Wound Product Selection Process

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.

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.

Braden scale (Braden & Makelburts, 2005) use in hospitals allows nurses to identify patients at risk for pressure ulcer based on their sensory perception, mobility, activity, moisture and nutrition. Although the Braden scale is a useful tool but healthcare administrations has yet found the best method to eliminate pressure ulcers or bedsore in intensive care units. The use of foam dressing will be introduced to the intensive

Franks, P. J., & Moody, M. (2007). Randomized trial of two foam dressings in the management

A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two

The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was developed in 2003 and updated in 2009 as a tool to utilize when assessing the methodology and quality of a CPG (Mohamed, 2014). An amended version of the AGREE instrument will be utilized to assess the quality and methodology of the Wound Preparation CPG published by the ENA. First the scope and purpose of the CPG will be discussed followed by stakeholder involvement. Next the rigor of development will be analyzed followed by recommendations and applications of the CPG. Lastly, the editorial independence and a summary will conclude this paper.

The clinical issue to be explored is the use of negative pressure wound therapy (NPWT) in the treatment of ulcers. A valuable journal containing articles pertaining to this topic is the International Wound Journal. It is a peer-reviewed journal used by various healthcare providers, including nurses, doctors, podiatrists, surgeons and others, seeking to gain up-to-date information on the prevention and treatment of wounds (Wiley Online Library). It has aided in enhancing the standards provided in wound care by health care professionals. Examples of subject matters covered are diabetic wounds, burn wounds, scar prevention and treatment, wound healing therapies, education and training and more (Wound Source). The journal is therefore

“I have neither given nor received help on this assignment, and pledge this work to be my original composition.” –Ashley Salinas

Burn wounds are extremely painful, and for many patients dressing changes are excruciating every time they are performed (Edwards, 2011). Patients not only experience the background pain that is constant from a burn wound, but also the procedural pain that is accompanied by dressing changes. Burn patients also endure anticipatory pain which is the worsening in pain due to the expectation of pain that is to come from dressing changes (Edwards, 2011). If dressings can be reduced from twice daily to every three to five days, the amount of pain reduction for these patients would be astronomical. Even if the hydrocolloid dressing could not last three days due to exudate, reducing dressing changes from twice daily to daily is still beneficial to the

The ANTT may be used by nurses when they are cleansing wounds or changing dressings. Wounds healing by primary or secondary intention should be approached in the same manner whether the wound is open or closed ensuring asepsis throughout. A solution that is non-toxic to the tissue is used to remove debris, wound exudates and metabolic wastes, these processes are used to cleanse the wound and help to promote wound healing (Briggs 2008). The ANTT should be adopted when attending to surgical site wounds, pressure ulcers, diabetic foot ulcers, leg ulcers and less superficial wounds such as skin tears and scrapes where the integrity of the skin has been breached or compromised

Background. Surgical site wound closure can play a key part in the recovery of patients post-operatively. The use of closure material is usually according to the preference of the surgeon and is a frequently debated issue.

Surgical Care Improvement Project has promoted many core measures to prevent SSI, one of the core measure is the selection of appropriate antibiotic and timing of antibiotic prophylaxis (Anderson D. , 2014). Ideally the antibiotic in the patient’s tissue should be at the highest level at the time of skin incision (Anderson D. , 2014). Recommended antibiotic should be completely infused 30 to 60 minutes before skin incision, this helps in optimizing adequate tissue levels at the time of initial skin incision (Anderson & Sexton, 2015). Anderson &

The majority of arterial leg ulcers will heal over time if the root cause is managed such as recovery from trauma or restoring sufficient blood flow to the affected limb(s) (Wilkinson, 2014) (Forster & Pagnamenta, 2015). Arterial ulcers, depending on the symptoms and the aim of the treatment, different dressings and topical agents are used to provide an optimal healing environment for the ulcer. In a review of different studies examining the effects on healing dressings or topical agents have on arterial ulcers, it was found while a ketanserin ointment group showed improved healing there is yet to be sufficient sample sizes and supporting evidence to conclude if the choice of a dressing or topical agent affects the healing process (Forster

I showed the supernumerary nurse the proper way of preparing for an NPWT using a non-touch sterile technique, and slowly cleaned the surrounding skin prior to the application of the pressure dressing. Since, it was the first time of the mentee to perform a pressure dressing. I have provided my mentee the principles of wound management, so that it will reinforce the knowledge of the supervised nurse and skills, on the management of an NPWT wound. I also provided the mentee the protocols and wound management chart to take note of the type of solutions to be used in managing a surgical wound.