Eloquent Learning Health Wound Care Blog

1 Desember 2011

2011-12-01T15:18:00.000+02:00

Dear Wound Care Enthusiast

The last month of the year is finally here. Today all we can do is to be thankful for all the blessings we had this year. This was truly a remarkable year from the Wounds International Conference till the last event which was the Diabetes Open day on the 26th of November 2011. I also had the opportunity to give a presentation at Ann Latsky Nursing College to the Gauteng Department of Health with regards to Pressure ulcer Management this week. The need for education is certainly underestimated in South Africa and it is great to see health professionals taking action in improving quality but also in empowering individuals.

Diabetes Open Day

Holistic Wound Management at our new venue

The Diabetes open day was a interesting and it also showed the importance of working in collaboration with different disciplines such as Opthometry,
Nutrition, Wound Care, Diabetes Education.

Practical explaining value of ABPI

With the last Holistic Wound Management Course we were also able to do a little more practical. The value of ABPI was also discussed and students were able to work with a handheld doppler as well as experience the new Ability Diagnostic Device as demonstrated in the photo. Next year is full of new opportunities as well as new courses and we are lookking forward to providing the best possible training in our field of expertise.

May you experienced a blessed December expect God's best because you are worth it!!

“Some excel because they are destined to, most excel because they are determined to.”

Best Wishes & a blessed Christmas

The Eloquent Team

Only 6 days to go!

2011-11-02T22:52:00.000+02:00

Only 6 days to go before we have our final Holistic Wound Management Course for 2011. This year is certainly closing fast. Remember to register for the upcoming Eloquent Breakfast on the 23rd of November 2011.

Pressure Ulcers still are a major problem world wide and in South Africa we are not the exception. A pressure ulcer has been defined by the National Pressure Ulcer Advisory Panel (NPUAP) as any lesion caused by unrelieved pressure that result in damage to underlying tissue. Even though pressure as external force may be a key causative factor other contributing forces such as moisture, shear, friction, immobility, sensory loss and certain underlying medical conditions cannot be excluded (www.npuap.org). Below is a table that relates the general principles of pressure ulcer care to the Wound Bed Preparation Recommendation/Guideline that was launched at the Wounds International Conference in February 2011. Always remember to first TREAT THE CAUSE as well as PATIENT CENTRED CONCERNS before you focus on the loca wound care.

GENERAL PRINCIPLES OF PRESSURE ULCER THERAPY	WOUND BED PREPARATION RECOMMENDATIONS
1. Relieve pressure	Identify & Treat the Cause - Diagnose and correct or modify treatable cause of tissue damage (No. 2 – Level of Evidence IV)
2. Eliminate reversible predisposing conditions	Identify & Treat the Cause - Assess the patient’s ability to heal. Adequate blood supply must be present as well as the correction of other important host factors to support healing (No.1 – Level of Evidence IV)
3. Avoid Friction, Shearing & Maceration	Patient Centered Concern - Assess and support management of patient centered concerns to enable healing (Pain & Quality of life) (No. 3 – Level of Evidence IV)
4. Debride Devitalized Tissue	Local Wound Care - Debride healable wounds, removing non-viable, contaminated or infected tissue (No. 6 – Level of Evidence IB)
5. Provide optimal wound dressing care	Local Wound Care - Select a dressing that is appropriate for the needs of the wound, the patient and the caregiver or Clinical Setting. (No. 9 – Level of Evidence IV)
6. Diagnose and treat soft tissue and bone infection	Local Wound Care - Assess and treat the wound for increased bacterial burden or infection. (No. 8 – Level of Evidence IIa)
7. Provide appropriate rehabilitation efforts	Patient Centered Concern - Provide patient education and support to increase adherence to treatment plan (No. 4 – Level of Evidence IV) Provide Organizational Support - For improved outcomes, education and evidence base must be tied to interprofessional teams with the cooperation of health care systems (No. 12 – Level of Evidence IV)
8. Perform operative closure, as appropriate	Local Wound Care - Use active therapies (biological agents, skin grafts, adjunctive therapies) when other factors have been corrected and healing still does not progress. (No. 8 – Level of Evidence IIa)

Rubenstein centre of Excellence

2011-10-27T22:10:00.000+02:00

Rubenstein Centre of Excellence

Today we had an informative meeting at the Centre introducing the various services available at the Centre. Liezl Naude introduced the audience to the Vision & mission of both the Advanced Lower Limb & Wound Managment Centre as well as Eloquent Learning Health. Deidre de Jongh introduced the De Jongh Optometry Centre. All 3 specialities are focussed on providing a service of excellence as part of a multi-disciplinary team.

