Introduction.
This report will discuss the risk of impaired wound healing, amongst patients in the community. Patients may be at risk due to increased age, malnutrition and underlying medical conditions (Timmons, 2003, White, 2008). However, this report concerns with patients’ knowledge deficit about the importance of nutrition, which may be the risk factor (Casey, 1998, Dealey, 2005, Timmons, 2003). In this respect, a management package in the form of a leaflet aimed at these patients has been prepared, (see appendix), which may improve patients’ knowledge. The report will evaluate how the risk could be minimised by using this leaflet.
The rationale for selecting the identified risk comes from observations, during community
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In the UK, there are 200,000 patients, who have slow healing wounds, which costs National Health Services £2.3-£3.1 billions per year and it reduces patients’ quality of life and mobility (Posnett & Franks, 2008). In addition, patients may have sleeping difficulties due to painful wound (Posnett & Franks, 2008). Patients may become depressed, isolated and have impaired body image due pain and embarrassment of unpleasant wound odour (Santy, 2008).
From observation, currently, the risk of delayed wound healing is managed, by nursing interventions and verbal health promotion, which may be due to the deficiency of packages designed for patients. This is supported by Collier (2003), who highlights the importance of nursing assessment, interventions and evaluation in improving wound healing. However, the importance of patients’ education, about balanced nutrition and dietary control of diabetes, may not be under estimated, as this may reduce the risk of infection and improve wounds healing (Casey, 1998, Dealey, 2005, Kemp, 2001, Timmons 2003, Ward, 2002). According to patients’ experience, their knowledge about nutrition helped them to achieve wound healing (Wound Care Information Network, 2008). For example, balanced proteins intake may encourage tissue repairs, as well as vitamin C intake may reduce the risk of infection, which may improve wound healing (Kemp, 2001, Ward,
Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.
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.
Deficiencies in a persons diet can impede progression through the normal stages of wound healing. Malnutrition has also been related to an increase in infection rates. Jean understood this and assured me she would take this in to account to enable the healing process. Jean went on to explain that the injury was caused when somebody ran into her leg with a supermarket trolley. She had initially applied a dry dressing but attended her GP’s when the wound became wet and painful.
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
• Nutrition- Mani (2003) claims that nutrition is a fundamental role that must be adopted in the treatment and healing process of pressure ulcers. A balanced diet with adequate nutrients should be key for all patients deemed to be at risk of pressure ulcers. Both nutrition and hydration are the basic components in promoting wound healing and maintaining normal tissue integrity. Patients at risk of pressure ulcers should be nutritionally assessed at regular intervals (Shepard. 2003). This could have been adopted by the use of assessment tools such as, The Nutritional Screening initiative. This tool includes nutritional screening at regular intervals and a comprehensive assessment that includes nutritional assessment, functional assessment and evaluation for depression. This comprehensive approach allows the nurse to quantify the nutritional problems and initiate the appropriate resources that will meet with the individual needs (Bryant, 2000). Another optional tool is the Malnutrition Universal Screening Tool or MUST. This has been designed by the Malnutrition Advisory Group (MAG) of the British
I get to see various types of wound, from pressure ulcer of different stages, unbelievable edemas, arterial and venous ulcers, diabetic ulcers, and many other wounds of uncertain causes. I have never expected to see those kinds of wounds. I have seen different drainage amount, color, and odor, various shapes and location of the wounds, and amputated edematous legs. I have learned also the different types of dressings and antibacterial ointments used. I had given the chance to observe a client on their high-tech hyperbaric oxygen therapy which makes the wound healing even faster. The most important lesson I have learned from the team members was, “DO NOT GET
While University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.
Even in the hospital setting while in Basildon Hospital Stroke Rehabilitation (Lister Ward) and in Mountnessing Court Billericay (The Mental Health Placement), I have found caring for patients with open wounds very interesting and diverse. Considering my interests in wound care, I slowly realised following this career path is what would suit me.
The process of wound assessment requires accurate and appropriate interventions while dealing with the patients. There are some major components which the operator must consider to effectively access an infection, and they require a range of skills and knowledge. These factors are the knowledge of relevant anatomy and physiology, the understanding of the various factors that accelerate wound growth, and the ability to listen and understand the patient’s needs. In wound accessing, the doctor should have an idea concerning the number and location of wounds, the required treatments depending on the type of infection, the type of wound in accordance to various grading given, and the procedures to follow to achieve the treatment
Stechmiller, J. K. (2010). Understanding the Role of Nutrition and Wound Healing. Nutrition in Clinical Practice, 25(1), 61-68. doi:10.1177/0884533609358997
Over the last century, registered nurses' participation in wound management has actually varied from that of following rigorous dressing routines to autonomous practice (Moore, 1997). In the past, nurse education frequently enhanced the overall results at the time. An adherence to apprenticeship-style learning, where registered nurses frequently had minimal knowledge of the results of the dressing they were putting on a wound, contributed considerably to a theory-practice space or gap of research in wound management. Registered nurses were not actively associated with the decision-making procedure (Madsen, 1999).
On assessment, the wound was slightly exudates, odour, sloughs and dry skin patches on the surroundings. Sprakes (2010) state that, holistic assessment of patient and the wound are essential in order to facilitate the wound healing process. Ousey and McIntosh (2010) points out that, chronic wounds are exacerbated by a sequence of misdiagnosis, neglect, incompetence or inappropriate treatment strategies. I observed that, M’s wound was with exudates and sloughs; this
Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.
The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer involves implementing a multitude of strategies to prevent amputation of the limb. This allow for decreased rates in mortality and can increase quality of life. Adequate wound management such as debridement, and offloading techniques should be instilled. Furthermore, education by the provider would be of critical importance for Mrs. Smith in terms of consistent foot care and management of her disease process (Yazdanpanah, Nasiri, & Adarvishi, 2015). Due
A wound can be described as damage to an area of the body, it can be internal or external, external wounds are damages that affect the skin and the anatomy of the skin. It is named by the type of forces that caused them. This essay briefly describes the current state of wound care in Canada, and also the projection wound care in Canada in the next 10 years. In order to understand where we are, we need to reflect on the genesis of wound care practice in