4.1 Discuss and appraise your approach to managing wounds that are classified as either healable, non-healable or maintenance. Comments on the differences of the approaches between these classifications.
Managing wounds whether it is healable, non-healable or maintenance are becoming more complex and dynamic process that are influenced significantly by the new discoveries and technologies, available researches work, companies’ recommendation, health care institutions recommendation, patients’ beliefs, practitioners’ belief, and availability of the logistics and human resources. My wound management style is based on the adaptation of informed framework, research based, tested recommendation and holistic approach including the patient himself as the centre of consideration of care including multidisciplinary inter-professional approached.
Wounds complexity conditions warrants different specialities and individualized approached from different dedicated professionals. Wounds will be better managed if more experts will deal on it rather than to be cared by single person alone.
In the wounds management, there are existing proven approached created by many experts in the wound management. There are such enablers for wound bed preparation available designed specifically for healable, maintenance and non-healable wounds. To follow this kind of enablers will guide you to your wounds management for a better wound care favourable outcomes.
To achieve desirable wound healing outcome, it should follow a systematic approached management. Wounds should be involved in an accurate assessment, a comprehensive holistic intervention, and requires periodic review or evaluations.
Assessment:
Complexity of human being and the patient wounds demands m...
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...an be regularly used. The issue of healthy tissue toxicity related to anti-infective is less consideration in this classification of the wound. Moisture is needed to be minimized, there is no necessity of moisture to proliferate the important substance for enhance wound healing; remember wound healing process will not advance from this stage. Edge of the wound treatment is not necessary. To keep the wound out from infection, pain free, dry, prevent further deterioration and is the goal of care.
Evaluation:
Wound that never decrease its size by half on its 6 weeks most probably will not heal on 12 weeks. If the wound is stalled, or not improving, it needs to revaluate the wound management and needs to be reassess by the multidisciplinary team and to improve or intensify the current approached. Wound care needs continue follow up and review to ensure its success.
Carlton suffered an acute tissue injury on his foot after stepping on a sharp edge shell, which disrupted the layers of the skin. Immediately after an injury occurs, an inflammatory response begins, which serves to control and eliminate altered tissue/cells, microorganism, and antigens. This takes place in two phases. 1) The vascular phase, in which small vessels(arterioles, venules) at the site of injury undergo changes. Beginning, with
Using the Skin Safety Model (SSM), prevention of pressure ulcers can be shifted to a more holistic patient-centered approach. The SSM comprises of four sections, potential contributing factors to skin injury, exacerbating elements, potential skin injury, and potential outcomes of skin injury. Each section then has subcategories of determinants that can change depending on the patient’s specific circumstance. The SSM helps the caregiver look at the patient as a whole and incorporate all of the patient’s risk factors that could potentially lead to impaired skin integrity or pressure ulcers (Campbell, Coyer, & Osborne,
...y parts should be elevated above the heart, a tetanus shot is given and the wounds are covered in cool moist bandages to prevent the development of infection. Patients with severe burns are more susceptible to infections so many doctors prescribe a broad stream antibiotic to avoid dealing with further complications. (Web MD, 2009). Minor burns are usually treated with a cool compression and a sterile bandage, avoid keeping the burn moist as it may take longer to heal, minor burns usually clear up on their own.
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
In conclusion there are many diverse types of dressings available for wound management, with no solitary dressing being claimed to be the best due to the differences amongst health care professionals. There are on going searches for an ideal wound dressing for the management of ulcers. In weighting out the negatives and positives there is no hesitation in saying that hydrocolloid dressings make a significant involvement in the contribution to modern wound management and is deemed a success for the management of patients with decubitus ulcers.
The Company publishes "Modern Methods of Antiseptic Wound Treatment," which quickly becomes one of the standard teaching texts for antiseptic surgery. It helps spread the practice of sterile surgery in the U.S. and around the world.
...l as salt could keep wounds clean,and although the process would still be painful, that pain was insignificant compared to pain while in surgery; operations in hospitals were often carried out while the patient remained conscious. When dealing with wounds, in the opinion of insert name here, inflamed wounds should never be closed, but rather dressed with gauze and a varnish, to allow for movement, but also provide support. Infected tissue was drained, while extremely infected tissue was cut off the body completely.
Whenever an injury cannot be avoided, however, it activates a series of mechanisms to repair the organism. Evidence of these systems comes from blood platelets that clot wounds to prevent bleeding out.
If two parts of the wound are far away from each other, this will cause the wound to heal a lot longer. Stitches and staples are used on certain wounds as well to make the scarring process heal faster as well. Wounds that are cleaned out quick are able to heal faster as well. I found in my research that being in car accidents can increase your chance of a permanent scar because all of the dirt and bacteria can reopen the wound.
Using this information, professionals design their treatment procedures that are already pre-tested and approved by clinical experts through trials. Makic et al.(2013) stated in his studies that evidence based practice is about using latest technology and genuine data, the ritual based practice on the other hand lacks innovation and comprises of techniques that was designed generations ago and are still followed in some cultures and countries. Recent studies indicate that argued the ritual or opinion based practices have no window open for accommodating the rapid advancements in the medical sphere (Peterson, Barnason, Donnelly, Hill, Miley, Riggs, & Whiteman, 2014). For example, based on evidences, burnt victims are now advised to apply water on their wound while on the other hand in ritual based practices, burn victims rarely used water on their wounds. If doctors and nurses follow the later, then the victims will not be receiving the best medical care. However, if the professionals are in favour of administering evidence based nursing practices which is up to date, then the patients will be receiving the best available treatment (Mahanes, Quatrara, & Shaw, 2013). Hence, an evidence based nursing care provides the most effective treatments and outcomes than the ritual or opinion based
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
... Even after finding evidence-based practice that would prompt a change in the patients care plan, you may still have problems convincing professional colleagues and the management of your findings and putting them into place. Journal of Wound Care p. 11. Practitioners have a responsibility to ensure their practice is based on sound clinical evidence and that the care delivered is of a high quality.
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.