The main focus of Eloquent Learning Health is to promote wound care excellence through providing scientific based education and practical skill application to all participants in the Eloquent courses. Our flagship course the Holistic Wound Management Course is now a 2 day course with a 1 day practical session in a clinical centre. This course focuses on Anatomy, Physiology, Patient Assessment as well as Treatment Planning according to the Wound Bed Preparation Guideline. The session on Product application focuses on the available products in South Africa and students are exposed to all the products available according to the WHASA classification system. Products are discussed in a neutral setting within the classification system; clinical experience and discussion are encouraged to facilitate optimum knowledge sharing.

You are welcome to visit the website for more information on all our events and other advanced courses. You are also invited to join us for our first breakfast event on the 23rd of November 2011 at the Centre please register on the website in order to be able to attend.

Thank you for your valued support, we strive to stay true to our mission in working towards wound care excellence.

The Value of ABPI

2011-10-21T17:47:00.000+02:00

Case Scenario:

Mr. P is a 60 year old male patient with a history of arterial insufficiency he had a fem-pop 16 years ago. Was admitted to hospital 5 weeks ago with severe cellulites, extensive bilateral wounds and "arterial insufficiency". Health Practitioners discussed above knee amputations with patient due to severity of the problem. Patient discharged himself from hospital one week ago after being on Ciprobay for 3 weeks (he completed the course).

First consultation at Centre of Excellence - Bounding foot pulses, clinical signs of venous hypertension with lipodermatoscerosis as well as oedema. Patient is a smoker and also hypertensive. Ankle Brachial Pressure Index was done by using the new Huntleigh Ability Diagnostic Device Left leg 1.06 and Right leg 1.03. No arterial insuffieciency a normal reading. Wounds were sloughy with senecents cells and signs of biofilm and an increased bioload. Wounds were dressed with Sorbact Hydroactive (in order to decrease bioload and facilitate autolytic debridement) and Compression Bandages (to address underlying venous hypertension and venous insufficiency).

Follow up consultation after 3 days - all wounds decreased in size with signs of healthy granulation and epithelial tissue present. Slough and biofilm were removed via sharp debridement. Oedema also decreased and overall patient improved significantly. Wounds were dressed the same way with Compression bandages. Patient was able to walk with ease and pain decreased to 3/10.

Perhaps the questions that need to be answered are:

Was there ever an ABPI measurement done during the last month?
Why was amputation even considered in a case like this?
Why 3 weeks antibiotics with no biopsy?

It's about getting back to basics first treat the cause and determine the diagnosis as well as the patient centered concerns before you address local wound care. In this case the cause was Venous Ulceration since the arterial problem was dealt with. The patient centered concern was fear, decreased quality of life as well as pain. Local wound care: Wounds needed debridement and moist wound healing principles together with Compression therapy.

What was great about working with this patient: to change his quality of life, and to be able to make a difference without using the most expensive methods available to us. And also to be able to see a difference in only 2 consultations. Can't wait to see the end result!

Diabetes Run/Walk Challenge

2011-10-12T10:27:00.000+02:00

Dear Wound Care Enthusiast

Diabetes SA will be holding their Gauteng Global Diabetes Run/Walk at the Voortrekker Monument in Pretoria on the 19th fo November 2011. This is the perfect opportunity to raise awareness for diabetic foot care as well as the importance of early intervention in order to save limbs. Registration is open online at www.diabetessa.co.za R30 adults and R20 per child.

We would like to challenge all Eloquent members to join us on the day to make a difference and to create awareness for the just cause of saving limbs.

For more information and any ideas on how we can raise the Lower Limb Salvage profile contact the Advanced Lower Limb & Wound Management Centre at (012) 998 9982. We would also love to hear who will be taking on the challenge.

Have a great week and remember:

"The most practical, beautiful, workable philosophy in the world won't work - if you won't."

The Eloquent Team

Eloquent News

2011-10-06T11:36:00.000+02:00

The past 2 month have been quite busy and we are very excited about the way forward. Eloquent is now fully operational at our new training venue at 886 Rubenstein Drive Moreleta Park. We have also successfully completed the Advanced Lower Limb Symposium, comments and photo's can be viewed on the Eloquent website at www.eloquent.co.za. We also had our first Holistic Wound Management Course presented at the new training venue in September 2011. Our next upcomming course will be at Rubenstein Centre from the 9th - 10th of November 2011. Registration is open and limited to 16 delegates.

