Description
During the first week of our new nurses in a surgical ward, I was supervising one of the supernumerary nurses. We were looking after a thirty-nine year old woman, Ms LC, who had undergone a laparoscopic peritonectomy. We had to start her on a negative pressure wound therapy dressing or NPWT; as suggested by wound clinical nurse consultant and the doctors during their ward round, since this would allow the fast healing of her wound.
I showed the supernumerary nurse the proper way of preparing an NPWT using a non-touch sterile technique, started by slowly cleaning the surrounding skin prior to the application of the pressure dressing. Since it was the first time of the preceptee to perform a pressure dressing, I have provided my preceptee the principles of wound management so that it will reinforce the knowledge of the supervised nurse and skills on the management of wound using NPWT. I also provided the preceptee the protocols and the wound management chart to take note of the type of solutions to be used in managing a surgical wound. We also documented in the progress notes what we have performed, and informed the nurse in-charge on the frequency of dressing change in a week.
Feelings
During the procedure it gave me an opportunity to share my knowledge about the proper management of a surgical wound. I felt relieved knowing that I was able to develop the skills of my preceptee in the aspect of wound care and knowing that the patient was also involved in the
Outline and discuss a clinical audit that you have undertook into one aspect of care delivery and reflect upon the experience using Driscoll’s model of structured reflection. Word Count (2197)
Nursing interventions play an important part in the reduction of pressure ulcers. A nurse can help to reduce the risk of pressure ulcers by promoting activity, carrying out skin inspections and assessments, and by using pressure relieving devices (Lynn, 2005). Some patients may fear being dropped when moved using equipment (Rogers, 1999), thus it is important for the Nurse to communicate with the patient, this way the Nurse can explain how the equipment works and the patient can express any concerns that they may have. It is important to remember that not all patients like lifting equipment and
Special dressings and bandages can be used to protect and to speed up the healing of pressure sores.
A meaningful event from my clinical experience was during week six when one of my colleague and I along with the RN performed a wound care procedure on one of my client who had pressure ulcers on her coccyx area and wound on the right foot. It was my first time doing wound care on a client who has severe wound type. Client is a 90 years old female who has been admitted to the unit for Osteomyelitis, it is an infection of the bone, caused by bacteria breaking into the body’s tissues and entering the bloodstream through an open wound (LeMone, p.1382). The client said a dog bit her foot at a park few years ago and that’s how she got the wound. Client has a wound care dressing order that needs to be changed daily with Betadine soaked gauze for all areas,
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.
An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team
After observing my mentor and other nurses performing various dressing changes using the Aseptic Non Touch technique (ANTT), and practicing the procedure
I am a dedicated and energetic RN writing to express interest in the Wound Care Registered Nurse on the Garden Park Medical Center website. My interest in the Wound Care position is from my work as a surgical nurse and the importance for incision/wound care infection control and my personal experience with taking care of a post-op surgical infection. I am seeking a long-term career transition back into the clinical field from the technical area, I have realized that the aspects of my work that I find the most rewarding are all in clinically related areas with direct care for patients and families. I offer years of nursing experience with strong medical knowledge and work experience that encompasses the areas of Medical/Surgical and Peri-Operative Nursing (OR), Ambulatory Physician Clinic, and Community Outreach Education. I believe that my strengths and multitude of skill sets would be an asset to your Wound Healing Team.
Pressure ulcers during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more
Pressure ulcers are a good way for the BSN prepared nurse to teach and educate RNs with an associate degree or diploma and other healthcare staff involved in patient care. This can be accomplished by introducing evidence-based practice information to them. They can be taught how to use to the Braden Scale effectively. They can teach others how to correctly stage and document pressure ulcers. Another important factor is stressing the importance of positioning, pressure-relieving devices, skin care and protection, and nutrition (Agency for Healthcare, 2009).
Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him.
J to prevent hospital acquired pressure ulcers. Frequent turning, repositioning, meticulous skin care and assessment are appropriate steps that would be taken to prevent pressure ulcers.
This report is presented as coordinated multidisciplinary approach. Persons involved would be representatives from board of directors, Materials Management, Physician and a Quality and Improvement team. Purpose of the presentation is to implement use of Mepilex Border Dressing throughout the hospital in order to prevent hospital acquired pressure ulcers.
According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.
Wound care nurses play a special role in the hospital environment, and hospitals without those specialized nurses may not be able to offer the level of care as hospitals that have these specialized professionals. "Wound care nurses, sometimes referred to as wound, ostomy, and continence (WOC) nurses, specialize in wound management, the monitoring and treatment of wounds due to injury, disease or medical treatments. Their work promotes the safe and rapid healing of a wide variety of wounds, from chronic bed sores or ulcers to abscesses, feeding tube sites and recent surgical openings" (Nursing Schools, 2012). While it may seem as if any nurse should be qualified to perform these functions, it is critical to realize that it is a specialized field. "Their main objectives are to assess the wounds, develop a treatment plan, clean wounds and monitor for signs of