Changing My Leaves

"Change your opinions, keep to your principles; change your leaves, keep intact your roots." - Victor Hugo

In 1990, this journal had recently been renamed Ostomy Wound Management, changed from being a quarterly to a bimonthly publication, and the topics expanded from ostomy and wound care to include skin care, incontinence, and nutrition. I was honored when asked to be part of that process and become a contributing editor. Nurses were the main readers of the publication and constituted > 90% of attendees at the Symposium on Advanced Wound Care. Neither skin care, prevention, chronic wounds, nor incontinence care were “hot topics” or on the radar screen of most health care professionals or health care systems, and enterostomal therapy (ET) nurses (as they were called then) were busy trying to educate their colleagues and employers about this new concept called “moist wound healing.”¹  Unlike the world of ostomy care in which surgeons and ET nurses had worked together for many years to improve patient outcomes, in many areas of health care, including skin, incontinence, and wound care, interdisciplinary care and collaboration were uncommon. Similarly, interaction between the science and practice disciplines was rare. All that changed in the 1990s.

We witnessed an unpreceded expansion of our understanding of the mechanisms of tissue repair in the 1980s.² In the 1990s, interdisciplinary books were published,³ and we learned about the importance of evidence-based practice and the development of evidence-based practice guidelines. To that end, the importance of the (then) Agency for Health Care Policy and Research (AHCPR) clinical practice guidelines for 2 areas within our scope of practice, Urinary Incontinence in Adults (1992 and 1996) and Pressure Ulcer Management (1994), as well as Pressure Ulcer Prevention (1992), cannot be underestimated. Not only did they shine a light on the extent of the problems and the importance of what we did, they also detailed for the first time that there were major gaps between what was known and what was done in practice.

The impetus for a more interdisciplinary approach to advancing and providing patient care and another major change at the journal were propelled by the need for conducting and publishing the evidence we need to practice and optimize patient outcomes, research on how to best implement what we know, and methods to optimize the development and implementation of future guidelines.^4,5 In 1997, when it was decided that Ostomy Wound Management should be published monthly and that clinicians should lead this process,⁶ I was asked to assume the role of clinical editor. Of course, I was honored by the request and accepted it, but not without a good amount of trepidation. How can we, a small team of editorial review board members and publications staff help fill the research–practice gaps and support clinicians by providing relevant information and sound science? How can we provide high-quality, index-worthy information 12 times a year? One can try for a little while, right? That “little while” turned into 25 years.

After 25 years, it seems like a good time for another change. A time to change my leaves. This time it is the end of my role as clinical editor of the journal and “trying this for a little while.”

I do not know how it will feel after the issue you are reading now (“my” last issue) is published, the manuscripts that need review or some TLC stop showing up every week, and I do not get to “talk with you” on this page after all these years. But I do know that the hundreds of publications we published during that time helped close some research–practice gaps, showcased the importance of interdisciplinary and international collaboration in research and practice, and helped us get closer to being able to provide evidence-based care. I also know that much of the credit for being able to do so goes to the authors who wanted to share the final product of their hard work with you, our readers, and entrusted their manuscript for review by our review board members and editing by our editorial staff.

We all share a common goal: improving the life of our patients. We all know that the trustworthy evidence to do so is generally built one small building block at a time. I am so grateful for the opportunity afforded me to be here with you as we all took gigantic steps forward in our collective knowledge. I look forward to the future when we will, no doubt, get answers to the quest.

Read words of appreciation for Lia's years of hard work and dedication here.

The opinions and statements expressed herein are specific to the respective author and not necessarily those of Wound Management & Prevention or HMP Global. This article was not subject to the Wound Management & Prevention peer-review process.

REFERENCES

1. Terence J, ed. An Environment for Healing: The Role of Occlusion. Royal Society of Medicine; 1985. International Congress and Symposium Series.

2. Cohen IK, Diegelmann RF, Lindblad WJ. Preface. In: Cohen IK, Diegelmann RF, Lindblad WJ, eds. Wound Healing: Biochemical and Clinical Aspects. WB Saunders; 1992.

3. Krasner D. Chronic Wound Care: A Clinical Source Book for Health Care Professionals. Health Management Publications; 1990.

4. Van Rijswijk L, Braden B. Pressure ulcer patient and wound assessment: an AHCPR clinical practice guideline update. Ostomy Wound Manage. 1999;45(suppl 1A):56S-67S.

5. Van Rijswijk L, Gray M. Evidence, research, and clinical practice: a patient-centered framework for progress in wound care. J Wound Ostomy Continence Nurs. 2012;39(1):35-44.

6. Van Rijswijk L, Kirsner RS. Editorial message. Ostomy Wound Manage. 1998;44(1):4.