AGED CARE DIVISION - Quality Medical Supplies and Service ... · 2 3 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected]

PEOPLE CARING FOR PEOPLE

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Issue # 3

EBOS HealthcareAged Care DivisionFree call: 1800 269 534 Free fax: 1800 810 257Email: [email protected]

July 2012

Save the environment, sign up to receive this newsletter via email. Visit: www.eboshealthcare.com.au

Managing Incontinence related Skin ConditionsPage 8

Post Productivity Commission ReportPage 5

Negative Pressure Wound TherapyPage 16

2 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected]

... to the third edition of Carelines!

It’s just amazing how time flies, here we are again with a new edition full of articles, new products and industry news.

In this edition Susanne Macri (Associate Commissioner with the Productivity Commission on the Inquiry into Caring for Older Australians) gives us her view on the ‘post’ Productivity Commission Report, and is inviting all stakeholders in the Aged Care industry to work together to meet the challenges that lie ahead.

In the new product section we are presenting PICO - Smith & Nephew’s latest innovation in Negative Pressure Wound Therapy. You will also find information on the new Medihoney range of dressings with Leptospermum Honey for wounds and burns and the new Vernacare pulp kidney dish- the ‘greener’ alternative to plastic.

A couple of reminders on how to get in touch with us:

• The latest issue of Carelines is now available in the news section of our corporate website www.eboshealthcare.com.au

• Our new online ordering system www.ebosonline.com.au has grown to contain over 7,000 products across all the product categories you need every day for your facility. Make sure to visit the website, browse the product range and register to order online – it’s quick and easy!

• We value your feedback and love to hear from you: if you want to send any comment or suggestion on what you would like to see

next in Carelines just email us at [email protected]

Cheers,

The Aged Care Team @ EBOS Healthcare

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page 3EBOS Aged Care Division - PEOPLE CARING FOR PEOPLE

page 4What’s Making News at EBOS In the Spotlight WA: Cherie Baxter

page 5Post Productivity Commision Report - Susanne Macri

page 7Vernacare Kidney Dish

page 8Managing Incontinence Related Skin Conditions

page 9TENA - New 3 in 1 Range

page 10Medihoney

page 12In the Spotlight TAS: Melanie Sargent

page 13Conference Update

page 15Tongan Baby Packs Program

page 16Negative Pressure Wound Therapy

page 18The Importance of Wound Cleansing - Dr Gerit Mulder

National Account ManagerDebbie Greenaway0400 424 [email protected]

Key Account Manager NSWElizabeth Conridge 0419 612 [email protected]

Key Account Manager VICCarolyn Knight 0411 542 [email protected]

Key Account Manager SAJanet Pitts 0416 130 [email protected]

Key Account Manager QLDLarissa Mueller0417 524 [email protected]

Key Account Manager QLDFiona Carey0414 486 [email protected]

Key Account Manager TASPattie Reptik 0419 377 [email protected]

Key Account Manager WACherie Baxter 0405 502 [email protected]

Our Aged Care Team

2 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected] www.eboshealthcare.com.au 3

CARELINES ISSUE #3

EBOS – A FRESH, INNOVATIVE PARTNER WITH THE PEOPLE, ORGANISATIONAL STRENGTH, PRODUCTS, SYSTEMS AND COVERAGE TO HELP YOU DELIVER SUPERIOR VALUE TO YOUR RESIDENTS

With the continued expansion of the general aged care sector, aged care providers are faced with the challenge of improving quality of service to residents at an economic scale.

EBOS provides a consistently high standard of service, support and a streamlined ordering process as a single supply partner for your medical consumable and equipment needs.

We have a dedicated Product Catalogue for our Aged Care division, where our customers can easily find all the product categories they need every day for their facilities.

Our customers can then review and order these products online through our fast and easy online ordering system at www.ebosonline.com.au. A simple and efficient way to do all your purchases.

We deliver economies of scale and measurable continuous improvement without compromising best practice.

EBOS is Australasia’s largest and

most experienced provider of medical supplies and equipment across the general healthcare market. We are proud to be ‘in-tune’ with the needs of our customers and are committed to providing the most responsive and professional service levels. With a commitment to sourcing sustainable products and providing first class supply chain solutions, EBOS is an outstanding supply partner for aged care facilities.

EBOS Aged Care delivers a comprehensive support package at facility, procurement and management level. We believe we:

• are capable of demonstrating an efficient track record with a national supply chain solution

• have proven management systems and consistent service standards

• are prepared to develop innovative support platforms that complement your culture and strengths

• offer a competitive price without compromising service or support levels

Most importantly, our people bring a commitment to customers, fresh ideas, integrity and determination that provide the best possible service and supply chain solution.

EBOS Aged Care DivisionPEOPLE CARING FOR PEOPLE

AGED CARE DIVISIONPeople car ing fo r peop le

We can meet all your product and service requirements

across all of the following categories:

One Supplier One Place

Infection Prevention

Wound Care

Medical Consumables

Incontinence

Rehab EquipmentNutrition

Key Account Manager TASPattie Reptik 0419 377 [email protected]

Key Account Manager WACherie Baxter 0405 502 [email protected]

4 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected] 4 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected]

Cherie Baxter is our Key Account Manager in Western Australia and has been with our Aged Care Team since early 2011. Cherie has worked in the healthcare industry for about 12 years and has a very hands on background in operations and customer service. What she enjoys most about her role at EBOS is working with her customers and offering a high level of customer service to ensure the best possible solution every time.

Here are a few things you may not have known about Cherie...

