Wound Cleaning

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.

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

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

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

The aim of treatment of wound management in Mr BW was to safely allow the exudation of pus to drain freely from the wound in order to expedite wound healing. At the same time, to consider the level of comfort, prevent further infection, increased mobility and ensure nutritional

In this paper we will present critical analysis on the different views on nursing the wound dressing focusing primarily on the possible infections ranging from technique to use of silver to the overall impact made by these choices.

| |Use of aseptic technique for wound |Reduces the risk of pathogens to the |

Warm water therapy is not applicable if there are open wounds in the hands and other infections with drainage.

The patient population that is being studied includes individuals with diabetic foot ulcers. Currently, many different types of dressings are being used on diabetic foot ulcers depending on the hospital and the attending physician. It is necessary to determine whether other specific dressings types such as collagen dressings, could be more beneficial than others in treating these wounds/ulcers. This raises the question, “In patients with diabetic foot ulcers, do wet to dry dressings compared to collagen dressings result in a decrease in wound healing time?”.

Lastly, non-adherence to Aseptic techniques for surgical patients and with the use invasive of devices such as urinary catheter and central lines can pose as a threat to patients. Bathing patients prior to surgery with a chlorhexidine solution rather than regular soap has proven to reduce the spread of hospital acquired infections. Following protocols with urinary catheters and central lines and also following the guidelines in the care and maintenance of such devices. Another factor is the importance of using chlorhexidine solution for patients who have central lines in an effort to prevent getting an infection in the blood stream. Finally, the importance educating patients on all lines and surgical site care. According to Lobley, “the National Institute for Health and Clinical Excellence found that surgical site infections (SSIs) accounted for 14% of all HAIs and affected 5% of all surgical patients” (Lobley, 2013). Surgical site infection which is another form of hospital acquired infection can

The proposed evidence-based practice change is to reduce the incidence of hospital-acquired infections (HAIs) and/or multi-drug resistant organisms (MDROs) through the daily use of chlorhexidine-impregnated wipes or chlorhexidine soap among patients in the intensive care unit (ICU) and medical-surgical units. Chlorhexidine gluconate is a broad-spectrum, antiseptic agent against several pathogens, such as S. aureus and enterococcus species (Climo et al., 2013, p. 534). Daily baths will be emphasized to patients with the current diagnosis of a HAIs, MDROs or are currently and/or have chronic suppressed immune systems. Furthermore, providing education to staff and patients and their families regarding the prevention of HAIs and MDROs through the use of chlorhexidine bath products will help implement this EBP change.

During my clinical simulation laboratory session 6: wound management, we all learnt about surgical wound dressing. However, what I found during the procedure was that maintaining sterile zone during surgical wound dressing is very challenging: there are complex procedure to ensure sterile zone and one simple mistake can result in restarting the whole process. Unfortunately, I made a mistake during the procedure and had to start again; it was very frustrating and time consuming process. However, there must be the reason behind this procedure so I decided to do some research and find out the consequences of poor surgical asepsis for wound management procedure.

Surgical site infections (SSIs) within a 30 day period of an operative procedure can contribute to an increased risk of morbidity and mortality every year. To prevent the occurrence of an SSI, healthcare professionals must include a scrupulous operative technique, administration of appropriate antimicrobial prophylaxis and minimize the introduction of contamination by hospital personnel and operating room environment. The student wishes to emphasize specifically the importance of skin preparation to prevent surgical site infection.

Their findings provide some support for the use of tap water for routine cleansing of acute and chronic wounds. The authors cautioned that the potential for harmful effects with the use of tap water cannot be excluded. Using tap water on surgical and sutured wounds did not increase infection rates, which may bring into question the standard practice of avoiding showering and irrigation during this early postoperative period. Among children, the use of tap water or normal sterile saline produced no significant differences in infection rates.

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora