...Wound Cleansing: Water or Normal Saline? Ashtin Plummer MidAmerican Nazarene University Wound Cleansing: Water or Normal Saline? Wound cleansing has been discussed about for many years, different solutions and techniques have been discussed to use, and it is an important part of preventing infection. Wound cleansing is described as the use of fluids to remove debris and dead tissue from the surface of the wound. The purpose of wound cleansing is to make the best possible conditions at the wound site, for uncomplicated wound healing. The most commonly used solution would be normal saline due to being an isotonic solution and it does not disrupt with normal healing process of wounds (Ljubic, 2013). Normal saline has just been known as best practice for many years. However, is tap water able to do the same thing as saline without increased risk for infection or delay in wound healing? “Tap water is also said to be effective in wound cleansing and has advantages of being cost effective and easily accessible” (Ljubic, 2013). Wound care is a major service provided in home health care and due to going to patients’ homes, normal saline is not always accessible. Saline is not always accessible due to running out of supply while at a patients’ home. Wounds can also take a decent amount of time to heal so using tap water with these patients may be more cost-effective in the long run, not delay wound healing, and not increase the patients risk for infection. PICO Question ...
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...Dietary Protein Increase and the Promotion of Wound Healing in Diabetic Adult Patients Dietary Protein Increase and the Promotion of Wound Healing in Diabetic Adult Patients Introduction There are approximately 23 million people diagnosed with diabetes in the U.S. (American Diabetes Association, 2012) and this population continues to grow. There are multiple complications associated with diabetes. One major and expensive complication is diabetic wounds. The cost of care in the U.S. alone for this population is approximately $245 Billion annually. (American Diabetes Association, 2012) Proper wound care is an essential step in the wound healing process, however,wound care alone is not sufficient. Nutritional status is extremely important in wound healing. Diabetic patients need to be educated and assessed for protein-energy malnutrition (PEM) as the body’s nutritional needs significantly increase during the wound healing process (Demling, 2009). Supplementation (especially protein) and the importance of it for wound healing need to be discussed with the patient. Without all the necessary interventions applied the process of wound healing can be lengthy and may lead to infection, excessive hospitalization and potential amputations. Understanding the body’s nutritional needs and how the body uses protein in the repair process is imperative. The recommendation for the amount of protein supplementation is between 0.8grams/kilogram to 1.2 grams/kilogram and is based on patient...
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...Wound Care Education Abstract The purpose of this paper is to identify a patient health issue that would benefit from patient education. During the clinical rotation at Jackson South the group identified a need in wound care especially for patients with other underlying health issues such as diabetes. A large percentage of patients had wounds that would require patients to properly care for them once discharged. The group identified a lack of patient knowledge on how to care for these wounds and decided to develop a patient education pamphlet to teach patients how to care for wounds while not in a hospital setting. The group identified one particular patient that had insufficient knowledge in self-care. Wound Care J.G. is a 65-year-old male patient with a history of a cerebrovascular accident, hypertension, diabetes and multiple pressure ulcers. The patient was admitted to Jackson South Community Hospital with multiple wounds for suspected infection. He currently has two pressure ulcers present. One is a stage IV ulcer located at his right hip and the other is a stage III ulcer located on the heel of his right foot. He is scheduled for a CAT scan to rule out any collections in the hip and medical management of the wounds will be continued. Factors that contributed to the development of these ulcers were his lack of sensation due to his diabetes and being bed bound. He is alert and oriented and is in no acute distress. He currently lives with his only daughter, who will...
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...Pressure Ulcers: Wound Care Assignment Harman Unitek College Foundations of Nursing VNSG 100 Mr. Dhanda November 10, 2015 Pressure Ulcers: Wound Care Assignment Have you ever wondered what it looks and feels like if our skin gets torn up? You haven’t right? There are approximately 2.5 million who get pressure ulcers from hospitalization each year. From those 2.5 million patients, 60 thousand patients die from complications (Cooper & Gosnell, 2015, para. 4). In this essay, I will be explaining the normal causes, common treatment (tx), and prognosis for healing. Pressure Ulcers (PU) overall usually occur when there is sufficient pressure on the skin over bony prominences causing blood vessels in an area to collapse. Pressure ulcers result in ischemia or lack of oxygen and nutrients to the cells. PU usually take place over bony prominences such as: sacrum, scapula, elbows, heels, inner and outer knees, back of the head, and the hips. Since we are talk about stage III pressure ulcers, PU involves full thickness tissue loss where the subcutaneous fat is sometimes visible, but bones, tendons and muscles are not exposed. Stage III pressure ulcers vary depending on the location which also include: bridge of nose, ear, and the occiput. Deep stage 3 PUs develop in areas within layers of deep adipose tissue. The two main factors that play a role in development for pressure ulcers are shearing force & friction. Shearing force involves when the tissue layers of the skin...
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...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. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer Rationale: Mr. Gordon has drainage coming from his surgical incision, and his dressing needs to be changed. What assessments of the incision should Joan perform while changing? Answer: Rationale: Claudia asks Joan what she can do when she takes him home to help prevent...