What chore do you absolutely hate doing? Cleaning the bathroom

If you won the lottery what is the first thing you would do? Buy a villa in south of France

Whats your favourite song of all time? Guns and Roses – November Rain

Who inspires you? My family!

If you could witness any event past, present or future, what would it be? The End of World War II

If you could choose anyone, who would you pick as your mentor? Dr Fiona Stanley (Perth Burns Specialist)

What is your favorite time of day/day of the week/month of the year? Dinner time (I love preparing dinner with a glass of wine) , Fridays (what can I say it’s the end of week), December (I love the Xmas festive period with my family and friends, plus it’s my birthday)

We have just launched our new EBOS Healthcare website.

It’s fresh, vibrant and informative. You can learn more about who we are and what we do at EBOS Healthcare. Here you will find information regarding all five of our core divisions, our vision as a company and links to all our specials, products and newsletters. Have a look today at www.eboshealthcare.com.au

Montefiore Returns to the Fold.

After trialling an alternative distributor for a 12 month period Montefiore has renewed their 15 year relationship with EBOS as their preferred supplier of all things medical. EBOS is proud to be renewing this relationship. Montefiore are happy to again return to the high level of service, product lines and competitive pricing that EBOS is famous for delivering. National Accounts Manager, Debbie Greenaway who is responsible for managing the account has always considered Montefiore to be a highly valued client and is once again enjoying assisting the many wonderful and caring staff members she has come to know throughout the organisation.

In February 2012, Andrew McCullum (EBOS Hospital Divisional Manager) embarked on the Epworth Mekong Cycle Challenge.

Originally designed to get cardiac patients back on their bikes after cardiac treatment at Epworth, the challenge is now offered

to friends and sponsors.

As a result of sponsorship from EBOS Healthcare, in conjunction with our major partners Eschmann and Vernacare, Andrew travelled from Laos down the Mekong River into Cambodia. The Challenge covers over 400km in 7 days of riding, with the aim to improve the health of body and mind whilst raising funds for cardiac services at Epworth.

EBOS Healthcare has a strong business relationship with Epworth HealthCare and this initiative is our way of supporting a not for profit organisation that provides terrific services to the community.

Baby Lee A big Congratulations to Gary Lee, our Vernacare Product Manager, and his wife Aoife on the birth of their first child. Ray Joseph was born on the 15th of May.

The newest member to join our Aged Care Team is Karen Amosa in Customer Service. Karen joined the EBOS team in March this year. She comes to us with 3 and a half years experience from St George Bank where she was working in the call centre taking calls for everyday banking, home & personal loan and credit card enquiries.

Karen loves travelling with her family, visiting mostly New Zealand & the Cook Islands where her parents were born, (she tries to make it a yearly trip).

What she loves most is when her sisters come over from NZ to spend time with her, but it is always a sad occasion when they leave. Catching up with close friends and family for dinner or just a girls night out which they try and plan every month, are also things she enjoys.

Karen’s next adventure is hopefully a trip to Hawaii with her family!

4 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected] www.eboshealthcare.com.au 5 4 EBOS Healthcare Aged Care Division. For more information please Phone: 1800 269 534 or Email: [email protected]

CARELINES ISSUE #3

Susanne Macri AM Consultant, Health & Aged Care

The aged care industry waited in great anticipation to see how the Australian Government would respond to the Productivity Commission Report (Caring for Older Australians) handed down on the 28th June 2011. The week prior to the Australian Government’s 2012 May Budget the Prime Minister, Julia Gillard and the Minister for Mental Health and Ageing, Mark Butler delivered the Government’s response to the PC Report with a package of reform measures that in essence saw a redirection and reprioritisation of funds that were already in the Budget forward estimates.

When the industry had the time to digest the package there was some disappointment especially for residential aged care providers as there appeared to be little to stimulate the future and ongoing building of residential aged care facilities. The message post budget has been that “this is the beginning of the reform process”, however, not wanting to be a skeptic, it is fair to say there has been a history of Reports and a significant history of those Reports gathering dust. There will need to be (more than ever) a concerted and unified effort going forward by all stakeholders to ensure that the reform process continues as much needs to be achieved in providing a financially viable industry for future generations.

For EBOS as one of the industry stakeholders, this becomes critical in terms of the Company’s capacity to sell, and for aged care providers to be able to purchase supplies and equipment. Quality care and positive outcomes for clients come at a cost and these costs are increasing and very rarely addressed in the discussions around the “true cost of care”. For example, I am advised that syringe drivers cost around $3,000, pressure

relieving mattresses $4,000, bariatric shower chairs $2,000, wheelchairs twice that price and lifters ranging from $2,500 to $7,000. With the review of Prescribed Services about to take place it is important that the additional cost of equipment and best practice medical consumables are considered within the overall cost of care and what should be provided by the Provider.

The question often arises, does ACFI funding take into consideration not only the cost of care and equipment, but also the rising costs? With the projected “clawback” of ACFI funding ($1.6B) many organisations are wrestling with budgets and the capacity to deliver quality care for residents whilst ensuring the safety of their staff. The clawback of this funding can only mean two things- reduced staffing levels and/or skills or the reduction in the purchase of equipment and quality medical supplies required to deliver safe care. Whilst $1.2B is earmarked for the improved terms and conditions of aged care workers little is understood on how this and the Compact will work; the remaining $0.4B will go into a pool to help fund other measures in the package.