Looking forward to posting some photo's soon about the new building!

"Find something you love to do and you'll never have to work a day in your life". - Harvey MacKay

Upcomming Advanced Lower Limb Management Symposium

2011-07-28T15:04:00.000+02:00

On Track

2011-07-14T13:26:00.000+02:00

We are truly living in exciting times. Only one week to our next Holistic Wound Managment Course in Pretoria. This time the course will be presented close to the new premises that will be opening in August. Currently the building site is in a bit of an inflammatory phase and the builders are removing all the foreign debris, hopefully we will be entering the Proliferation phase soon and Maturation will start in August 2011. You are welcome to come and visit us during August to experience this transition first hand!! (Inflammatory phase at the moment is not advisable! :-))

We are also very excited about the latest Speaker Dr. Elsa van Duuren (President of the Rheumatology Association) joining forces with the Advanced Lower Limb Symposium 26-27 August 2011 at St. Georges Hotel. Remember Early registration ends 27 July 2011. Remember to visit the website www.eloquent.co.za to make your booking as soon as possible since only a limited number of delegates are allowed due to the practical courses. Final program will be available shortly.

"Education is the most powerful weapon which you can use to change the world" - Nelson Mandela

Holistic Wound Management - East Rand 8-9 June 2011

2011-06-15T09:43:00.000+02:00

Finally we had our first East Rand Holistic Wound Management Course - Thank you FEBE! Attendees had a very cold East Rand to battle with but made mince meat of the course. This time we were joined by a wide variety of students including a Pharmacist as well as Practice Manager! Looking forward to the next course. We will keep you posted about the date. Good luck to the students with their portfolios and practical sessions!!

The Eloquent Team

EXCITING NEWS

2011-06-15T09:36:00.000+02:00

We are very excited to announce that the registration has openened online for the Advanced Lower Limb Management Symposium 26-27 August 2011 at the St George Hotel and Convention Centre, Gauteng. Please visit the website at www.eloquent.co.za for more information.

First Holistic Wound Management Course in Potchefstroom

2011-05-12T08:48:00.000+02:00

Last week we had our First Holistic Wound Management course at the Elgro Hotel in Potchefstroom. We had a great time with positive feedback from the delegates eager to use their newly aquired knowledge in practice.

In the words of some of the delegates:

"The wound management course was very useful and also encouraging. I have learned a lot and also benefited a lot" - Patty

"I liked the step by step way of wound assessment and the detail we received. It was also good to do our won assessments so we more or less know what to do and in which phase the wounds are. Thanks for a good course" -Stefan

"Die aanbieder ken haar vak, sy is nie eentonig nie! Kan dalk kurses 3 dae maak, meer tyd vir prakties! Het baie geleer en dit was interessant aangebied." - Wilna

The 2 days were jam-packed, but full of fun especially with regards to the games we played and the case discussions. Now it is time for the students to complete their portfolio's and their practical day together with Dr. Petra Kahl. We are frilled to have Dr Petra out of hospital and wish her a speedy recovery.

Looking forward to the next East Rand Holistic Wound Management Course from the 8-9th of June 2011

The Eloquent Team

Training needs

2011-04-29T11:53:00.000+02:00

Eloquent is now moving into a new direction. It is clear that we all have less time and financial resources available for attending training events. Keeping in mind that the global economy is still in recession and sponsorships are far and in between for educational events such as conferences and also courses. It is therefore understandable that all over the globe education is now moving into cyber space. What is more easier than sitting in front of your computer reading through a document, and answering some questions to qualify for CPD points, or by viewing a video clip or listening to a podcast online? Surely this is more time saving than actually attending a venue, paying for the conference as well as accomodation and travel?

We are currently in the process of going online with our first E-learning course and would like to invite comments from all our readers as to what would be worth your while on E-learning. The first E-learning course will be te much anticipated "Starting & Running a Private Practice". This will be available on the Eloquent website at http://www.eloquent.co.za/ within the next 2 months.

Other topics will include:

Holistic Patient & Wound Assessment
Utilizing the Wound Bed Preparation Paradigm
Differentiating between leg ulcers
Understanding the 60 Second High Risk Diabetic Foot Screening tool
Pressure Ulcers the new grading systems - how to apply them
Products: what is available and when to use them

Hope that this will open discussion as to what you would like to learn more about in E-learning. And also that this is the start of sharing our experiences with one another. Please let us know what you want.