Wound care (Pressure Ulcer)
Descriptions
During community placement, my mentor and I visited M (patient), a 75years old lady, who was presented with a Pressure Ulcer, on the heel of her right leg. On arrival, my mentor asked me to manage M’s wound. However, I have observed and participate in carrying out this skill (wound care) with my mentor on several occasions. I explained the procedure to M and gained her consent to carry out the procedure.
The preparation and application of aseptic technique was quite challenging in M’s home, however I washed my hands, worn apron and gloves, and adopt aseptic technique. When I remove the old dressings and assessed the wound, I observed that M’s wound was slightly exudates, odour, sloughs and dry
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Barrett (2009) concurs that, the management of wound required dressing that can maintain a moist environment, absorbs exudates as well as remain in situ over number of days.
As a novice practitioner, I found it quite challenging carrying out aseptic technique in M’s home. Hallett acknowledge this situation and state’s that
“The nature of the home environment makes it difficult to maintain control over any procedure, but particular problems arise when the procedure involves trying to prevent contamination” (Hallett 2000 cited in Unsworth 2011).
Another bad situation was when M asked me ‘How is the wound?’ I could not answer her and my mentor had to rescue me. NMC (2004) warns that, Nurses are accountable for their actions in practice and it’s the nurse responsibility to explain treatments to the patients.
Analysis
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
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
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.
The wound is very painful,
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.
Wound odour is often a complication of bacterial infection and the presence of infection explained why Mrs. Smith had experienced a worsening of the odour in recent weeks (Hack, 2003).
The design of this study will be quasi-experimental, in that the standard elements of the studies mentioned before will be present in this proposal, but with the inclusion of a newer solution, that are being used in order to clean wounds and prevent infection from occurring once the wounds have been dressed with a novel silver dressing. This will include a solution that contains Manuka Honey in it (the active ingredients are not all known yet, only that a chemical reaction that takes place when exposed to a wound is the formation of benzoyl peroxide (Mandal and Mandal, 2011)), and covered/packed with Mepilex wound dressings. This will also serve as only a baseline sample — no combinations
Pressure Ulcers, Wounds, and Wound Management: Signs of Wound Healing (Basic Concept, RM Fundamentals 8.0 Chp 55)
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
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
I completed my seventh and eighth shift during the nights of !0/14 and 10/28. Both nights I had a fairly heavy patient load caring for four patients each night. The census on the unit was also relatively high. The first night I had a patient with septic shock, a man who was experiencing chest pain, blurred vision and periods of near syncope, a woman with CHF exacerbation and hypoxemia, and finally a woman with hematuria with a history of chronic kidney disease stage III. The second night I was assigned 59 year old man diagnosed with rapid A-fib with a history of COPD, CHF, and cardiomyopathy, a 52 year old woman with a lower GI bleed with anemia status post colonoscopy that day and had a history of breast cancer with left mastectomy, a 53 year old woman with sepsis and necrotizing fasciitis from her right buttox to her vulva, and 81 year old woman with fungal pneumonia and SIRS. On this shift I performed many actions like performing a wound dressing change on my patient with necrotizing fasciitis, performed hygiene care, administered medications, performed head to toe assessments, called the doctor regarding critical information, and assisted in range of motion exercises. In a lot of my interactions I continually saw how necessary forgiveness is in nursing. One interaction in particular was when I was cleaning out the wound on my patient’s buttox and vulva. The wound was so deep that it was excruciatingly painful. We premeditated her giving her a bolus of dilaudid and she
Typically, acute wounds heal without disruption in 21 days or less and re-establish skin structural and functional integrity (Hamm, 2015). However, chronic wounds occur as a consequence of disruptive healing process and it takes months or years to heal. The occurrence of chronic wounds is two to three times higher than any other types of wounds, including surgical, burns, and acute (Hamm, 2015). According to wound healing society, chronic wounds affect approximately 6.5 million people in the United States and a failure of healing of chronic wounds is the biggest health issue globally (Wound healing society, 2016). Five major categories of chronic wounds based on etiology are arterial, venous, pressure, diabetic, and non-healing surgical wounds. The chronicity of wounds can be determined based on one of the five common factors: malnutrition, decreased oxygenation, diminished perfusion, increased mechanical forces, or systemic disease (Hamm, R.,
Wound healing is a complex biological process and lot of research has been conducted for long period of time. The main consideration of dermatologists has to close wound area without any microbial infection. Inflammation, coagulation, proliferation and remoulding of tissues is the main events on wound healing process. One of the prominent feature is marked by the repair of extracellular matrix forming epidermis of skin (Gurtner et al., 2008; Lamers et al., 2011). Chronicity in wounds patients is the leading cause of death worldwide due to wound sepsis. Wound sepsis is the condition in where systemic infection occurs at the site of wound and increase the chances of patient’s deaths. Various factors such as formation of biofilm, microbial pathogens
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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
These dressings have shown good results, with 73% of wounds healing with no other intervention needed (Allen &