Viability and sustainability of the aged care industry goes way beyond the providers of aged care services, it extends out to the broader industry which provides services, equipment and consumables which not only have to meet relevant Australian standards, be contemporary and affordable, but also deliver the required outcomes. One only needs to read the various journals or attend the aged care conferences around Australia to see the fantastic support that trade exhibitors provide in supporting the industry to realise that without the commitment of these businesses the aged care industry as a whole would be further compromised.

The relationship between industry and aged care providers is going to become increasingly important over the next five years, we are seeing the demise of manufacturing in this country, we are seeing building companies going into administration/liquidation and businesses downsizing. The capacity for businesses to sell to the industry and the industry to purchase is going to rely very much on a trusting and professional relationship. For a financially viable aged care industry going forward it is much broader than what happens within our own four walls, it is about collaboration and partnerships amongst all stakeholders and it will require our collective wisdom to meet the challenges ahead.

Susanne Macri has had a long involvement with the aged care industry at a political level with her last assignment as Associate Commissioner with the Productivity Commission on the Inquiry into Caring for Older Australians.

Caring for Older AustraliansPost Productivity Commission Report

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www.eboshealthcare.com.au 7

CARELINES ISSUE #3

EBOS Healthcare introduces the Vernacare kidney dish, a greener and cost efficient alternative to plastic

The Vernacare kidney dish is part of the Vernacare range of pulp products – a full line of single-use maceratable pulp containers that has been helping to advance infection prevention in hospitals and aged care facilities around the globe for more than 60 years.

Why is a single-use pulp kidney dish better than either single-use and re-usable plastic options?

• The pulp kidney dish significantly reduces the spreading of infection from cross-contamination, as patients get a clean dish every time.

• No cleaning or autoclaving is required: the pulp kidney dish can

be disposed of in macerators or in general waste, making it suitable for all types of healthcare facilities. For this reason a pulp kidney dish saves money, energy, water, and valuable nurses’ time versus reusable plastic dishes which need to be cleaned.

• It is made from recycled paper and it is environmentally friendly - which cannot be said of a single-use plastic kidney dish

• It is cost efficient, with a cost to healthcare facilities that is comparable to a standard single-use plastic dish

In 2011 EBOS Healthcare conducted over 15 trials of this product in hospitals throughout Australia. The feedback from the majority of hospitals was extremely positive. The main reasons why hospitals commented positively on their use of the pulp kidney dish were:

1) expected reduction of cross infections. The pulp kidney dish is single-use, so the risk of spreading infection is reduced. This is the main benefit of moving to a single-use dish, and preventing infections is top of mind for most hospitals and healthcare facilities.

2) biodegradable. The pulp kidney dish is made from recycled paper and is biodegradable, so it fits well in the future ‘green’ plans of most facilities. There is no need to have macerators installed; the pulp kidney dish can be disposed of in general waste.

3) convenience: single use over reusable. Most hospitals use both the disposable and reusable kidney dish, but they see the benefit of replacing them with one type of disposable kidney dish only. The pulp kidney dish is an interesting option as its price is comparable with the price of a standard single-use plastic dish.

The Vernacare Kidney DishThe Greener alternative to plastic

When selecting a kidney dish there really is no contest

Vernacare Pulp Kidney Dish

Free Call 1800 269 534 Free Fax 1800 810 257

To place an order or for information:

The Vernacare pulp kidney dish is environmentally friendly as it is made from recycled paper. Reusable plastic kidney dishes can harbour all types of nasty bugs which are easily transferred around the hospital. With the pulp kidney dish, a new clean dish is used each time, meaning no need for cleaning and saving hospitals both money and valuable nurses time.

Helps prevent the spread of infections Patient gets a clean dish every time Saves money & valuable nurses time

No cleaning or autoclaving required Environmentally friendly

SINGLE USE BIODEGRADABLECOST-EFFECTIVE


Skin breakdown related to incontinence has a considerable affect on a patient’s physical and psychological wellbeing1. The good news is that conditions like Incontinence Associated Dermatitis (IAD) can be well managed and pain reduction is achievable.

IAD is the clinical manifestation of moisture-associated skin damage2. The condition is characterised by the erosion of the epidermis and a macerated appearance of the skin in the pad area of the continence aid. The prevalence of IAD has been reported to be as high as 27% in hospital patients3, 50% in nursing home residents, and 10-35% of adults in the community4. From a treatment perspective, maintaining healthy skin in patients with IAD is a daily challenge for Healthcare Professionals (HCPs)5.

What causes IAD?

It’s well known that an important function of the skin is to protect the body against invasive micro-organisms6. Yet in the case of prolonged exposure to moisture, the skin’s barrier function weakens and struggles to protect against invasion.

The reasons for this increased skin vulnerability are multifactorial where one factor often leads to, or is aggravated by another. For example, the occlusive environment created by a pad without breathable functionality can lead to skin humidity, mechanical abrasion can occur between the skin and pad materials7 and in the case of patients with double incontinence, ammonia in urine and faeces can raise the skin’s normal pH levels - which then promote digestive enzymes that directly decompose skin constituents8.

Who is at risk?

Elderly skin is more susceptible to IAD with longer treatment and recovery times when compared to younger skin – a fact that can be attributed to a decline in immune responsiveness, sensory

perception and barrier function as we get older. IAD can be extremely painful for the patient, and a severe rash may also signal an infection of the yeast Candida albicans or bacteria, which could be secondary to the already compromised skin9.

Assessment

There have been many questions raised within the healthcare industry on the link between IAD and pressure sores. From a diagnostic perspective, HCPs can identify a pressure sore (a deep tissue injury) by its characteristic dark red or purplish tones resembling a bruise over bony prominences10. In contrast, IAD (skin breakdown caused by undesirable microbes) is usually present in skin folds or where the skin has prolonged exposure to urine and faeces.

