Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of clinical 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: Chronic wounds in long term care are common, and include pressure ulcers, arterial and venous ulcers, diabetic foot wounds, and others. Practitioners in long term care need to know how to diagnose and treat these wounds. This session will provide a series of cases involving wounds in long term care. Each case will be discussed by an interdisciplinary team and include audience participation.
Identify common wounds seen in long term care.
Describe the array of treatment modalities available for wound treatment, and the interdisciplinary approach.
Discuss the ethical issues that sometimes accompany development of a treatment plan.
Recognize that wound care is often system based, and the medical director and practitioner need to understand how to optimize the system to achieve optimum outcomes.
Speaker(s): Jeffrey M. Levine, MD, CMD; Paul Y. Takahashi, MD, CMD; Mary Frances Valle, MS, CRNP
Reference(s): Levine JM, Ayello EA, Zulkowski KM, Fogel J. Pressure Ulcer Knowledge in Medical Residents: An Opportunity for ImprovementAdvances in Skin & Wound Care 25 (3), pp 115-117, 2012. Baronoski S, Ayello EA, Tomic-Canic M, Levine JM. Skin, an essential organ. In: Wound Care Essentials: Practice Principles, 3rd edition, Wolters Kluwer/Lippincott Williams & Wilkins. 2011. Levine JM, Ayello EA.MDS 3.0 Section M: Skin Condition: What the medical director needs to know. Journal of the American Medical Directors Association 12 (3) pp 179-183, 2011. Levine JM. Pressure Ulcers and Wound Care. In: Geriatrics Review Syllabus Audio Companion. NY: American Geriatrics Society; 2010. Ayello EA, Levine JM, Roberson S. CMS Updates on MDS 3.0 Section M: Skin Conditions – Change in coding of blister pressure ulcers. Advances in Skin & Wound Care 23 (9) p 394 – 397, 2010. Levine JM, EA Ayello, S Roberson. The Essentials of MDS 3.0: Skin Condition. Advances in Skin & Wound Care 23 (6) p 273-283, 2010. S Roberson, EA Ayello, JM Levine. Clarification of pressure ulcer staging in long-term care under MDS 2.0. Advances in Skin & Wound Care. 23(5):206-210, May 2010. Levine JM, S Humphrey, S Lebovits, J Fogel. The unavoidable pressure ulcer: A retrospective case series. Journal of Clinical Outcomes Management. 16(8), p 359-363; 2009. Levine JM, S. Lebovitz. Optimizing pressure ulcer care: A checklist for system change Ostomy and Wound Management 55(6), p 6; 2009. Levine JM. Peripheral arterial disease and its consequences: Considerations for long-term care. Annals of Long-Term Care 17:2, p 22-26, 2009. Kalava UR, Cha SS, Takahashi PY. Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case-control study. Clin Interv Aging. 2011;6:213-9. Epub 2011 Aug 2. Takahashi PY, Chandra A, Cha SS. Risk factors for pressure ulceration in an older community-dwelling population. Adv Skin Wound Care. 2011 Feb;24(2):72-7. Takahashi PY, Chandra A, Cha SS, Crane SJ. A predictive model for venous ulceration in older adults: results of a retrospective cohort study. Ostomy Wound Manage. 2010 Apr 1;56(4):60-6. Takahashi PY, Kiemele LJ, Chandra A, Cha SS, Targonski PV. A retrospective cohort study of factors that affect healing in long-term care residents with chronic wounds. Ostomy Wound Manage. 2009 Jan;55(1):32-7. Takahashi PY, Cha SS, Kiemele LJ. Six-month mortality risks in long-term care residents with chronic ulcers. Int Wound J. 2008 Dec;5(5):625-31. Takahashi PY. Pressure ulcers and prognosis: candid conversations about healing and death. Geriatrics. 2008 Nov;63(11):6-9. Takahashi PY, Kiemele LJ, Jones JP Jr. Wound care for elderly patients: advances and clinical applications for practicing physicians. Mayo Clin Proc. 2004 Feb;79(2):260-7 Srikureja W, Takahashi PY. 73-year-old woman with painful lower extremity ulcers. Mayo Clin Proc. 2001 Jul;76(7):745-8.
Associate Clinical Professor of Geriatrics and Palliative Medicine,
Icahn School of Medicine at Mount Sinai