Throughout the world there are approximately 300,000 deaths caused by burns with about 4,000 of those deaths occurring in the United States. These numbers indicate that burn injuries are ranked as the 3rd leading cause of accidental deaths in the United States (Burn Injury Recovery Center, 2013). As a nurse, it is likely that you will care for a patient with burns at some point in your career. When caring for these patients it is important to create a plan of care that prevents infection and minimizes pain.
Because the skin is the bodies’ first line of defense against infection burn wounds create a portal of entry for bacteria to colonize and multiply. Causes of burn wound infection are related to the impaired tissue integrity and thrombosis of the subcutaneous blood vessels. This avascular wound bed creates a medium that supports the growth of bacteria. The burn wound will be colonized with organisms until the wound heals therefor systemic antimicrobials are not given. Routine administration may even promote emergence of resistant organisms. Instead topical antibiotics and antimicrobials are used (Weber, 2013). All patients are given Tetanus toxoid, 0.5mL intramuscularly to protect them from the growth of Clostridium tetani. The healthcare team must take precautions when providing wound care to prevent cross-contamination.
Pain caused by burns is a result of direct tissue damage and the inflammatory response that follows. This pain can cause patients considerable suffering and distress. Proper pain management can reduce anxiety in the patient, decrease anticipatory pain and promote patient participation in daily care regimen (Fletcher, Managing wound pain during application and removal of dressings, 2010).
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...ngs. British Journal of Nursing, 19(20), 4-6. Retrieved March 15, 2014
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Determining the seriousness and appropriate treatment of a burn requires its classification. Burns are classified according to three factors, the depth and number of affected tissue layers, the total percentage of the body surface that is involved, and the presence of homeostasis disruption or destruction such as respiratory distress, fluid loss, or loss of blood pressure control (Patton & Thibodeau, 2014). According to Mr. MacPherson’s appearance and symptoms, his burns are classified as second-degree or partial-thickness burns. The evidence for this diagnosis according to Patton and Thibodeau (2014), are his presenting symptoms of severe pain and the appearance of blisters, edema, and fluid loss. This type of bur...
As a result of Lily’s extensive hospitalisation period, a grade 3 pressure ulcers developed on her buttocks. A pressure ulcer is a localised injury to the skin which is usually located over a bony area as a result of pressure or pressure combined with friction (Willock et al., 2007). According to Sibbald et al., (2003) excreted bodily fluids are often common factors which contribute to the breakdown of skin, especially as a consequence of urinary or faecal incontinence. There were many factors which contributed to the breaking down of Lily’s skin, such as infrequent nappy changes and lack of mobilisation. Ensuring the maintenance of skin integrator within the critical care setting has its challenges. Often, patients are attached to multiple
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).
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...
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.
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Polit, D. F., & Beck, C. T. (2010). Essentials of Nursing Research (7th ed): Lippincott, Williams & Wilkins.
In the world there is an alarming trend where what seems to be harmless accidents take the lives of thousands of people every year. However, the loss of life and human potential is unacceptable. These unintentional injury deaths take on a myriad of forms that are brought out by the World Health Organization (WHO) and the U.S. Department of Health and Human Services (HHS). With the guidelines provided by these organizations Public Health Nurses (PHN) can help develop and execute strategies in an effort to decrease the lives lost to unintentional injuries.
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
Burns are caused by many different factors. Heat burns are caused by fire, steam, hot objects, electricity, ultraviolet rays and hot liquids (Living With Burn Trauma). According to “Prevention,” an online article, the “Leading causes of fire and burn death and injury for older adults are smoking, cooking, scalds, electrical, and heating.” When one is burned, a instinct called “fight or flight” catalyzes. “Fight or Flight” causes one’s breathing and pulse to increase. When this happens, their adrenal glands release a hormone that causes pain to diminish causing some to vaguely remember their accident (Living With Burn Trauma). Many times because a victim begins to breathe rapidly, they can experience respiratory complications from the burns often resulting in respiratory failure (“First Aid and Emergencies”).
Secondary:Curtis, L. (2008). Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20
The focus of every health care professional is the patient and the goal is to return the patient to optimum health where the patient can be independent. When the patient’s safety is being compromised it’s everyone’s job to fix the problem and make sure that it doesn’t happen again. However, there’s a dark side to nursing. The nurse is one of the few health care workers that have the most daily contact with the patient. The nurse plays a very important role in the patients care from teaching to simply being a listener while withholding any judgement. When the nurse to patient ratio isn’t balanced, it causes nurse burnout. Nurse burnout is when the nurse becomes “physically, emotionally, and mentally exhausted” (Michigan, S. S. (n.d.). News.
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.
Potter, P. A., & Perry, A. G. (2009). Fundamentals of nursing (Seventh ed.). St. Louis, Mo.: Mosby Elsevier.