There is research that suggests IAD may be a factor in the development of pressure sores, yet further analysis of patients with IAD and pressure ulceration reveals different patterns11.

Specifically, IAD is associated with skin inflammation while pressure sores are associated with ischemia (inadequate blood flow to the affected area). While incontinence is a risk associated with pressure sores and is a component of multiple risk assessment tools, it is thought that faecal or urinary incontinence does not directly cause pressure sores12. It is also important to ensure that IAD and pressure sores are diagnosed correctly and are not confused with one another.

Managing IAD

Incontinence associated skin issues can be managed using a Care Plan involving other HCPs where appropriate13 – starting with a referral to a Continence Nurse Advisor (CNA) for a comprehensive continence assessment. Upon assessment a clearer picture of the

Managing Incontinence Related Skin Conditions

Breaking the cycle of Incontinence Associated DermatitisCombined with a high quality, breathable continence aid that is successful at keeping urine locked away from the skin, a careful and thorough skin care regime can alleviate and improve incontinence associated skin conditions for higher quality outcomes. Ensure your skin care regime includes:

• Regular checks and changes

• Cleansing with gentle no-rinse skin cleansers

• Gentle pat drying so as not to disturb the inflamed skin

• Skin moisturisation• Use of a suitable barrier

cream if required • The correct size,

application and absorbency level of a continence aid.

Runeman B, Skin interaction with absorbent hygiene products. Clinics in Dermatology 2008 26 (1): 46

“IAD is a daily challenge for Healthcare Professionals…”


CARELINES ISSUE #3

“Incontinence associated skin issues can be managed using a Care Plan… “

patient’s overall health can be established.

Following the initial assessment process, It is suggested to implement a structured perineal skin care program including a skin cleanser, moisturiser and protectant. This has been proven to significantly lower IAD incidence and grade 1 pressure ulcers. Below are a number of factors to consider when formulating a management plan14.

Management plan

• Skin cleansers

Skin cleansers that support the natural pH of the skin have been found to be more effective than water and soap for the prevention of incontinence-related skin problems.15

• Moisturising

When treating IAD, it is important to also apply a moisturiser16 as a natural moisture level is required for the skin to be smooth and supple17.

• Skin protectant

The use of skin protectants after cleansing are vital as they can reduce the incidence of perineal dermatitis by half18.

The importance of modern incontinence products

The term ‘breathability’ is used to describe a material’s ability to transport water vapour. When applied to absorbent hygiene products it is usually the back sheet film that is made vapour-permeable so as to reduce the effect of occlusion. In a study by Schäfer et al, it was shown that products with breathable backsheets were able to reduce skin over hydration. Products without this breathability can result in prolonged occlusion of the skin, higher humidity, pH and microbial growth19. Therefore, products that offer lower air humidity are not only more comfortable, but can also assist in bringing the skin back to its natural pH level, lead to lower moisture levels on the skin surface, improved patient outcomes and better quality of life.

REFERENCES1 Sibbald R et al, Intact skin an integrity not to be lost. Ostomy/Wound Management J 2003: 27-33

2 Gray et al, Incontinence-associated dermatitis: a consensus. Journal of Wound, Ostomy, and Continence Nursing 2007 34: 45-543 Gray M, Ostomy Wound Management 2007 53 (12): 28-324 Beeckman D et al, Prevention and treatment of incontinence-associated dermatitis: literature review, Journal of Advanced Nursing 2009:11425 Beeckman D et al, Prevention and treatment of incontinence-associated dermatitis: literature review, Journal of Advanced Nursing 2009:11426 Beeckman D et al, Prevention and treatment of incontinence-associated dermatitis: literature review, Journal of Advanced Nursing 2009: 11427 Berland C, Sköld M, Runeman B, Our delicate skin. R&MI Global Hygiene Category May 2010 12.8 Runeman B, Skin Interaction with absorbent hygiene products. Clinics in Dermatology 2008: 26 489 Berland C, Sköld M, Runeman B, Our delicate skin. R&MI Global Hygiene Category May 2010 12.10 Black J et al, National Pressure Ulcer Advisory Panel’s Updated Pressure Ulcer Staging System Den Nurs 2007 19 (4): 343-35011 Grey M, Is the distinction between superficial pressure ulcers and moisture lesions justifiable? A clinical-pathological study. SKIN med 2007 6 (3): 113-117 12 Ersser SJ et al, A critical review of the inter-relationship between skin vulnerability and urinary incontinence and related nursing intervention. Int J Nurs Studies 2005 42 (7): 823-83513 Royal Australian College of General Practitioners. Managing incontinence in general practice. Clinical practice guidelines 2002.14 Beeckman D et al, Prevention and treatment of incontinence-associated dermatitis: literature review. Journal of Advanced Nursing 2009: 115215 Beeckman D et al, Prevention and treatment of incontinence-associated dermatitis: literature review. Journal of Advanced Nursing 2009: 114516 Driver D S, Perineal Dermatitis in Critical Care Patients, The InnoVision Group, 2007: 36317 Berland C, Sköld M, Runeman B, Our delicate skin. R&MI Global Hygiene Category May 2010 12.18 Driver D S, Perineal Dermatitis in Critical Care Patients, The InnoVision Group, 2007: 36419 Runeman B, Skin Interaction with absorbent hygiene products. Clinics in Dermatology 2008: 26 (1): 4820 Royal Australian College of General Practitioners. Managing incontinence in general practice. Clinical practice guidelines 2002.

