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. It will seek to demonstrate the appropriateness in supporting the patient and their family, whilst reflecting upon personal experience, and how literature may influence the healing effectiveness. The factors that enhance and inhibit the learning environment will be explored and suggested techniques to improve clinical learning will also be discussed. Finally the nurse-patient learning relationship will be explored along with the application of teaching and learning strategies will be examined. Mr. B has type 2 diabetes and is insulin dependent, which he developed classically in later life and he is also slightly obese. Type 2 diabetes occurs when the body doesn't produce enough insulin ... ... middle of paper ... .... Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection. Conclusion: Education on the use of risk assessment scales in practice is identified as a recommendation along with the continued use of nurses clinical judgment being used combined with a risk assessment tool. This, along with surveillance for complications, is very relevant when considering the diabetic foot. Living with foot ulceration has been linked to diminished wellbeing, quality of life and physical health in patients. Identification of the patient’s pain status is vital when treating patients with diabetic foot ulceration and addressing the challenges of either pain or no pain.
Using the Skin Safety Model (SSM), prevention of pressure ulcers can be shifted to a more holistic patient-centered approach. The SSM comprises of four sections, potential contributing factors to skin injury, exacerbating elements, potential skin injury, and potential outcomes of skin injury. Each section then has subcategories of determinants that can change depending on the patient’s specific circumstance. The SSM helps the caregiver look at the patient as a whole and incorporate all of the patient’s risk factors that could potentially lead to impaired skin integrity or pressure ulcers (Campbell, Coyer, & Osborne,
Diabetic wounds result from uncontrolled blood sugar that causes nerve and circulatory damage (Kifer, 2012). Diabetic ulcers usually found at the bottom of the foot and take the shape of a circular. The assessment of the diabetic foot is very significant. It plays major roles in preventing foot ulcers by
Syx, R. L. (2008). The practice of patient education: The theoretical perspective. Orthopedic Nursing, 27(1), 50-54. doi:10.1097/01.NOR.0000310614.31168.
In conclusion there are many diverse types of dressings available for wound management, with no solitary dressing being claimed to be the best due to the differences amongst health care professionals. There are on going searches for an ideal wound dressing for the management of ulcers. In weighting out the negatives and positives there is no hesitation in saying that hydrocolloid dressings make a significant involvement in the contribution to modern wound management and is deemed a success for the management of patients with decubitus ulcers.
The field of nursing is one that requires much passion, hard work and critical thinking. It is a nurses job to promote the well being of their patients and help the return to normal function. However unfortunate events occur, resulting in patients receiving adverse health conditions as a result of being in a medical facility One of the most prevalent of these nosocomial conditions are pressure ulcers. Not only do the patients suffer from the pain of pressure ulcers but the hospitals and medical facilities are effected as well. A randomized controlled trial conducted by Pickham et al. reported that “ Pressure ulcers are insidious complications that affect approximately 2.5 million patients and account for approximately US$$ 11 billion in annual health care spending each year” (2016). Pressure ulcers not only cause the patient pain but “even contribute to disability and
The relationship between the person seeking help and the nurse/counsellor should be appropriate for producing therapeutic change, to ensure that the patient maximizes from the therapeutic relationship. The health care provider should ensure that they communicate effectively to the patient/client. The skills explained in the above essay are the relevant skills that nurses in the contemporary hospital environment should adhere to and respect.
The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions.
According to Casey in Kai Tiaki Nursing journal (2012), within the last twenty years available dressings for wound healing have increased exponentially now including fifty-eight categories. The nurse has the responsibility to select the best dressing, for a specific wound to promote optimal healing. The idea behind dressings has also changed. Dressings previously were designed to keep a wound dry, absorbing secretion, and preventing infection (Casey, 2012). Dressings today are designed to facilitate healing, provide a moist environment, debridement, infection control, thermal insulations, and possible suction to remove drainage and pull oxygen and nutrients to the wound bed (Casey, 2012).
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...
The goal of my learning plan is to promote health maintenance and restoration for hip or knee replacement surgery patients by providing patient education sessions and information pamphlets on post-operative pain and swelling management between the periods of week 8 to week 10. During the implementation process of my learning plan I used the Community Health Nurses association’s standard as a guide to help me advance with the production and presentation. I focused my learning plan on the standard of health maintenance, restoration, and palliation under the category of promoting health. This standard can be defined as “providing clinical nursing, palliative care, health teaching and/or counseling to individuals and families as they experience illness and life crisis…” (Peter, Sweatman, & Carlin, 2012, p. 66) I am doing a teaching session and pamphlet for my learning plan which is included in the area of health teaching. Peter et al also described the possible outcomes of this process which is to encourage participation of patient and family members to engage in the development of their care plan by maximizing their capacity to take responsibility for and manage their own care. (Peter et al, 2012, p. 66) I hope the implementation of my learning plan can educate the patients so they can understand more about their health and gain knowledge on types of interventions they can use at home to enhance their recovery. For example, if the patient feels pain and swelling at home, they will be able to have the knowledge that they can use ice to help reduce the pain and swelling. I followed the CNO’s ethics practice standard. This standard stated about respecting client’s choice and ensuring privacy and confidentiality during the caring process...
When a nurse is providing patient care, he/she creates a safe environment for the patient and enables the choice to establish a relationship on a human to human interaction or on a transpersonal level. The patient will be acknowledged as a person with the wholeness of their soul despite their illness or number on the bed. The ten carative factors in this theory are used as an education tool for nurses around the world and should be applied to the different care situations in practice. Nurses use the factors to promote growth in themselves and within the patient. A nurse should respect the patient’s decisions and take the time to fully be present in the moments with the patient. A lot of nurses complain about the time limitations they have and do not provide the necessary amount of time to listen and gather the patient’s perspective of the situation. Another way this theory can be applied to practice is by recognizing the caring moment between you and the patient. This will determine how the relationship will
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.
... advice to wear comfortable shoes, preferable leather, and not to walk barefoot. Maintaining proper weight and exercising regularly is essential. Early and correct detection of the type of diabetes is necessary to prevent severe health complications.
The global prevalence of Diabetes Mellitus is 5.1% and is constantly rising. It is anticipated to be 7.7% by 20301. It is calculated that 15% - 25% of Diabetic patients will suffer from diabetic foot infection and ulceration. Whilst 60–80% of them will eventually heal, 5–24% will end with amputation.
To summarize, there is a constant need for health frameworks to govern nursing procedures. Nursing assessments require frameworks to reduce risks of wrong treatment, effective communication is required between colleagues and patients to avoid confusion. A standard of professionalism is required to ensure nurses aren’t over involved with their patients, education is important in promoting individual health, clinical reasoning is vital for the immediate treatment of a patient. Lastly reflection is ideal to analyse the positives and negatives, it is best to follow the Gibbs reflective cycle when evaluating methods. Health frameworks will play a constant role in the regulation of procedure.