Feasibility, acceptability, and tolerability of RGN107 in the palliative wound care management of chronic wound symptoms.

OBJECTIVE: To assess the feasibility, acceptability and tolerability of RGN107 use, a natural powder blend of Arnica Montana, Calendula Officinalis, Mentha Arvensis and Santalum Album, among hospice patients and their wound caregivers in the palliative wound care management of chronic wound symptoms at end-of-life. METHOD: Data were collected between May 2013 and November 2015. A pilot trial conducted among 50 hospice patients with symptomatic (pain, odour, or exudate) chronic wounds. Caregivers received initial RGN107 protocol training, actively applied the powder to patient wounds for 4-weeks, and completed an 8-week retrospective survey. Feasibility was assessed by measuring process outcomes, including the number and proportion of participants referred, screened eligible, enrolled, withdrawn and successfully completed. Acceptability measures included: a protocol training evaluation, caregiver pre and post self-efficacy ratings, retrospective usability, symptom control management and comparative technique caregiver ratings, and recorded open-ended comments. Tolerability was assessed through a 12-week cumulative review of the study adverse event profile. RESULTS: Feasibility, tolerability and acceptability of use of the RGN107 powder for chronic wounds were established. Recruitment goals were achieved and 92 % of the patients successfully completed the study. 95 % of wound caregivers would recommend the powder for use in this population. CONCLUSION: This study supports the feasibility, acceptability and tolerability of a wound care powder that espouses a multi-symptom palliative comfort care approach for hospice patients with chronic wounds at end-of-life. Further research is needed to establish the efficacy of the powder.

Patient with dystrophic toenails, calluses, and heel fissures.

Options in Practice presents different management approaches to the same clinical situation. You are invited to submit a brief case description, including the specialty nursing care provided, and several glossy, color photographs of the clinical situation. The case material will then be sent to another wound, skin, ostomy, or continence care clinician, who will also address management concerns. Alternative solutions to difficult wound, skin, ostomy, or incontinence clinical situations will be published.

Intrapreneurial nursing: the Comprehensive Lower Extremity Assessment Form.

The Comprehensive Lower Extremity Assessment Form was developed in response to the need for a screening tool in a nurse-managed foot care clinic. It differs from other such tools because it includes clinical measures that identify the potential for foot pathology. The Comprehensive Lower Extremity Assessment Form also serves as an assessment teaching guide in a foot care course and is included as part of a home-study program. The authors demonstrate how the Comprehensive Lower Extremity Assessment Form has generated revenue as part of an intrapreneurial outgrowth of their foot clinic and provides a comprehensive approach to lower extremity assessment. The form can be tailored to meet the needs of the advanced practice nurse, the clinical setting, or patient population.

An intrapreneurial approach to foot care.

Continual maintenance of an intrapreneurial foot care clinic has proven to be challenging and financially rewarding for two gerontological CNSs who designed and implemented the clinic. The foot care clinic has been in operation for over three years, and is now considered a part of the routine health services offered to patients in a large, university-based, ambulatory care clinic.