Wound care treatment for burn patients is a painful experience where pain relief options are limited or otherwise too expensive and dangerous such as general anaesthesia (Patterson & Ptacek, 1997). Burn patients are given opioid-based drugs like morphine to manage their pain but this rarely eradicates the pain completely and some patients may find these drugs have little effect at all (Hoffman et al., 2004; Patterson, Hoffman, Palacios, & Jensen, 2006; Patterson & Ptacek, 1997). Burn patients undergoing wound care treatment experience increased pain in the early stages of recovery; more so than the initial incident of being burned. (Harandi, Esfandani, & Shakibaei, 2004; Patterson & Ptacek, 1997). Burn patients not only experience physical trauma but psychological trauma as well; as such, these factors can have an adverse effect on the patients’ recovery (Harandi et al., 2004). To provide additional pain relief and expedite recovery, several studies have been conducted to explore adjunctive pain relief methods that can be used frequently with minimum cost and risk. Rapid Induction Analgesia (RIA) and Virtual Reality Treatment (VRT) are two types of adjunctive treatments that researchers have investigated for managing burn patient pain (Patterson et al., 2006). Therefore, the current study investigated if a combination of RIA and VRT will produce a greater analgesic effect than VRT alone; and, to also determine if the environment in VRT has any effect on pain relief. So
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.
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)
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
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.
I observed the documentation process from week -2 in my clinical setting and through reading the related documents I gained theoretical knowledge of documentation . I week -4 I did the the return demonstration of documentation with my instructor successfully and started the documentation process in clinical and developed my communication skill . I think my learning plan helped me to achieve this goal . When I started this semester I wanted to learn about the wound care . To achieve this goal I observed the techniques of wound care in week -10 demonstrated by my instructor and reviewed the related resources of wound care . In week -11 I was successful in return demonstration of wound care and evaluated by my instructor . The plan I made
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.
Severe burns are physically and psychologically catastrophic. Which result in a hypermetabolic and catabolic state characterized by elevated resting energy expenditure, tachycardia, muscle weakness, loss of bone mass, delay in growth, and whole body catabolism, all of which are worsened by prolonged bed rest and physical inactivity [4-6].
It has been shown that in studies that pain management is not always touched with wound care (Maddox, 2012). Uncontrolled and untreated pain has a negative impact on the healing process thus having a negative in quality of life. When nurses conducted a research study on the experience patients with venous ulcers, what led the patients to consult practitioners was pain (Maddox, 2012). This study led to the realizations that pain was being properly addressed by doctors and nurses. This was the constant recurring physical symptom in venous ulcers, acute and chronic. Even in some cases the pain was so severe that it interfered with activities of daily living, and normal tasks such as walking became
I can relate to one of the points in your discussion. I work in a small community hospital in the Wound Healing Clinic. We are an outpatient addition to the hospital. We have one nurse who has the primary responsibility of the acute admissions wound care. Last year we were bought by a large health systems. Recently, we were informed that we, the Wound Center, are held responsible if a patient has a hospital acquired pressure ulcer (HAPU). As part of this new directive we were also informed that prevalence rounds were to be done weekly. This is what you described your facility does once a month. These changes place responsibility for care which our staff does not even provide, moreover the changes were never discussed with our clinical coordinator.
Tammy, I would agree there is a major difference between knowing how to perform a specific skill and knowing how to perform that skill effectively. I think it is great that you offer new nurses to your department an extensive orientation and training. Wound vac care can be tedious, depending on the wound, requiring much training and then follow-up training to ensure it is being performed correctly. The surrounding skin appearance of a wound bed is a good indicator of correct wound vac application. Your expertise in wound care with precise skin barrier methods prevented further complications with this already painful wound. When patients get, frustrated or are having a lot of pain related to a treatment or procedure, many times they will refuse
Pain is different for everyone, because the brain “…[creates] its own selective picture; a picture largely determined by what is important for the survival and reproduction of the species” (Axel 234). In addition, because “[o]ur perceptions are not direct recordings of the world around us, rather, they are constructed internally according to innate rules” (Axel 234), classifying and treating pain for a large group of individuals is problematic. When attempting to address this issue, the question must be presented: is there a particular type of therapy which hospitals can use to reduce pain perception of patients, thus improving (or upholding) their physical
4. The client is in severe pain. What is the drug of choice for pain relief following burn injury, and how should it be given?
Pharmacist – Burn patients experience pain during dressing changes, debridement, surgical interventions & physical and occupational therapy. Pain management is essential . Also burn patients need to prevent infection so its up to the Pharmacist to coordinate these meds to have the best outcome for the patient.
Multimodal intervention along with attentive care and patient participation is necessary to achieve a balance between analgesia and side effects. Assumptions to the conceptual framework must be identified to understand the specific relevance of the theory to pain
Engwall (2009) defined pain as a "symptom and a warning that something is wrong in an organism” (p 370). Rathmell et al., (2006) maintained that fear of uncontrolled pain can be a traumatic situation for a patient undergoing surgery. Moreover, Pellino, et al (2005) sustained that “pain is a multidimensional experience, consisting of not only physical stimuli but also psychological interpretations of pain” (p. 182). Alleviating peri-operative pain is traditionally achieved with the use of pharmacological interventions. analgesia can incur undesirable side-effects like drowsiness, nausea and vomiting. Controlling the pain by complimenting analgesics with the use of non-pharmacological interventions, might ameliorate patients’ response to pain with fewer resultant side-effects. Thus, the need to evaluate the effect of non-pharmacological measures such as music, relaxation, hypnosis and others is highly solicited in the evolving heath system (Pyati & Gan, 2007).