ulcer as “Never Event”: Fact or Myth?

The term “never event” is commonly applied to pressure ulcers, giving the impression that they are always associated with medical error. As such, it lends this outcome an emotional charge that can lead to misplaced patient dissatisfaction and unnecessary accusations of wrongdoing or poor quality. Although pressure ulcers are sometimes associated with factors such as inadequate staffing and nutritional care, the preventability of all pressure …Read More

Webinar on Wound Care for Medical Directors in LTC

Later this month I will be giving a free webinar sponsored by McKnights Long-Term Care News & Assisted Living entitled Wound Care: What the Medical Director Needs to Know. This Webinar will be part of McKnights 8th Online Expo, that will feature other webinar topics including MDS 3.0 update, technology in LTC, and survey preparation.  McKnight’s Long-Term Care News is a news magazine serving the institutional …Read More

Webinar on Palliative Care for Chronic Wounds

When healing is not the goal, a palliative care approach can reduce suffering, avert painful procedures, and reduce re-hospitalizations.  I will be giving a live webinar on Thursday, February 13th from 12 to 1 PM on Palliative Care for Chronic Wounds, sponsored by the New York State Department of Health Gold STAMP Program to reduce pressure ulcers. This free program will run for approximately 50 minutes, followed …Read More

New Research Suggests Hypotension is a Risk Factor for Pressure Ulcers

The industry-wide acceptance of risk assessment scales for pressure ulcers has gotten us accustomed to evaluating risk factors for skin breakdown. The most popular is the Braden Scale which incorporates subscales of sensory perception, moisture, activity, mobility, nutrition, and friction and shear. There are however, other factors which add to pressure ulcer risk which need to be taken into consideration. According to research recently published in the …Read More

Wound Healing in the Geriatric Patient

I recently served as guest editor of a special issue on aging for Today’s Wound Clinic, a magazine devoted to contemporary approaches to wound clinic management.  This special issue on the geriatric patient was published in November/December 2013, Volume 7, Issue 9. Please take a look at the links below to the articles. The following paragraphs are reprinted from my editorial.  I developed an interest …Read More

New Research Challenges “Q2H” Turning Standard for Pressure Ulcer Prevention

The industry standard for turning and repositioning a patient at risk for pressure ulcers is every two hours. There is, however, limited research to support this standard. As the costliest elements of pressure ulcer prevention are support surfaces and repositioning, a change in this standard would have major economic impact. A research study published in the October 2013 issue of the Journal of the American …Read More

The Unavoidable Pressure Ulcer Gains Credibility with Geriatrics Practitioners

The 8th Edition of the Geriatric Review Syllabus (GRS8) released this year contains a brief but significant addition to the chapter on pressure ulcers: a section on the unavoidable pressure ulcer. This is the first time an official study guide for the medical specialty of geriatrics acknowledges that pressure ulcers can occur in the regular course of care delivery. The GRS is published by the …Read More

CMS recognizes the Kennedy Terminal Ulcer in Long-Term Care Hospitals

The Kennedy Terminal Ulcer (KTU) has been around for over two decades, and continues to play a large part in discussions as to whether pressure ulcers are avoidable or unavoidable. Until now the Center for Medicare and Medicaid Services (CMS) has not acknowledged the KTU in its regulatory and reimbursement guidelines for hospitals and nursing homes. In a new transmittal from CMS, the KTU can …Read More

Peripheral Arterial Disease: an Often-Overlooked Cause of Poor Wound Healing

This article was published in Today’s Wound Clinic, Volume 7, Issue 5 (June/July) 2013 and is available on-line. It was authored by myself and Michael Cioroiu MD, FACS, CWS, who is co-director of the Center for Advanced Wound Care at Beth Israel Medical Center. Peripheral arterial disease (PAD) of the lower limbs is often neglected when evaluating reasons for poor wound healing, particularly in elderly patients. …Read More