Wound Healing: A Case Study

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.

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.

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

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

To start the search for evidence within University Hospital, questions were asked in regards to pressure ulcers. Monthly updates are often sent out via email from the wound care team to keep everyone up to date on knowledge. While there was informative numbers within those updates, this information falls short according to Moore, Webster, & Samuriwo (2015). The main limitation of the study is the lack of a control group in pressure ulcer prevention and treatment. There is no clarity in the specific criterion that contributed to improved clinical outcomes. Teams used more than one method in the research project. Also, there is no study that meant the inclusion criteria in the random clinical trials. The lack of standardized

Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.

A pressure ulcer is a localized injury to the skin usually over bony prominence, as a result of pressure, or pressure in combination with shear. It is estimated that 5 to 10 percent of patient admitted to the hospital acquire a pressure ulcer and it result in increased suffering, morbidity and mortality. The policy titled Pressure Ulcer Prevention and Managing Skin integrity provides direction for the nurses to prevent the development of pressure ulcer. It

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

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

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.

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.

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.