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...Education on Wound Care for Diabetic Patients Education on Wound Care for Diabetic Patients Abstract Non-compliance of wound care management has increased the risk of infection and amputations. Diabetes wound care management is an important and fundamental aspect when it comes to diabetes teaching and education. Assessment of the feet daily and at a primary care office will provide information such as noncompliance, risks for neuropathy, peripheral vascular disease, macro-vascular disease, and possible amputation. Education provided by health care practitioners to the diabetic population will promote decrease in risk for further complications and the patient to be involved in their own care. Assessment, treatment, and education on wound care management with the involvement of the patient will increase the patient’s quality of life and be very beneficial to both the practitioner and the patient. Keywords: diabetic wound care management, diabetic ulcer care, outpatient diabetes management, diabetic care management Introduction Working in a primary care setting will involve a multitude of disease processes- diabetes mellitus being one of them. Diabetes is a disease that is characterized by high levels of blood glucose with a defect in insulin secretion and cell resistance. Without proper management, diabetes may lead to other issues in health. Examples of such, would be, delay in wound healing, leading to foot ulcerations, which thus increases the risk for amputations...
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...Reflective 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) During the course of this piece of work, it is my intention to outline and discuss a clinical audit that I undertook into one aspect of care delivery and reflect upon the experience using Driscoll’s model of structured reflection (Driscoll, 2000). The audit, which focused upon the completion of prescription cards, was undertaken during my recent clinical practice placement at Holcroft, a twenty four bed mental health residential unit, situated in the North West of England. In addition to providing a summary of the exercise itself, I would also hope to explore the relationship between the clinical audit process and the wider framework for quality improvement in healthcare. The development of regulation and clinical governance systems in the United Kingdom will also be addressed as will the administration of medication as a significant element of nursing practice. Where necessary, use will be made of academic, research and other evidence based material to underscore or augment specific issues or indeed illustrate examples of good clinical practice. The Nursing and Midwifery Council (NMC) standards for conduct, performance and ethics (NMC, 2004) have been diligently applied in the construction of this assignment. Pseudonyms will therefore be used to ensure staff and patient...
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...Wound Care Specialists has a current ownership structure of a LLC. This company is majority owned by Cressey Company, with founders being other majority owners. They are located within fourteen states. Those states are AR, LA, MS, FL, GA, IL, KS, MO, MS, NE, NM, OH, OK, and TX. Within these fourteen states there are a total of ninety-five clinics. These clinics are filled with hospital services such as critical access, acute care, LTAC, and HBO. They also have a series of products that are typically involved with wound care. There website being http://www.woundcarespecialists.com/ take a look and see how professional and how deliberate they are for employers as they are for customers. ” Wound Care Specialists is one of America’s largest operators...
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...Surgical Wound Infection ? I will like to identify patients conditions and other factors contribute to the development of Surgical Wound infections. * Determine the aims or purposes of analysis The purpose is to understand the effect of environment in surgical wound infections. Prevention of infection requires the application of the principles of microbiology and accept practice. Measure of this concept is based on the stages of wound healing and the Centers of Disease Control and Prevention guidelines defining surgical site infection as occurring 30 days postoperative. * Identify all uses of the concept The Merriam-Webster Dictionary was used to explore the general definition of surgical wound infection Surgical of or relating to the process of performing a medical operation: of or relating to surgery. Wound an injury that is caused when a knife, bullet, etc., cuts or breaks the skin. Infection is the act or process of infecting someone or something: the state of being infected. The Oxford English Dictionary (OED) was also used to explore the definition. Surgical relating or used in surgery. Wound is an injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken. Infection is the process of infecting or the state of being infected History of Surgical Wound Infection Hippocrates (Greek physician and surgeon, 460-377 BC), known as the father of medicine, used vinegar to irrigate open wounds and wrapped...
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...necessary? Barbara A Body Grand Canyon University Research Critique Introduction Since 2008, the Centers for Medicaid and Medicare Services (CMS) no longer pay the full cost of care if certain hospital acquired conditions (HAC) are coded as a secondary diagnosis. Surgical site infection (SSI) is classified as a HAC and considered a preventable condition. For an eligible patient with a SSI coded as a secondary diagnosis, the hospital will only be reimbursed based on the primary diagnosis. (Medicare Learning, 2012) The hospital is left to absorb the remainder of the cost for the care of this patient. Much research has been done on ways to prevent SSI. This is a review of one quantitative study related to the effects of postoperative dressings on surgical complications, including surgical site infections. Protection of Human Participants In the study “Are Postoperative Dressings Necessary?” (Borkar & Khubalkar, 2011), 123 patients were recruited and signed informed consent. The researchers demonstrated protection of the participants from harm by way of the selection criteria. Only patients undergoing clean or clean-contaminated surgical procedures were included. Those with co-morbidity factors like diabetes or jaundice were excluded from the study, as well as those with contaminated wounds such as ruptured appendix or peritonitis. No particular benefit or risks to the participants were clearly identified by the authors; however, this reviewer could infer benefits such...
