Wound Care: A Case Study

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.

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

One of the articles that was reviewed to determine if tap water would be appropriate for wound cleansing was a systematic review by Fernandez and Griffiths (2007). In this study, various randomized and quasi-randomized controlled trials comparing the effects of water with other solutions for wound cleansing were assessed. Of the nine trials used in this study, five trials were identified that compared the rates of infection in wounds cleansed with water or normal saline (Fernandez & Griffiths, 2007). These trials involved people of all ages, with a wound of any etiology, in different settings including hospitals, communities, nursing homes, general practice, and wound clinics. The trials also included an objective measure of wound infection, such as bacterial counts, wound cultures, or wound biopsy (Fernandez & Griffiths, 2007). After data extraction and analysis of the trials, the authors concluded that there was no statistical significance between cleansing with tap water and normal saline (Fernandez & Griffiths, 2007). However, the authors also acknowledged two major flaws in this review, including “the lack of consistency in the criteria and validated tools of measurement used to assess wound infection, as well as insufficient detail in reporting the method used for

According to the AAPC website and the guidelines for coding, repairs are classified and coded in the following manner.

Research has been done around the use of sterile vs. clean technique in the management of wounds, trying

Implications of discharging patients who do not understand their wound care discharge instructions, and follow-up care can lead to several problems. The problems included: poor health outcomes, increased risk of infection, increased health care cost, decreased insurance reimbursement, low HCAHPS scores, non-compliance with health care recommendations, recurring hospitalizations, and increased morbidity. An example that involves several implications listed above would include a patient who is non-compliant with his diabetes care, does not understand his wound care instructions and how his diabetes effects wound care healing, does not have a follow-up appointment and the wound becomes severely infected requiring a long readmission stay in the

The wound care clinical setting portrayed a comforting and therapeutic atmosphere that applied to both the waiting and treatment areas. The treatment area met the patient’s needs through the abundance of privacy curtains displayed and implemented within each patient interaction. The noise level of the facility was maintained at an acceptable level for the professional environment and the smell was clean with light fragrances. The lighting differentiated in the facility and corresponded to the patient’s desires. An example of these considerations included low lighting in the area which a two-and-a-half-hour Hyperbaric Oxygen therapy was being implemented. Overall the clinical setting embodied a comforting atmosphere through various features to adequately meet the patient’s needs.

• Bedside reporting • Wound care • IV insertion & venipuncture • Telemetry monitoring • IV medication therapy • TPN administration • Central line dressing changes • Time management PROFESSIONAL EXPERIENCE WEISMAN CHILDREN’S REHABILITATION HOSPITAL OCTOBER 2017-PRESENT Registered Nurse Marlton, NJ • Assess and treat patients from ages 3 weeks to 21 years of age • Administer medications safely • Performwound care • Communicate effectively with report KINDRED HOSPITAL SOUTH PHILADELPHIA OCTOBER 2017 -PRESENT Registered Nurse Philadelphia, PA • Efficient with bedside reporting • Communicate with doctors and verify orders • Perform IV insertion and blood draws • Trained in central line dressing

The victim is bed bound, has multiple wounds, a total care patient, some dementia, and relies on a caretaker for help with her ADLS. The victim's daughter removed her from her nursing home placement less than month after admission and isnt maintaining her basic needs. The victim is verbally abused; Ms. Bishop degrates the victim, lacks compassion and symphathy for her condition and providing proper wound care. The victim's wounds get worse and she has a new wound weekly, she's on given 2-3 bites of food before Ms. Bishop stops feeding her; Ms. Bishop feeds the victim whatever she eats. When asked about feeding tubes for the victim, Ms. Bishops lack education that they can be used in the home, and asked if she would have to care for it. When

Surgery is one of the most common medical practices across the United States. Patients of all ages that undergo surgical procedures are left with some sort of surgical wound. Every surgical wound can be classified by the type of surgical procedure and will have a type of wound healing. Although only approximately 2.6% of surgical wounds become infected, surgical wounds can manifest into serious complications for a patient (Harbarth, Hoffmeyer, Lew, Peter & Pittet, 2010). One of the major complications of a surgical wound is postoperative infection. Due to the potential of surgical site infections, surgical technologists are among the operating room (OR) personnel

The founders of Wound Care Specialist determined that the rural population was under-served when it came to wound care services. This is when the wound care specialist was created and provided within critical access hospitals. This opportunity was defined by the need and financial ability based on what exactly the Wound Care Specialist would charge the facilities and the reimbursement to the facilitates so that it was a profitable venture for both sides. Their main concern was for the patients that would be seen and then their financial situation because the number one cause for failing businesses is not enough money. They need to see that both sides of the company will get profit from the Wound Care Specialists. The opportunity is to grow

Infections are the most common complication following surgical procedures and are associated with significant morbidity, mortality and increased cost in health care (Anderson, 2014). As a nurse working in a surgical capacity this is a concern for the patients. Working for a general surgeon, surgical site infections are not commonly seen in the office, however, it remains one of the top concerns for the well-being of patients. Many evidence based studies are aimed at nurses who provide care for patients in the pre, peri, and post- operative periods. Perioperative nurses prepare the skin for surgery to remove soil and microorganisms at the point of incision (Cowperthwaite & Holm, 2015). Surgical site infections are easy to reduce given the proper guidelines for prevention. This includes skin antisepsis, and surgical hand hygiene and technique.

Infections are a significant problem in many medical and environmental situations. These infections are caused by an array of different microorganisms including bacteria, protozoa, fungi, yeasts, and viruses. The prevention of infections, and reduction or elimination of an infection once it is established is of importance,6 particularly in the area of skin and wound care. Environments that increase a patient's risk to infection include the surfaces of objects (internally and externally), fluids and fluid conduits. In healthcare, infections lead to longer hospital stays for patients and increased hospital costs. Even worse, a large number of patient deaths are attributed to infections.

Wound healing is an intricate process, whereas the skin may heal itself after an injury. At the time of injury, the inflammatory phase begins and is noted as a significant time, because this process prepares the wound environment for recovery. Since Mr. Jones laceration is five days old, suturing the laceration may not be appropriate. The wound was not stitched and allowed to heal by primary intention (first intention), because scarring is minimized during this process and no tissue loss is noted. Mr. Jones wound will have to heal by primary intention. Cleaning the laceration daily and applying a clean dressing will invoke healing. Since Mr. Jones will be a risk for infection, the continuation of antibiotics will be beneficial. Mr. Jones

During the 18 month study period, 663 consecutive patients were enrolled, but only 631 were used for the study. From the 631, 318 were randomized into the Tap Water (TW) group and 313 into the Sterile Saline (SS). There were a total of 20 infections (6.4%) in the SS group compared to 11 infections (3.5%) in the TW group. Indicating that there is no difference in infection rate of wounds irrigated with either TW or SS solution, with clinical trends towards fewer wound infections in the TW group, making it easy to conclude that tap water is a safe and cost effective alternative to