Wound Dressing: A Case Study

When nursing comes to mind, it is common to think of only acute care nurses working the floor of the local hospital. However, nurses work in a variety of settings, one of which I was able to witness at St. Mary’s wound clinic. Of the five patients that I was able to interact with here, one of the most interesting was the case of a 33-year-old male patient who presented to the clinic with a venous leg ulcer. The ulcer, located on the lateral portion of the lower leg just below the patient’s calf, was draining a significant amount of serosanguinous fluid. Additionally, cellulitis infected the entire calf area, while the skin immediately surrounding the wound

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.

The goal to treat an ulcer in a diabetic patient is to heal the wound faster to prevent infection, pressure has to be take off the area by “offloading” the foot, remove dead tissue by the process of debridement, apply to dress per doctors order, and focus on managing the patient’s blood sugar effectively to promote healing. In addition, to prevent infection, the patient must keep the dressing clean, cleanse the wound daily and change the bandage and dressing, the patient must also avoid walking on barefoot.

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.

“Wound Dresser” During the 19th Century, there was considerable controversy over the expansion of slavery and women’s rights. The United States was about to engage in one of the most deadly wars on its soil; with the total number of deaths in the Civil War was 624,571 (Toledo-Pereyra). In 1860, a Republican against the expansion of slavery, Abraham Lincoln, was elected the 16th President of the United States. Walt Whitman, a poet from New York, became passionate about the welfare of the soldiers after visiting his wounded younger brother George in a Fredericksburg hospital. Injuries the soldiers sustained often were severe requiring the amputation of a limb.

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

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.

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.

The recommendations for change to practice at the level of the provider would include first treating the underlying problem that Mrs. Smith was admitted for. According to the literature, a progressively worsening diabetic foot ulcer involves implementing a multitude of strategies to prevent amputation of the limb. This allow for decreased rates in mortality and can increase quality of life. Adequate wound management such as debridement, and offloading techniques should be instilled. Furthermore, education by the provider would be of critical importance for Mrs. Smith in terms of consistent foot care and management of her disease process (Yazdanpanah, Nasiri, & Adarvishi, 2015). Due

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

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 case mentioned a nurse already using hydrocolloid dressing for blemishes by cutting it into little pieces. > cutting the size down cuts costs

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

Evidence based practice in wound care is a significant element in healthcare. It is a combination of high quality clinical research and practice knowledge obtained from eariler experiences and studies (Buysse et al, 2012). We health professionals rely on this knowledge to help us make clinical decisions to meet better patient outcomes. Decision-making is an intrinsic and essential skill that all health professional uses in wound management. Health provides need to make numerous, rapid decisions in highly complex environment. For example, what type of wound it is, how to clean and disinfect it and what type of dressing is most suitable for the wound? The purpose of this essay is to critically appraise a qualitative research article titled, “Health professionals’ decision-making in wound management: a grounded theory.” There is a lack of research on this topic; over the last 20 years only three qualitative studies on clinical decision-making in wound care were published (Gillespie et al, 2014). Therefore, this qualitative research article is important to give healthcare professionals a better understanding about the decision-making process behind wound management (LeeI, 2006, pp. 32).

According to Bastable and Doody (2007) an objective is a specific, single one-dimensional behavior. Objectives are used to form a map to provide directions on how to achieve a particular goal. In this lesson the students will have two goals. The first is for the student nurses to be able to identify all the supplies necessary to change a sterile dressing and to be able to correctly assess when a dressing needs changed or reinforced. The lesson plan will contain the following objectives: