Wound Healing: A Case Study

Pressure ulcer prevention (PUP) in surgical patients has become a major interest in acute care hospitals with the increased focus on patient safety and quality of care. A pressure ulcer is any area of skin or underlying tissue that has been damaged by unrelieved pressure or pressure in combination with friction and shear. Pressure ulcers are caused due to diminished blood supply which in turn leads to decreased oxygen and nutrient delivery to the affected tissues (Tschannen, Bates, Talsma, &Guo, 2012). Pressure ulcers can cause extreme discomfort and often lead to serious, life threatening infections, which substantially increase the

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.

PROCEDURES: I. Indications for V.A.C. Therapy A. For patients who would benefit from sub atmospheric (negative) pressure therapy for promotion of wound healing B. For patients who would benefit from drainage and removal of infectious material or other fluids from wounds under the influence of continuous and/or intermittent sub

Implementation stage consists of: (1) tracking, (2) collaboration, (3) planning, and (4) management. It will take place during the second month. During this stage, skin condition record (Appendix A), multidisciplinary team checklist (Appendix C), and chain of communication guide (Appendix D) will be implemented. All clinicians involved during this stage must utilize these documents. This stage involves bedside nurse, nutritionist, physical therapist, wound care nurse, and an intensivist. Primary nurse will track pre-admitted and developing pressure ulcers in patients. Skin condition record will be used to assess and document description. Staff nurse will follow chain of communication protocol afterwards. Collaboration will take place once a pressure ulcer is

• Nutrition- Mani (2003) claims that nutrition is a fundamental role that must be adopted in the treatment and healing process of pressure ulcers. A balanced diet with adequate nutrients should be key for all patients deemed to be at risk of pressure ulcers. Both nutrition and hydration are the basic components in promoting wound healing and maintaining normal tissue integrity. Patients at risk of pressure ulcers should be nutritionally assessed at regular intervals (Shepard. 2003). This could have been adopted by the use of assessment tools such as, The Nutritional Screening initiative. This tool includes nutritional screening at regular intervals and a comprehensive assessment that includes nutritional assessment, functional assessment and evaluation for depression. This comprehensive approach allows the nurse to quantify the nutritional problems and initiate the appropriate resources that will meet with the individual needs (Bryant, 2000). Another optional tool is the Malnutrition Universal Screening Tool or MUST. This has been designed by the Malnutrition Advisory Group (MAG) of the British

I showed the supernumerary nurse the proper way of preparing an NPWT using a non-touch sterile technique, started by slowly cleaning the surrounding skin prior to the application of the pressure dressing. Since it was the first time of the preceptee to perform a pressure dressing, I have provided my preceptee the principles of wound management so that it will reinforce the knowledge of the supervised nurse and skills on the management of wound using NPWT. I also provided the preceptee the protocols and the wound management chart to take note of the type of solutions to be used in managing a surgical wound. We also documented in the progress notes what we have performed, and informed the nurse in-charge on the frequency of dressing change in a week.

Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et

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.

The breadth and depth of information about pressure ulcer and its treatment presented are appropriate for a new graduate to gain insight into the clinical management of pressure ulcers.

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

Pressure ulcers are often a clinical complication condition that can become serious if not treated. The condition and treatment can require extended length of stay in the facility, is painful, can lead to infections and even death. The objection of the healthy skin project was to educate and document results from an extensive study on this condition. The result of the study was to decrease widespread evidence and presence of this condition commonly found in patients.

Through the significance of the literature review, it will contribute additional insights in wound management. Also it will provide a better understanding on the function of a negative pressure wound therapy. Thirdly, it will provide information on the effectiveness of negative pressure wound therapy in managing wound. Lastly, the literature review will provide benchmark information on the limits of NPWT.

Pressure ulcer is a common geriatric syndrome seeing in patients suffering from acute and chronic illness. Pressure ulcers can be acquired while in the hospital, long term care facilities or in the home. Personal definition of Pressure ulcer is an injury to the skin and underlying tissue due unrelieved pressure and other factors, including by not exclusive to decreased tissue perfusion, excess moisture, and shear and friction. The NPUAP defines Pressure Ulcer as “injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/friction” (NPUAP as cited in Stonelake, 2015, p. 2). Pressure ulcers can be regarded as negligence and poor nursing

Does the use of closed-incision negative-pressure therapy (CINPT) dressings on post-surgical patients reduce wound infections and other complications verses traditional dressings? Post-surgical infections and complications are a major problem for both patients and hospitals. Complications can reach 66% with high risk patients(XX). Surgical site infections (SSI) and other complications delay patient recovery resulting in longer hospital stays and increased healthcare costs. Patients who develop SSIs endure longer and more expensive hospitalizations, greater post discharge wound-care costs, and more readmissions than noninfected patients. Interventions that can reduce complications affect nursing practice through better patient

Turning to the efficiency of negative pressure therapy in comparison to the usual care of wound, it is absolutely more helpful for the patient in terms of fast healing for a chronic wound. This point is also sustained by the study that was conducted by Suissa, Danimo & Nikolis (2011) where with the assistance of a negative pressure therapy promotes wound healing in the quickest possible time. This also not only allow the patient to return from its daily activities but also at the same time it is a cost effective for the facilities that have used the negative pressure therapy to their patient. Unlike the normal wound management, it will require the usage of various dressing and will perform the hit and miss strategy until certain dressing work to the patient’s wound.