Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society最新文献

{"title":"Comparative Evaluation of Microbial Transfer in Intermittent Catheters: An in vitro Study of Protective Features Against Uropathogens.","authors":"Nicole L Dean, Mariely Medina-Rivera, Daniel Gordon, George Skountrianos, Abdullah I Mafiz, James Gras, Aaron Strickland, Tadas S Sileika, Michael Craven","doi":"10.1097/WON.0000000000001326","DOIUrl":"10.1097/WON.0000000000001326","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated whether protective features incorporated into commercially available intermittent catheter (IC) types reduce microbial transfer contamination during catheterization.</p><p><strong>Design: </strong>A previously developed in vitro Contamination Touch Transfer Method (CTTM) was used to model microbial transfer during catheter handling and insertion.</p><p><strong>Materials and methods: </strong>Four hydrophilic intermittent catheters (ICs) from 2 brands (TSC-A, TSC-B; SC-1, SC-2) and 2 French sizes (14 Fr, 16 Fr) were evaluated in an in vitro simulated urinary tract model. The TSC-A and TSC-B incorporated a ring cap, introducer tip, and protective sleeve, whereas SC-1 and SC-2 incorporated a protective sleeve only. To assess microbial contamination under worst-case conditions, the model meatus and operator's gloved hands were inoculated with approximately 10 8 colony-forming units of Candida albicans , Escherichia coli , or Enterococcus faecium . Microbial recovery from catheter segments was analyzed on the log 10 CFU scale using Tobit mixed-effects models to account for enumeration method-specific limits of quantification and experimental replicate effects. Sleeved catheter segments were compared with corresponding unsleeved controls, and catheter-type differences were evaluated for the first 2-inch (5 cm) catheter segment within each microorganism and French size.</p><p><strong>Results: </strong>Sleeved catheter segments generally showed lower transfer contamination than corresponding unsleeved controls, with 46 of 48 planned comparisons statistically significant after Holm adjustment. There were statistically significant overall catheter-type differences within all 6 Microbe x French size families. TSC catheter types incorporating a ring cap, introducer tip, and sleeve had significantly lower transfer contamination than sleeve-only SC catheter types in 21 of 24 planned cross-type comparisons. Separation was most consistent for C. albicans and E. faecium across both French sizes. For E. coli , TSC catheter types had significantly lower transfer contamination than SC catheter types at 14 Fr, but fewer pairwise comparisons were significant at 16 Fr.</p><p><strong>Conclusions: </strong>These findings indicate that catheter protective features reduce microbial transfer contamination to the underlying catheter tube. Under this in vitro transfer contamination model, IC designs incorporating a ring cap, introducer tip, and protective sleeve provided more consistent reduction in transfer contamination than sleeve-only designs.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Offloading Lesser Toe Deformities: A Case Study.","authors":"Stephanie R Cunningham Gregor","doi":"10.1097/WON.0000000000001321","DOIUrl":"https://doi.org/10.1097/WON.0000000000001321","url":null,"abstract":"<p><strong>Background: </strong>Lesser toe deformities such as hammer, mallet, claw, or cross over toe deformities are common in the elderly. They are attributed to mechanical, neuromuscular, congenital, inflammatory arthritis, or other disorders. They become clinically relevant when they produce pressure and friction at the distal ends of the digits leading to preulcerative callus or ulcer formation. These deformities can be difficult to offload with custom orthotics, accommodative footwear, and off-the-shelf devices such as crest pads and toe crutches.</p><p><strong>Case: </strong>Mr. D was an 82-year-old man with bilateral lesser toe deformities and a history of preulcerative callus and ulceration. This case describes use of a custom silicone molded toe prop/orthoses to offload pressure on the distal toes.</p><p><strong>Conclusion: </strong>Custom silicone molded toe props/orthoses can be used to offload areas of concern because of pressure and friction with lesser toe deformities, decreasing preulcerative callus, reulceration, and pain. In this case, use of molded toe props/orthoses devices provide less costly than custom orthotics or off-the-shelf devices for patients, and they were well tolerated.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"435-438"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in Procedural Tasks and Decisions Made During Ostomy Pouching System Changes Performed by Nurses With Different Nursing Credentials: A Clinical Simulation Study.","authors":"Marketa Haughey, Melinda Harman, Casey S Hopkins, Hannah Gerlach, Leena Syed, William Bridges, Abigail Washburn, David M Neyens","doi":"10.1097/WON.0000000000001315","DOIUrl":"10.1097/WON.0000000000001315","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to explore clinical practice and decisions made during ostomy pouching system changes and procedures performed by nurses with different nursing credentials using a validated metric-based clinical simulation procedure.</p><p><strong>Design: </strong>Explanatory sequential mixed methods design.</p><p><strong>Subjects and setting: </strong>The study population comprised 24 participants with different nursing credentials: 6 were certified ostomy care nurse specialists, 8 were registered nurses working in acute care, and 10 were senior baccalaureate student nurses. Data were collected between September 2021 and February 2024 at the Clinical Learning and Research Center within the Clemson University School of Nursing (Clemson, SC, USA).</p><p><strong>Methods: </strong>This study used a validated metric-based clinical simulation procedure to assess tasks performed during ostomy pouching system changes, task duration, and supplies used. The simulated experience was followed by administration of the System Usability Scale and a structured debriefing interview. Two-way repeated-measure ANOVA, mixed-effects logistic regressions, and single factor ANOVA were used to analyze quantitative variables according to variable type. Content analysis was used to analyze debriefing interviews and comments made by the participants during the simulated experience.</p><p><strong>Results: </strong>Certified nurses with expertise in ostomy management (CWOCN, CWON, COCN) spent significantly longer performing ostomy and peristomal skin care and pouching system changes tasks when compared with registered and student nurses. Differences between the nurse groups were observed for product selection, skin barrier sizing and adhesion, ostomy and peristomal skin care, along with infection control task categories. Scores on the perceived usability of ostomy pouching systems were above average for ostomy care specialists and registered nurses. Certified nurses with expertise in ostomy care had significantly higher perceived usability scores when compared with student nurses.</p><p><strong>Conclusions: </strong>Variability in psychomotor and critical thinking tasks were observed among 3 groups nurses with different credentials. This knowledge provides targets for expanding training of nurses in ostomy care.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":" ","pages":"402-415"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Pressure Injury Development in Black or African American Critically Ill Patients: A Multisite Retrospective Case-Control Study.","authors":"Jeanne Hlebichuk, Carolyn Jacobson, Jessie Hooks, Alexander Ruffetti, Michelle Emick","doi":"10.1097/WON.0000000000001322","DOIUrl":"10.1097/WON.0000000000001322","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate pressure injury (PI) occurrences, along with risk and protective factors for PI in critically ill Black or African American patients.</p><p><strong>Design: </strong>Retrospective case-control (1:4 case to control ratio) multisite study.</p><p><strong>Subjects and settings: </strong>The target population was Black or African American patients receiving care in intensive care units (ICUs) at 4 medical centers in the Midwestern United States. The sample comprised 650 participants; 130 (30%) had pressure injuries (cases) and 520 (80%) were controls. Their mean age was 61 (SD 16.6) years, 53% (n = 345) were male. Data were collected from January 1, 2023, to September 30, 2023.</p><p><strong>Methods: </strong>Data were extracted from an electronic health record report and manual abstraction. The outcome was PIs, and exposure was ICU stay. Demographics and pertinent clinical variables were collected using a standardized form designed for purposes of the study. Pressure injury characteristics were compared between cases and controls with differences between groups analyzed with logistic regression to identify risk factors for PI.</p><p><strong>Results: </strong>Fourteen different skin preventive interventions were used, with a mean of 5.38 interventions (SD 2.45) per patient. Cases had M = 1.32 (SD 0.72) pressure injuries that occurred 13.7 (SD 16) days from admission. Most PIs were in the inguinal area and partial thickness (Stages 1 and 2) with (n = 31, 18%) medical device related and (n = 26, 15%) resolved at discharge. Logistic regression modeling showed that nutrition consult (β = 1.17, P < .001), number of days on a vasopressor (β = .047, P = .038), and fecal incontinence (β = 1.58, P < .001) were associated with an elevated risk of PIs. Patients with higher Glasgow Coma Scale scores (β = -.125, P = .009) and albumin (β = -.698, P = .023) had a lower likelihood of developing PIs.