Modern Skin CareTENA’s NEW modern skin care range works to provide a complete hygiene solution; gently cleansing the skin, restoring the natural moisture balance and protecting it from external irritants. The range also includes two 3-in-1 products: TENA Wash Cream and TENA Wet Wipes, which cleanse, moisturise and protect, all in one application!

NEW

TENA Wash Cream 3-in-1 A gentle cleanser, a restorative moisturiser and a protective cream, which can be safely left on the skin.TENA Wet Wipes 3-in-1 Extra soft and strong wipe that gently cleanses, restores and protects delicate skin. TENA Soft Wipe A soft and strong cellulose wipe designed for gentle skin cleansing.TENA Skin Lotion A mild and gentle moisturiser ideal for dry and sensitive skin. TENA Barrier Cream A protective cream ideal for skin at high risk.

Contact your EBOS Healthcare Aged Care Representative for more information on this NEW range today!


MEDIHONEY® Antimicrobial Manuka Honey dressings are a new line of dressings for the management of challenging and stalled wounds.

MEDIHONEY® is a global medical-grade honey-based product for the management of wounds and burns. These dressings contain Leptospermum Honey, a special honey from New Zealand that has beneficial plant-derived properties and is able to maintain its effectiveness even in the presence of wound fluid.

MEDIHONEY® dressings have been shown in several large randomized controlled studies to be effective on hard-to-heal wounds, that have stalled under first line treatment. 1,-7 The range consists of various patented dressings that can manage a wide variety of wound types in a variety of settings.

Since the dressings are antimicrobials, assist in debridement, and help manage moisture balance, MEDIHONEY® dressings can be thought of as “all-in-one’ dressings for effective wound bed preparation. Additionally, since Leptospermum Honey is noted for its ability to be used in all phases of wound healing, placing these dressings as the cornerstones of a wound care formulary can take a great deal of the guess-work out of wound management.

MEDIHONEY® helps to promote healing as it cleanses and debrides due to its high osmolarity and helps to lower overall wound PH. It promotes a moisture-balanced environment conductive to wound healing, and is easy to use, with the potential for extended wear times (depending on level of exudate).1,-7

MEDIHONEY® dressings are available in several formats, including:

• MEDIHONEY® Alignate

• MEDIHONEY® Antibacterial

• MEDIHONEY® Barrier Cream

• MEDIHONEY® Gel Sheet

• MEDIHONEY® Wound Gel

The below woundcare and product selection chart can be used as a reference guide for choosing the appropriate product for your wound site.

[Effective on a variety of etiologies]

helping to make wound

management easier

MEDIHONEY® on left, plain alginate on right WK #3 after initiation of MEDIHONEY®

Steven J. Kavros, DPM: Case #1 of 3 presented at 2008 SAWC

Patient history of Crohn’s disease

Two wounds were both managed with systemic steroids, light compression to reduce edema and either plain alginate, or MEDIHONEY® alginate

MEDIHONEY

®

initiated

By WK #2, the wound managed with MEDIHONEY® was reduced by 62%

By WK #3, the wound managed with MEDIHONEY® healed, and the other wound is switched to MEDIHONEY® (heals at WK #4)

Peripheral neuropathy, ESRD, and CCL I

Dense fibrin tissue, slough and limited granulation tissue upon initial presentation

MEDIHONEY

®

initiated

Dressing changes every other day

Wound volume reduced by 25% by WK #4, and by 85% by WK #8. Complete healing by WK #16

Pyoderma

Gangrenosum

Recalcitrant

Diabetic Foot Ulcer

Catherine T. Milne, APRN, MSN, CWOCN: Case #3 of 3 presented at 2008 SAWC & WOCN

Non-healing diabetic foot ulcer WK #8 after initiation of MEDIHONEY®

Medihoney_brochure_9.21.09.indd 5 12/5/11 3:16:28 PM

MEDIHONEY®

Woundcare & Product Selection Chart

For skin protection around exudating wounds use Medihoney™ Barrier Cream NB Secondary dressings should be suffi ciently absorbent to manage exudate levels

5. Cutting KF. Honey and contemporary wound care: An overview. Ostomy Wound Manage. 2007;53(11):49–54. 6. Gethin G, Cowman S. Case series of use of Manuka honey in leg ulceration. Int Wound J. 2005;2(1):10 –15. 7. Gethin G, Cowman S. The impact of Manuka honey dressings on the surface pH of chronic wounds. Int Wound J. 2008; 5:185-194.

1. The Use of MEDIHONEY on surgical wounds post-CABG. Bateman S, Graham T (2007) WOUNDS UK. Vol 3. 76 – 83. 2. Leptospermum scoparium Honey vs. Hydrogel to deslough venous ulcers: A randomised controlled trial. Gethin G. EWMA 2007. 3. Chronic lower extremity venous ulceration – Use of a Leptospermum honey impregnated alginate to facilitate wound closure. Regulski M. SAWC 2008. 4. Wound care with MEDIHONEY in paediatric haematology-oncology. Simon A, Sofka K, Wiszniewsky G, Blaser G, Bode U, Fleischhack G. (2006) Supportive Care in Cancer. 14. (1): 91-7.

