Further Infection due to the effects of age, location of the wound, malnourishment, and diabetes mellitus. - Refer Mrs Shore to a dietician to assist in improving Mrs Shore’s nutrition intake and decrease the risk of further infections.
- Have a wound care plan in place that includes regular dressing changes and assessment of the wound to avoid the wound deteriorating and decrease the risk of further infections.
- Refer Mrs Shore to the Aged Care Assessment team for assessment for further help in the community such as blue care nurses that can regularly visit Mrs Shore and change the dressings and monitor the wounds progress, manage the diabetes and medication.
- Set up regular appointments for Mrs Shore at the community health centre for
A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two
In relation to Mr Hardy's observations, I would firstly notify the registered nurse if she or
Also the Long Term Care Act, 2007, Ontario Regulation 79/10, Skin and Wound 50 (1), 50 (2)
My new role as an adult/gerontology nurse practitioner (AGNP), will be part of team that provides care for Long-term acute care LTAC, Skilled Nursing Facilities (SNF), or Rehabilitation hospital. After gaining considerable experience, my focus in future will be working in home healthcare and primary care clinics. My scenario will involve an organization that provides innovative, collaborative, health care team for one hundred bed LTAC Hospital. Working as an LTAC registered nurse, I noted that, despite the variety of diagnosis, majority of patients’ presents to LTAC hospital have wounds that require complex wound care management. The wounds can range from pressure ulcers to non-healing illness/injury wounds such as diabetic foot ulcer, venous leg ulcers, and post-surgical wounds among others. For this assignment, my scenario will focus on the role of Nurse Practitioner (NP) on skin care and wound managements.
The following assignment will take the form of a case study. The subject is a 79-year-old sikh gentleman, who will be known as patient X. Patient X only speaks English as his second language. Patient X has developed a wound on his right hip after being admitted a few days previously, after suffering from a stroke. Patient X has a history of a mild stroke and has slow mobility and uses the aid of a frame to mobilise. Patient X is obese, a heavy smoker and now
It is crucial for nursing personnel to have knowledge of the intrinsic factors as well as simple measures than can be taken to prevent wounds becoming infected. Strategies to decrease infection risks should be included as part of a wound management regimen.
Elizabeth Crotteau will be responsible for gaining the knowledge and understanding the skills related to caring for a wound of ranging severity. Caring for patients will require that Ms. Crotteau will assist Mr. Eck in supportive tasks that can be completed without certification. She will understand what it takes to interact with patients and other co-workers, while gaining knowledge about causes and treatments of wounds along with other medical issues. Ms.Crotteau will work a total of 35 hours during the spring.
Shawna Garito BSN, RN, CWON is a nationally certified wound and ostomy specialist at Sacred Heart Hospital in Pensacola, Florida. She has been serving the Sacred Heart Ministry for 8 years in the cardiology, intensive care, and wound care capacity. She holds certifications in Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS) and Diabetic Foot and Nail Care. Currently, she provides advanced wound healing modalities for patients with wounds originating from diabetic complications, venous and arterial disease as well post-operative dehiscence. She also provides pre and post-operative education and teaching to new colostomy, ileostomy and urostomy patients.
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.
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.
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.
Population-(P) Inpatients receiving wound care. Intervention- (I) Wound Care Education for Health Care Provider. Comparison- (C) Usual care by a healthcare provider who has not participated in wound care education. Outcomes- (O) Improving wound care skills among healthcare providers, alleviation of pain resulting from improperly treated wounds, speedy healing of wounds. Time- (T) 6 months. The project will seek to establish the level which continued or frequent wound care education for health care providers, especially the nurses would facilitate the
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
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
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,