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study to examine PI solely in Black or African American ICU patients. Predictors of PI development align with previous literature. Pressure injury locations were consistent with predictors in logistic regression modeling. Future work on early identifiers and prevention implementation is warranted.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"376-385"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Driven by Passion, Defined by Impact: Celebrating the WOCN Fellows Class of 2026.","authors":"Christine Chris Berke, Kevin Emmons","doi":"10.1097/WON.0000000000001323","DOIUrl":"https://doi.org/10.1097/WON.0000000000001323","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"367-368"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Simplifying Skin Failure: A Response to the Skin Failure Think Tank.","authors":"Kenneth Olshansky","doi":"10.1097/WON.0000000000001324","DOIUrl":"10.1097/WON.0000000000001324","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"442"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: Simplifying Skin Failure: A Response to the Skin Failure Think Tank.","authors":"Joyce Marie Black","doi":"10.1097/WON.0000000000001320","DOIUrl":"10.1097/WON.0000000000001320","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"443"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JWOCN Manuscript Award Winners (2026).","authors":"Mikel Gray","doi":"10.1097/WON.0000000000001331","DOIUrl":"https://doi.org/10.1097/WON.0000000000001331","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"364"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Our Future Through Integrity, Leadership, and Knowledge.","authors":"Christine Chris Berke","doi":"10.1097/WON.0000000000001314","DOIUrl":"https://doi.org/10.1097/WON.0000000000001314","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"365-366"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatological Effects of a Beeswax-Pine Resin Mixture on Abdominal Skin: A Proof-of-Concept Study Supporting the Development of an Affordable Investigational Ostomy Pouching System in Low-Income Regions.","authors":"Darienne Rogers, Joanna Peng, Amy Guan, Westbrook Jensen, Jessica Alvarez, Pooja Patel, Ayesiga Herman, Dorothy Dow, Ann Saterbak, Amy Barto","doi":"10.1097/WON.0000000000001316","DOIUrl":"https://doi.org/10.1097/WON.0000000000001316","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare short-term abdominal skin responses, including erythema and edema, after the application of 2 beeswax-pine resin mixtures and a hydrocolloid sample prepared from an ostomy barrier ring used as an active comparator.</p><p><strong>Design: </strong>Proof-of-concept, blinded, within-participant comparative skin irritation study.</p><p><strong>Subjects and setting: </strong>The sample comprised 50 healthy volunteers over 18 years of age; 54% (n = 27) were female; 68% (n = 34) were White, 18% (n = 9) were Asian, 4% (n = 2) were Black, 6% (n = 3) were multiracial, and 12% (n = 6) were Hispanic. The study setting was Duke University campus, located in the southeastern region of the United States.</p><p><strong>Methods: </strong>Participants simultaneously wore 3 samples: the first was a beeswax-pine resin sample with beeswax sourced in the United States; the second was a beeswax-pine resin sample with beeswax sourced from Tanzania; and the third was a hydrocolloid active comparator from an ostomy barrier ring. Participants were examined by a physician on day 1 for preexisting dermatologic conditions on the lower abdomen, after which the 3 samples were placed and each covered with a thin-film wound dressing. The samples and dressings were removed and replaced daily, and a daily survey prompted self-reporting of adverse effects (itching and redness). Participants returned on day 7 for follow-up evaluation. The physician rated edema and erythema using the Draize skin scale (a previously validated instrument). Equivalence of the difference in mean day 7 combined Draize scores between each beeswax-pine resin mixture and the active comparator was tested using the Schuirmann two one-sided test procedure for equivalence.</p><p><strong>Results: </strong>Day 7 Draize score assessments were analyzed from 35 subjects; 15 did not complete data collection for all end points. Both the United States and Tanzanian sourced beeswax-pine resin preparations were equivalent to the active comparator based on the mean differences in Draize scores (erythema plus edema) using the two one-sided test procedures for equivalence.</p><p><strong>Conclusions: </strong>The beeswax-pine resin mixtures did not produce increased short-term skin irritation when compared with the hydrocolloid active comparator, supporting further evaluation of this material as a skin-contact adhesive in an investigational ostomy pouching system.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"416-424"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}