• Free Call 1800 269 534 • Free Fax 1800 810 257

• Email [email protected] • Visit www.eboshealthcare.com.au

WOUND CARE & PRODUCT SELECTION CHART

THE ORIGINAL WOUND CARE SOLUTION


WOUND TYPE INFECTED BLACK, NECROTIC YELLOW, SLOUGHY RED, GRANULATION PINK, EPITHELIAL CAVITY OR SINUS/FISTULA MALODOROUS

TREATMENT OBJECTIVE Reduce infection and colonisation

Assists wound healing

Clean wound

Rehydrate

Debride

Wound protection

Remove slough

Rehydrate

Wound protection

Manage exudate

Maintain moist wound bed

Assist wound healing

Wound protection

Manage exudate


Wound protection


Aid granulation


Wound protection

Remove malodour

MODE OF ACTION High osmotic potential helps clean the wound and disperse biofi lms.

Cleaning the wound reduces bacteria loadings, which are a source of infl ammatory endotoxins.

Provides an antibacterial barrier to protect the wound bed.

The osmotic action produces an outfl ow of body fl uid helping to lift debris and remove necrotic tissue.

The moist wound environment reduces the risk of eschar formation.

Provides an antibacterial environment that helps protect the wound.

The high osmotic potential of Antibacterial Medihoney™ wound dressings causes a mass fl ow of bacteria, endotoxins and sloughy material away from the wound bed. This material is then contained in an antibacterial matrix for easy removal at dressing change.

Osmotic action brings fl uid into the wound providing a moist wound environment to assist the granulation process

Antibacterial barrier protects the wound from infection by bacteria.

Provides moist wound environment to encourage the epithelialisation process.

Antibacterial barrier to protect the wound from contamination and reduces risk of colonisation.

Helps reduce oedema, pain and exudate levels and protects exposed tissue from infecting bacteria, reducing the risk of colonisation.

Inhibits the bacteria that cause odour.

Helps clean the wound and lift debris to rapidly reduce odour.

EXUDATE LEVEL Heavy/Moderate

Low/None Heavy/Moderate






Low/None

Medihoney™ Antibacterial Medical Honey™ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Wound Gel™ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Gel Sheet ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Alginate ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Tulle ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Medihoney (Europe) LtdPost Box 2205 High StreetMaidenheadSL6 1JNUK Toll free: 0800 071 3912Int Tel: +44 1628 779461 www.medihoney.com

NB Secondary dressings should be suffi ciently absorbent to manage exudate levels

It’s not just any honey

It’s MEDIHONEY™

For skin protection around exudating wounds use Medihoney™ Barrier Cream

For skin protection around exudating wounds use Medihoney™ Barrier Cream NB Secondary dressings should be sufficiently absorbent to manage exudate levels

v

MEDIHONEY®

Wound & Burn Dressing with Leptospermum Honey.




THE ORIGINAL WOUND CARE SOLUTION


WOUND TYPE INFECTED BLACK, NECROTIC YELLOW, SLOUGHY RED, GRANULATION PINK, EPITHELIAL CAVITY OR SINUS/FISTULA MALODOROUS

TREATMENT OBJECTIVE Reduce infection and colonisation

Assists wound healing

Clean wound

Rehydrate

Debride

Wound protection

Remove slough

Rehydrate

Wound protection

Manage exudate



Wound protection

Manage exudate


Wound protection


Aid granulation


Wound protection

Remove malodour

MODE OF ACTION High osmotic potential helps clean the wound and disperse biofi lms.

Cleaning the wound reduces bacteria loadings, which are a source of infl ammatory endotoxins.

Provides an antibacterial barrier to protect the wound bed.

The osmotic action produces an outfl ow of body fl uid helping to lift debris and remove necrotic tissue.

The moist wound environment reduces the risk of eschar formation.

Provides an antibacterial environment that helps protect the wound.

The high osmotic potential of Antibacterial Medihoney™ wound dressings causes a mass fl ow of bacteria, endotoxins and sloughy material away from the wound bed. This material is then contained in an antibacterial matrix for easy removal at dressing change.

Osmotic action brings fl uid into the wound providing a moist wound environment to assist the granulation process

Antibacterial barrier protects the wound from infection by bacteria.

Provides moist wound environment to encourage the epithelialisation process.

Antibacterial barrier to protect the wound from contamination and reduces risk of colonisation.

Helps reduce oedema, pain and exudate levels and protects exposed tissue from infecting bacteria, reducing the risk of colonisation.

Inhibits the bacteria that cause odour.

Helps clean the wound and lift debris to rapidly reduce odour.

EXUDATE LEVEL Heavy/Moderate







Low/None

Medihoney™ Antibacterial Medical Honey™ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Wound Gel™ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Gel Sheet ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Alginate ✓ ✓ ✓ ✓ ✓ ✓Medihoney™ Antibacterial Honey Tulle ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Medihoney (Europe) LtdPost Box 2205 High StreetMaidenheadSL6 1JNUK Toll free: 0800 071 3912Int Tel: +44 1628 779461 www.medihoney.com

NB Secondary dressings should be suffi ciently absorbent to manage exudate levels

It’s not just any honey

It’s MEDIHONEY™

For skin protection around exudating wounds use Medihoney™ Barrier Cream

For skin protection around exudating wounds use Medihoney™ Barrier Cream NB Secondary dressings should be sufficiently absorbent to manage exudate levels


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CARELINES ISSUE #3

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Solving the supply chain

puzzle

Melanie Sargent works in our Tasmanian office in Customer Service, entering customer orders and assisting with their enquiries. Melanie believes that our customers are our business and being in a position to help them is very rewarding.

We asked Melanie to answer a few questions about herself...

What chore do you absolutely hate doing?Vacuuming!!!

If you won the lottery what is the first thing you would do?Buy one of those automatic robot vacuum cleaners.

