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Ethics in patient care
Quantitative research in pressure ulcers
Dassen et al., 2010 pressure ulcers
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Recommended: Ethics in patient care
In the literature review, some of aspects of the topic are covered. Most of the literature has identified that the important part are requires periodic reassessment for pressure ulcers and the nursing care plan of pressure ulcer should be mentioned. The overall goals are that the patient with a pressure ulcer will reduce or eliminate the factors that lead to pressure ulcers; will have healing of the pressure ulcer; and not develop an infection in the pressure area (Guy, 2012).
Kaitani et al. (2010) show clearly details that the majority of patients admitted to a nursing home should be assessed, regardless of their aged, gender or weight, and the results need to be documented. Each patient will then be given a date for regular assessment (Kaitani et al. 2010). Kaitani et al. (2010) also pointed out that nursing assessment is a dynamic and continuous process involving synthesis of information from a variety of sources including underpinning knowledge, previous experience, and specialty based knowledge, recognition of important indicators and knowledge of the patient. Meanwhile, many aspects should be assessed in preventing pressure ulcer, such as nursing assessment of nutrition, wound assessment, risk assessment and assessment of quality of life. Immobility, altered consciousness, greater age and weight (BMI) are important risk factors for pressure ulcers. Factors identified included altered level of consciousness, impaired nutritional intake, faecal incontinence and factures (Kaitani et al. 2010).
Kwong et al. (2009) summarized risk assessment in nursing practice detailedly. Assessment is context-specific, combining knowledge of key risk factors with patient circumstances (Kwong et al. 2009). The literature discussed important as...
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... perform ethically, thus undermining their own authority. Fowler et al (2007) identifies listening skills and the encouragement in the participation of care motivates nurses to actively support changes in patient care. Robison, Curry, & Gruman (2007) remind practitioners that participation requires communication skills that are not universally possessed so nurses must be flexible in their approach to champion the participation of others. Using these concepts Registered nurse should always have built a rapport with carers, praising them for the care they provide, promoting partnership in care whilst emphasising the importance of the care plan. The Partners in Caregiving in a Special Care Environment program is an evidence-based intervention that enables these partnerships to develop and thrive, translating into improved experiences for residents, families, and staff.
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
Safety competency is essential for high-quality care in the medical field. Nurses play an important role in setting the bar for quality healthcare services through patient safety mediation and strategies. The QSEN definition of safety is that it “minimizes risk of harm to patients and providers through both system effectiveness and individual performance.” This papers primary purpose is to review and better understand the importance of safety knowledge, skills, and attitude within nursing education, nursing practice, and nursing research. It will provide essential information that links health care quality to overall patient safety.
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
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).
Patients often have complex care needs, and often present with multiple co-morbidities or problems. The process of conducting a comprehensive nursing assessment, and the coordination of care based on these findings is central to the role of the Registered Nurse (NMBA 2006). Evidence-based interventions must then be planned and implemented in a patient-centred approach in order to achieve agreed treatment goals and optimise health (Brown & Edwards 2012).
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
A care relationship is special and requires skill, trust and understanding. This essay will elaborate how the quality of that relationship affects the quality of the care given and the experiences felt in receiving care. These different relationships will depend on the type of care given, who the care is given by and what sort of previous existing relationship there was to begin with. For a good care relationship to work it needs to follow the 5 K101 principles of care practice which are 'support people in maximising their potential','support people in having a voice and being heard','respect people's beliefs and preferences','support people's rights to appropriate services' and 'respect people's privacy and right to confidentiality'.(K101,Unit 4,p.183). If all of these needs are met a far exceptional quality of relationship between the carer and care receiver will be achieved.
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
One of the five key principles of care practice is to ‘Support people in having a voice and being heard,’ (K101, Unit 4, p.183). The key principles are linked to the National Occupational Standards for ‘Health and Social Care’. They are a means of establishing and maintaining good care practice. Relationships based on trust and respect should be developed between care receivers and care givers, thus promoting confidence whilst discussing personal matters without fear of reprisal and discrimination.
O’Daniel, M., & A.H., R. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2637/
Participant 4 stated, “I think just basically being there for the family as well…I think even just a cup of tea can go a long way with any family (McCallum & McConigley, 2013). Another theory that intertwines with Watson’s is Barbara Dossey’s Theory of Integral Nursing. Dossey articulates, “Healing is not predictable, it is not synonymous with curing but the potential for healing is always present even until one’s last breath,” (Parker and Smith, 2015, p. 212). Dossey believes that integral nursing is a comprehensive way to organize different situations in fours perspectives (nurse, health, person and environment) of reality with the nurse as an instrument in the healing process by bringing his or her whole self into a relationship with another whole self. In the HDU, the RN’s interacted with each patient while providing high quality care to create a healing environment for the patient and family even when their prognosis was otherwise. Patient 3 specified that “We still have to provide care...and make the family feel that they are comfortable and looked after” (McCallum & McConigley, 2013). These theories ultimately show the importance of a nurse through the aspects of caring to create and maintain a healing environment that is not only beneficial to the patient but to their loved ones as
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
Mitchell, P. H. (2008). Defining patient safety and quality care an evidence-based handbook for nurses. Rockville,Maryland: Hughes. DOI: //www.ncbi.nlm.nih.gov/books/NBK2681/
Mrs S. is an 88 years old female patient who lives on her own, and was admitted into a rehabilitation ward following a hip operation due to a fall at home. She has a past medical history of Congestive Cardiac Failure (CCF), diverticulitis, and asthma. Also, Mrs S presented with rapid weight loss, palpitation, feeling tired, peripheral oedema, fatigue, difficulty breathing when lying flat in the bed, waking up at night with shortness of breath and anxiety. In addition to all that she had a pressure sore in her bottom that was not broken. In order to have good holistic care of Mrs S, the nursing process was used as identified by Sibson. Sibson (2010) identifies four key steps to the nursing process, which are assessment, planning, implementation and evaluation; which are important for ensuring a quality standard of nursing care.
Assessment is the accurate collection of comprehensive data pertinent to the patient’s health or the situation (“American Nurses Association,” 2010). Assessment is the first step in the nursing process and the most important. Assessment is the accurate collection of the patient’s health date including both subjective and objective information. Subjective data includes information that can only be described or verified by the patient. This may include chest pain, headache, or body aches. Objective date is data that can be observed and measured. This type of data is obtained using inspection, palpation, percussion, and auscultation during the physical exam. Objective data can also be provided through diagnostic testing. This is important for proper diagnosis, planning, and intervention. Examples of this may include vital signs, warm and moist skin, and coughing up yellow colored sputum.