WOUND MANAGEMENT IN CLINICAL ENVIRONMENT

Wound Management In Clinical Environment

Wound Management In Clinical Environment

Introduction

This assignment is concerned with developing skills in the ability to relate theoretical knowledge and evidence, obtained from nursing literature, to a patient for whom caring for. This particular study aims to evaluate the care given to a patient diagnosed with hysterectomy.

Case Study

The patient Sarah Victor, is to act in accordance with the code of professional conduct, set by the Nursing and Midwifery council (NMC) (2002) section 5.1, not to breach confidentiality of the patient. Geraldine is a 53year old lady who lives alone. She enjoys walking reading and gardening. She has a daughter who lives near by and visits every day to help with her mother's general care. Gerldine's daughter works part-time but always fits her in each day.

Sarah Victor who had a hysterectomy 12 days ago. Sarah has been readmitted with a wound dehiscence and has completed a course of antibiotics for her wound infection. There are no signs and symptoms of systemic infection at this stage although there is still a moderate amount of exudate. Sarah states that her wound is sore and a bit smelly.

She thought this would heal, however 12 days later there were no signs of the lesion closing over. She contacted her GP who sent a referral form to the hysterectomy clinic, asking for an assessment to be completed. It was established from the lesion that this was a small hysterectomy.

In order to establish a systematic, comprehensive and constant assessment of a patient, written forms have been specifically designed. These are completed for each individual. In Geraldine's case the forms used had three sections. The first part is mainly personal details GP, next of kin situation at home, previous medical history, family history and previous hysterectomy history. Williams (1999) stresses the importance of getting in-depth patient history and that it helps nurses and medical staff make accurate informed decisions. Moffat (1998) agrees with this adding that underlying causes must be determined before planning a care programme.

The second part of the form is dealing with medication status of the patient with any prescriptions a patient is receiving being documented. This can have direct impact on hysterectomy care treatment. Any allergies may be irritated by topical treatments and can cause healing process to be complicated or difficult (Cameron 1996). Urine and blood test should be carried out to screen for diabetes and rheumatoid arthritis. Duncan (1999) says these test should be included as part of a holistic framework. Patients should have a GP examination to make sure conditions such as heart disease are diagnosed and treated (Green 1997).

The third part of the form is interested in factors such as activities of daily living, before during and after the persons breakdown in health and loss of independence. The questions in this section are interested in assessing mobility, pain, sleeping patterns, nutrition and psychosocial factors. The patients understanding of their own diagnosis is also considered. Shipperley (1997) points out that including and recording ...