What do you miss most about being kid?The freedom. It’s not something you ever really appreciate as a kid.

Have you ever lived in another country?No. I can’t imagine ever wanting to – this really is the best place in the world.

If you could witness any event past, present or future, what would it be?That’s a tricky one. When we cure cancer. I don’t think there’s anyone who wouldn’t want to witness that.

Have you ever broken any bones?No, thankfully. Have chipped a few nails, but I’m told that’s not quite the same.

The NEW EBOS Aged Care

Consumables Catalogue is OUT NOW!

Call your Key Account Manager or visit

www.eboshealthcare.com.au

to download your copy TODAY!

Aged CareConsumables Catalogue

EBOS Healthcare are proud distributors of the following brands:


CARELINES ISSUE #3

Conference UpdateHow time is flying, it is already July! It was great to see so many of our clients in March at ACQ and also meet with new people in the industry. We are looking forward to doing the same in the second half of the year.

Nurses In Management Aged Care (NIMAC) Conference and Trade Exhibition 2012 brings together nurses working in the aged care industry.

NIMAC will be held at Jupiters, Gold Coast 11-13th July 2012. This years theme ties in with the London Olympic Games, “Going for Gold - Achieving Excellence in Aged Care”. You can find us at Stand 29.

This annual event provides the opportunity

for nurses to gather, network and visit trade exhibitions and speak with sponsors who target practice issues and products. Also Attendance to the NIMAC Conference and Clinical Workshop will attract CPE points.

LASA Congress 2012 The LASA Inaugural Congress will provide a unique opportunity for members of the aged care industry to extend their knowledge in their respective professional fields.

It has been proven repeatedly that despite the technical advances in communications, face to face contact and discussion is still one of the best methods of learning new things.

The 2012 Congress program will address a range of issues. The program will include presentations on workforce, care models of the future, systems reform and financing aged care, applying technology in an ageing society, service models of the future, changing patterns of clinical care, and marketing aged care.

This year the LASA Congress will be held at The Perth Convention and Exhibition Centre in WA from the 28-31st October 2012. The theme is “Moving with the Times - Changing Needs in a Changing World”. You will be able to find us at Stand 87.

Leading Age Services AustraliaINAUGURAL CONGRESS

www.lasacongress2012.com.au

REGISTRATION AVAILABLE FROM JULY

Contact: Congress ManagersConsec – Conference ManagementPO Box 3127 BMDC ACT 2617T: +61 2 6251 0675 E: [email protected]: www.lasacongress2012.com.au

SPONSORSHIPS AND EXHIBITION BOOTHS SELLING FAST

Contact: Jane Murray T: +61 8 9405 7171E: [email protected]

Perth Convention and Exhibition Centre28–31 October 2012

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Multi-surface cleaning wipes perfect for areas

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Hills Healthcare equipment at great low prices...


CARELINES ISSUE #3

Kate Mafoa Thompson Health Care

In April, EBOS healthcare participated in the distribution of much needed medical supplies on the pacific island of Tonga benefiting some of the poorest and most disadvantaged families in Liahona, Lomaivit, Lapaha and Takaomotong villages. Through our connection with Kate Mafoa from Thompson Healthcare we provided supplies that were put into care packs for the ‘Tongan Baby Pack Program’ including Bonjela and Sudocream. A total of one hundred packs where distributed, along with other donations of baby products including nappies and clothes.

A number of packs were provided to the village of Popua, a very poor area where following the distribution each child received an ice cream cone as a very special treat.

During the project Kate had the opportunity to speak with the mothers; during a discussion with one woman she discovered that when the Tongan babies teethe their mothers can’t afford Panadol and they were unaware that there was a gel like Bonjela that could help relieve the pain and discomfort of their child. “It was lovely to see a smile on so many new mums’ faces that don’t have the material necessities that we take for granted in Australia. I can’t thank EBOS enough for being a part of the Tongan Baby Packs Program”.

Lubricating Jellywater soluble forgeneral lubricating needs

The OptiLube brand is a range of class IIa sterile lubri-cating gel which is available in many different formats. OptiLube is a water based, water soluble gel, which has a non sticky, non greasy formulation. OptiLube will not damage rubber or metal and is designed to use on human tissue.

STERILE LUBRICANT JELLY SACHETSCode Product Description Inner Pack

OM1123 2.7g Sachet Box of 144

OM1120 5g Sachet Box of 150

STERILE LUBRICANT JELLY TUBESCode Product Description Inner Pack

OM1121 42g Tube Each

OM1122 113g Tube Each

OptiLube is a universal lubricating gel and is recommended for the following uses:• Insertion of Catheters• Insertion of Speculum• Rectal thermometers• Enemas/douches• Gynaecological

examination• Insertion of tampons

• Digital & instrument examinations

• Lubrication of condoms

• General hospital procedures

Tongan Baby Packs Program


Until recently, most NPWT systems have consisted of a pump, canister and dressing. The systems are no longer as large as they once were, and many are more lightweight, allowing patients greater freedom and mobility. Smith and Nephew has launched a NPWT system designed to help reduce the human and economic cost of wounds.

For elderly patients even a small traditional NPWT system can have an impact on their mobility, particularly if they have a walking frame. However, such systems may not be ideal for patients who are confused and/or at risk of falls.

PICO is a small, lightweight ultra-portable, negative pressure system, which consists of a dressing supplied with a pocket sized negative pressure pump powered by two AA batteries. The pump produces negative pressure at -80mmHg continuously, and therapy can be started or paused using the single orange button. The PICO system is designed to be used on wounds which do not have the large volumes of exudate which require the larger NPWT systems. The portability of the system makes it an ideal dressing for patients who are being discharged to the community. PICO can also be used with a filler material such as gauze or foam to treat

patients with slightly deeper wounds.

