Essay On Wound Infection

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,

My practical competencies have been obtained through working with a general and orthopaedic surgeon. Whilst working with my clinical supervisor, (a consultant orthopaedic surgeon) we decided it would be beneficial to review orthopaedic wound infections. I chose to concentrate on wound infections during a Total Hip Replacement (THR). Wound infections is a massive subject so I have selected specific areas to look at, which are:

Special dressings and bandages can be used to protect and to speed up the healing of pressure sores.

I have significantly developed my skill in wound care assessment and dressing, in developing this skill I now recognize the importance of documenting each dressing. Morison (2001) supports this in saying that by detailing pressure ulcer assessment it provides a basis for deciding the effectiveness of the current treatment.

Nurses need to realise what they are looking for when performing skin assessments for patients. A study conducted by Thoroddsen et al (2013), found that out of 45 patients that had pressure ulcers only 27 were correctly recorded in the patient’s records.

Pressure ulcers are a problem and can lead to poor patient outcomes as well as hospital fines. Evidence based studies have shown that “the average cost of care in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the Centers for Medicare & Medicaid Services (CMS) is $43,180” (Jackson, 2008). Pressure ulcers and other skin breakdowns are among the most significant adverse events causing distress for patients and their care givers and compromising patients’ recovery from illness or injury (Gardiner, 2008). It is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.

To start the search for evidence within University Hospital, questions were asked in regards to pressure ulcers. Monthly updates are often sent out via email from the wound care team to keep everyone up to date on knowledge. While there was informative numbers within those updates, this information falls short according to Moore, Webster, & Samuriwo (2015). The main limitation of the study is the lack of a control group in pressure ulcer prevention and treatment. There is no clarity in the specific criterion that contributed to improved clinical outcomes. Teams used more than one method in the research project. Also, there is no study that meant the inclusion criteria in the random clinical trials. The lack of standardized

The assessment of the patient’s care needs is based on the type of infection. As such, nurses have the responsibility of providing a high quality health care to the patients. The postoperative assessment involves assessing the patient’s perceptions related to behavior and physiologic responses. It also involves the monitoring of the pain from the patient during the treatment period based on the operations performed. In postoperative assessment, the patient’s wound is monitored in relation to the healing frequency, pain felt, and the availability of some foreign substances like the body discharges. Obtaining the information relating to post operative assessment ensures that the patient is well taken care of by the nurse after operations, and avoids incidences of other circumstances that might hinder quick healing (Grocott, 2007). Once the patient gathers the information concerning the postoperative assessment, then a decision is made whether to seek medication from the same hospital or look for other alternatives. In the case of Sophie, it was clear that the nurses were not keen in following the postoperative assessment, therefore, causing the wound to obtain infections.

Pressure ulcers are a serious health care problem and it is crucial to assess how patients acquire pressure areas after admission to the perioperative environment (Walton-Geer, 2009). In the operating room factors related to positioning, anaesthesia and the durations of surgeries along with individual patient related factors can all contribute to pressure ulcer development. This essay aims to review current standards of recommended practice regarding pressure ulcer prevention efforts for the surgical patient.

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

Braden scale (Braden & Makelburts, 2005) use in hospitals allows nurses to identify patients at risk for pressure ulcer based on their sensory perception, mobility, activity, moisture and nutrition. Although the Braden scale is a useful tool but healthcare administrations has yet found the best method to eliminate pressure ulcers or bedsore in intensive care units. The use of foam dressing will be introduced to the intensive

Franks, P. J., & Moody, M. (2007). Randomized trial of two foam dressings in the management

Background. Surgical site wound closure can play a key part in the recovery of patients post-operatively. The use of closure material is usually according to the preference of the surgeon and is a frequently debated issue.

Mouës et al (2007) noted that the overall cost of vacuum-assisted closure wound therapy was equal to conventional dressings. Although the initial start-up costs were higher for this form of therapy, these were offset by lower personnel costs and a shorter duration of treatment (Mouës et al 2007). The use of vacuum-assisted closure wound therapy reduces the number of dressing changes required, leading to improved patient compliance and satisfaction (Mouës et al 2007). The mean cost of direct wound treatment using topical negative pressure therapy is equal when comparing treatment in the primary setting and acute setting (Hiskett 2010). However, this does not consider the hospital bed-day cost, which significantly increases the overall cost of

vThe term surgical site infections (SSIs) include all post-operative infections occurring at surgical sites. Inspite of advances in infection control, SSI remains major limitation of surgical horizons1. SSI is the most common post-operative complication and represents significant burden in terms of patient morbidity and mortality, and cost to health services around the world. SSIs are the second commonest nosocomial infection accounting for approximately one quarter of 2 million hospital acquired infections in USA annually2. To combat SSI, antimicrobials are being prescribed. The concept of prophylactic use of antimicrobials in surgery was introduced first in 1957 by Miles and in 1961 by Burke. It is currently an essential component of the