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...approximately a third of pregnant women in the US and 15% worldwide deliver by cesarean, and this prevalence is on the rise" (Dana Figueroa et al., 2013, p. 33). Since Cesarean sections are incredibly common and are only increasing, the risks for complications, such as infections, increase with it. To try and decrease the risks as much as possible, this study aims to look at the differences between two types of closing material used in Cesarean sections; absorbent sutures and staples. Are absorbable sutures more effective and safer than staples for Cesarean sections? The purpose of this study is to compare absorbent sutures and staples for clients undergoing a Cesarean section and to see which material has a lesser risk for infection and wound complications, which is more cost effective for the hospital, and patient satisfaction. This paper will help shed light on this subject by compiling multiple research articles and journals to create a better understanding on which material is best to use. Review of Literature There are a multitude of articles on the subject of absorbent sutures compared to staples. Every article, except for one, was a peer reviewed article with a study that was randomized and controlled. The exception article by Suzanne Corcoran et al. (2013) was, “A peer reviewed study that was a prospective observational cohort study involving...
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...resuscitation, does the pt take beta blockers that may mask an appropriate tachycardia? -evaluate the pts ability to follow commands and respond appropriately. Is neurological disability a central phenomenon from shock, or is there a direct spinal cord injury? The patient must always be adequately exposed to evaluate all injuries, don’t over look the axial, back, gluteal cleft, and perineum. Patients with penetrating abdominal injuries are best served by antibiotic therapy prior to operative intervention. Initial therapy should be broad, with coverage of both gram-positive and gram negative organisms. Current practice guidelines advise broad spectrum antibiotics prior to incision and throughout operation -tentanus toxoid upon admission The care of the trauma patient does not end with intraoperative repair of injuries. The hypothermic, coagulopathic laparotomy patient is prone to numerous postoperative complications: Expect...
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...Wardha, Maharashtra, India. drnitinborkar25@gmail.com Abstract OBJECTIVE: To determine whether or not the routine use of postoperative dressings prevents surgical site infection and wound dehiscence. MATERIAL AND METHODS: Patients with clean or clean-contaminated (e.g. hernia, orchidectomy cystolithotomy, ureterolithotomy, appendectomy) sutured surgical wounds were randomised into two groups: those who did not receive postoperative dressings (the study group) and those who did (the control group). Variables like adequate haemostasis, sterile techniques, obliteration of all wound cavities, and approximation of divided structures were not controlled for. Wounds were assessed after 6 and 24 hours, and on the third and fifth postoperative days for clinical signs of infection and dehiscence. RESULTS: A total of 123 patients with 124 clean surgical wounds were recruited into the study. The mean age and ratio of men and women in each group were comparable. There was no significant difference in the rate of wound complications between the two groups: 4.76% for the study group and 4.92% for control. CONCLUSION: Based on these preliminary data, surgical wounds left open do not have an increased incidence of surgical site infection and wound dehiscence, compared with similar types of wounds dressed postoperatively. In a large teaching hospital, the extrapolated cost savings of dressing materials alone can be significant. Larger studies are needed to confirm these results. CONFLICT...
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...lift or break the skin over the object. Lift the tip of the object out and grasp it with your tweezers. • Squeeze the wound gently to allow bleeding to wash out germs. • Wash the area again and pat dry. Apply an antibiotic ointment. Lacerations (Cuts) * Wash your hands. This helps avoid infection. Also put on disposable protective gloves if they're available. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If not, apply gentle pressure with a sterile bandage or clean cloth and elevate the wound. * Clean the wound. Use clear water to rinse the wound. Keep soap out of the wound, as it can cause irritation. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. * Apply an antibiotic. Apply a thin layer of an antibiotic cream or ointment to help keep the surface moist. These products don't make the wound heal faster. But they can discourage infection and help the body's natural healing process. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. * Cover the wound. Bandages can help keep the wound clean and keep harmful bacteria out. If the injury is just a minor scrape, or scratch, leave it uncovered. Stings To take care...
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...sores An 80-year-old was admitted to an assisted-living center and had small pressure wounds on her tailbone as well as her left foot. During the following two weeks, the sores got a lot worse, but no medical treatment was given. The lady began to have a high temperature and was taken by ambulance to the local hospital; doctors were shocked. The sore on her tailbone was so infected that the bone was exposed. Surgery was done to clean out the wound, and a piece of the tailbone had to be taken out. Once the patient returned to the assisted-living facility, her sores got worse, and she died of sepsis four months later. http://www.sandiegoaccidentinjurylawyer.com/lawyer-attorney-1279341.html 2. Leg cut off due to untreated heel sore An 85-year-old resident of a South California assisted-living facility developed an ulcer on his right heel and it was left untreated for almost seven weeks. Regardless of the nurses’ notes stating that the sore was responding to treatment, the sore grew to be very large, discolored, necrotic, and began to smell. After the infection was discovered, the man was taken to the hospital and his leg was cut off above the knee. http://www.sandiegoaccidentinjurylawyer.com/lawyer-attorney-1279341.html 3. Patient passes away due to Neglect An 84-year-old resident of an assisted-living facility passed away due to a very bad case of urosepsis because the facility did not care for and clean her catheter. http://www.sandiegoaccidentinjurylawyer.com/lawyer-attorney-1279341...
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