Exemplars of complex assessment and care for hospitalized older adults: genital herpes infection.

Hospitalized older adults oftenpresentwithmore thanone acute illness and/or multiple chronic conditions. Their assessment and care requires nurses and inter-professional team members to be “tuned in” to complex conditions and trajectories. The herpes simplex virus (HSV) is an emerging/re-emerging infection and chronic condition that contributes to the complexity of care for older people during acute hospitalization and across care settings. The estimated current incidence (more than a half billion people worldwide) and future global impact of genital herpes infection is staggering. Nursing care during hospitalization includes prevention of transmission, wound care, anti-viral treatment, patient-family education and counseling, and follow-up care planning. In this article, guest contributors, Dr. JodiMcDaniel andMichele Giovannelli, present the special considerations regarding HSV infection in wound assessment among hospitalized older adults as exemplars of complex acute care in geriatric nursing. Two case exemplars illustrate the problem, presentation, and treatment of HSV wounds. Wounds that develop unintentionally in older adults during hospitalization often have serious and costly health consequences. Both patient and environmental factors can promote their occurrence. For example, aging skin is associated with a decline in skin barrier function, sensory perception, thermoregulation and immunologic responsiveness.1 These changes can collectively contribute to an increased risk for skin tears, skin infections and pressure ulcers during hospitalization when patients are less mobile and/or require assistancewith activities of daily living.1 Chronic