Introduction.
This report will discuss the risk of impaired wound healing, amongst patients in the community. Patients may be at risk due to increased age, malnutrition and underlying medical conditions (Timmons, 2003, White, 2008). However, this report concerns with patients’ knowledge deficit about the importance of nutrition, which may be the risk factor (Casey, 1998, Dealey, 2005, Timmons, 2003). In this respect, a management package in the form of a leaflet aimed at these patients has been prepared, (see appendix), which may improve patients’ knowledge. The report will evaluate how the risk could be minimised by using this leaflet.
The rationale for selecting the identified risk comes from observations, during community placement, where many patients had chronic wounds, which would not heal, despite nursing interventions, which is supported by Moffat (2001). Personal observations highlighted that some patients may have a knowledge deficit about the importance of balanced diet, to achieve wounds healing. However, despite nurse’s involvement in verbal health promotion, some patients were reluctant to follow nurses’ advice, which may increase their risk (Wientjes, 2008).
Methodology.
As the result of this observation a literature review was undertaken, which included RCN Journals, Library and on-line resources using key words, such as ‘delayed wound healing’. In addition, the observation on availability of health promotion tools on wound healing was carried out, within my placement. Personal observations highlighted some gaps within existing packages, aimed at patients. In addition, a literature review and observations identified that most packages are designed for nurses, rather then patients, for example, the Woun...
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.... It, also, requires patients’ cooperation and effective pain management (Gould, 1999).
Nurses may evaluate this package by undertaking observational audits, which may include accurate recording of wound presentation, measurements and photographs (Sterling, 1996). This may involve nurses using the Wound Care chart to reassess patients, within six weeks. In addition, nurses may ask questions about patients’ diet and enquire if patients have food in their fridge. In addition, nurses may check patients’ blood test results for glucose level and insufficient nutrients (Walkland, 2002). The success may be measured by the reduction of weekly visits to patients, as the result of patient cooperation.
This report highlighted that wound healing may be improved by patients education and cooperation in improving their diet (Casey, 1998, Dealey, 2005, Timmons, 2003).
Nurses had also suggested debridement, specifically mechanical debridement whenever necessary. Based on some of the responses from nurses, this is not performed by debridement of the afflicted area by the nurse. However, this task is shared with the team of dressings from the
Pressure ulcers development occurs in every hospital and it remains a major worldwide health problem for many years. However, pressure ulcers have received minimal attention when we talk about it as a patient safety issue. It is a patient safety issue as it can lead to serious damage such as life-threatening infections and pain (Richardson & Barrow, 2015). On a med/surg unit, individuals may experience long or short hospital stays depending on the situation. For the short stays, the focus of care is often on regaining activities of daily living (Registered Nurses’ Association of Ontario, 2011). Therefore, assessment and education regarding pressure ulcers is often minimal or non-existent (RNAO, 2011). Every client who is at risk needs to be assessed and educated regarding pressure ulcers and the subsequent skin breakdown (Cooper, 2013). During the hospital stay, clients may have limited movement and pressure ulcers can extend into the muscle, tendon, and bone (RNAO, 2011). In many cases, clients do not notice the formation of an ulcer and as it may be in areas that are out of sight such as the coccyx. Often,
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Malnutrition can quickly develop due to the catabolism that occurs from critical illness, and secondary infections and impaired skin integrity can occur from such malnutrition. Therefore, it is vital that nutrition is started quickly with minimal interruptions to reduce
Utilizing this tool will allow The Restorative Nurse and Wound Nurse to generate a graph based off of the data retrieved from the Center of Medicare and Medicaid Services (CMS) quarterly Quality Measures Report (APPENDIX B). The Wound Nurse and Restorative Nurse will start with the last data reported before the start of the On-Time Project and then graph the data every three months during the On-Time Project for the following areas: falls, weight loss, in- house acquired pressure injuries and nosocomial infection. For that purpose, to monitor the effectiveness of the On- Time Project the Wound Nurse and Restorative Nurse will provide a designated share drive to present to the Director of Nursing and other stakeholders on a quarterly schedule at the quarterly Quality Assurance Improvement Program(QAIP)
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...
Registered Nurses Association of Ontario (RNAO). (2005). Best practice guideline (BPG): Risk assessment and prevention of ulcers. Retrieved from http:// www.rnao.org
To be part of a WOCN team, it is imperative to have excellent wound assessment skills, wound care techniques and knowledge of wounds, healing process, and appliances (Fitzpatrick, 2012 p. 200). The goal will follow the SMART format of being, specific, measurable, attainable, realistic, and time bound.
This reflective essay will demonstrate the concept of reflection. The model of reflection by Driscoll, 2007 has been followed in this essay to reflect the clinical skills that I have studied and practiced in week 7to week 9 of this unit which assisted me to get prepared for the practical experience which I will commence at the end of this semester. I have practiced numerous skills during the practicals class, but this essay will be a focus on taking care of bedsore and wound management.
(patient) and the Clinical Nurse Manager both parties agreed that the author could proceed. All information will be kept confidential and no names will appear on this assignment that could be traced back to the client or hospital. As a student nurse this will comply with the guidelines set out by An Bord Altranais (2009). All nurses should be able to account for the care they give, why they give the care and also an evaluation of the care they have given. Barett et al (2009) maintain that this is a core part of care planning.The Department of Health and Children (2001) has shown its commitment to organising care plans and the importance of them as was evident in the 'Primary Care A new Direction' health strategy.This identified the importance of discharge planning and and the development of individualised care plans following discharge. This assignment will cover a full assessment of a person whose care the author has managed in the clinical setting. Based on this assessment the author will compile a care plan focusing on two key nursing diagnoses derived from the nursing assessment. The author will list all nursing diagnosis related to this patient and give a rationale for each.
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
This assignment will discuss the nurse’s role with an individual elderly male patient they have been involved with, in their treatment for a diabetic foot ulcer within a community setting. An overview of the patient’s care will be explained including an explanation of type two diabetes and blood glucose control for this class. The development of the ulcer will be explored and the factors that influence it within the community setting for district nurses. This essay will critically analyse the role of the nurse in establishing learning opportunities and issues that relate to the healing of a diabetic ulcer, whilst facilitating the patient’s home environment and correspondingly educating them on their changing health care. The importance and need for risk assessment scales in clinical practice is also discussed using the Waterlow scale. It will also review and discuss relevant literature relating to diabetic foot ulcers, their development and treatment, then reflect on the nurse’s own experiences in clinical practice and evidence based practice.
...s expressed by most treating physicians if best treatment is not possible. Most of those wound are sadly sent to a community nurse for dressing change without the patient coming back to the treating physician for assessment of "maintenance wound" treatment.