The pump connects to the dressing via a port which is anchored on the dressing. The dressing comprises:

• a silicone wound contact layer which allows easy application and is atraumatic on removal

• an airlock layer which allows negative pressure to be distributed evenly across the dressing

• a superabsorbent layer which absorbs exudate, and

• a highly breathable transparent film which allows moisture vapour to transfer from the dressing into the atmosphere

The PICO system can handle up to 300ml of exudate over a week without the need for a bulky canister. Each kit contains one pump with batteries and two dressings to provide up to 7 days of therapy. The pump is completely disposable.

The use of PICO could broaden the scope of negative pressure in a number of areas including acute care, aged care and the community.

Indications for PICO

Clinical indications for PICO include:

• Moderate to highly exuding wounds

• Pressure injuries

• Leg ulcers

• Surgical wounds

• Fasciotomy wounds

• Cavity wounds

• Skin grafts

Improving the uptake of NPWT in the community

The use of NPWT in the community has been limited, given pressures to reduce the cost of woundcare and the time constraints placed on community nursing staff1. There are also a number of perceived barriers in community settings relating to the size of the system, patient concordance, training issues and possible supply issues.

The introduction of a more portable, easy-to-apply and easy-to-operate negative pressure system may help to alleviate some of these issues, such as training and patient concordance, with patients much more able to mobilise and return to a normal lifestyle while using the system.

The application of the product is simpler than traditional negative pressure therapy and requires less training to use. PICO is also less expensive, which should help improve cost efficiencies, in addition to reducing the frequency of dressing changes.

Advertorial by Smith and Nephew.

Reference: 1 Ousey and Milne, 2009

INNOVATION in Negative Pressure Wound Therapy (NPWT)

Image courtesy of Vanessa Morris, Mount Hospital Western Australia

NEW


CARELINES ISSUE #3

NEW


Interview with Dr. Gerit Mulder DPM, MSThe Importance of Wound Cleansing

Wound bed preparation is an important process in facilitating the care, maintenance and eventual healing of a chronic wound. However, the emphasis that should be placed on wound cleansing as part of this preparation process is often unclear, as well as the correct cleansing methods to use in order to get the best results.

Recently, B. Braun spoke with world renowned wound care clinician, Dr Gerit Mulder, the Director of the Wound Treatment and Research Centre, and Professor of Surgical Orthopaedics at the University of California in San Diego, USA. Dr Mulder has been a wound care expert for over 30 years, entering this field after seeing tremendous medical voids and needs in the wound care area.

We asked Dr Mulder what his opinion was regarding the importance of wound cleansing during the wound bed preparation process, “You can’t separate wound cleansing from the actual debridement process, wound cleansing in itself is a form of debridement allowing you to flush out bacteria and loose debris and materials on the wound bed. Cleansing is a part of the debridement process, you can’t take it out as a separate component as it’s part of the wound bed preparation process,” he responded.

As the Australian approach to wound cleansing can differ from the American practices Dr Mulder is accustomed to, we asked him if he had any specific advice he could offer Australian wound care clinicians.

“What I would cautiously advise all clinicians, especially when it comes to wound bed preparation, is that it [wound cleansing] should always be included as a part of the complete care of a problematic wound,” he responded.

We asked Dr Mulder if it would be

appropriate to simply use soap or salty water to clean a wound, and his response was clear, that while this is a method that could be adopted, it is not the most efficient way to see results and speed up the wound healing process.

“This is an allegoy to asking “Why do I need a car, why can’t I just get around walking?” It’s how quickly and effectively you want to reach your destination,” he stated.

Dr Mulder was then asked what his experience had been in using wound cleansing agents, “Over the years I’ve used many different solutions and cleansers on wounds, and my primary concern, particularly in view of the increasing infection rates and increasing complications in the hospital settings, has become important to choose something that will assist with my greatest concern which is infection of the vital tissue,” he responded.

Dr Mulder spoke about some of the products available on the market he has had experience with that he feels are effective cleansers; “My personal choice has been to go with Prontosan® [B. Braun] because it contains two very important components, and will affect the entire wound bed preparation process.”

Dr Mulder then continued to explain what these two ingredients within Prontosan® were; “The first is the use of betaine which will assist with the loosening and removal of some of the avital tissue, and the second component is the microbial ingredient, which is the polyhexanide, which has properties which are anti-bacterial, anti-viral and anti-fungal.”

The reason these ingredients are so important, Dr Mulder explained, “I’m doing two things, I’m washing the wound, I’m using something which will assist with the debridement process, and I’m using something which I personally believe will also help to reduce bacterial levels, and hopefully decrease the subsequent risk of the complication of infection.”

Finally, we asked Dr Mulder if he would recommend the use of Prontosan® to other wound clinicians, and his response was a very clear yes, however also encouraging his peers to seek out answers for themselves when deciding if this product is for them or not. “One has to look at all the products available and decide what is the benefit in terms of outcome, and what is the benefit in terms of cost. To date I have not seen a similar product that will provide both assistance with debridement and assistance with reducing colonisation and at the same time act as a cleanser. Prontosan® is very unique in that respect, and it’s been adopted by not only my clinic, but by many of my colleagues.”

If you are interested in finding out more about wound cleansing, and about how Prontosan® can help, contact your Key Account Manager or email [email protected] Advertorial by B.Braun


CARELINES ISSUE #3

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