...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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...The Significance of Having a Multidisciplinary Team 3 Abstract The growing prevalence and hospital acquired pressure ulcers is an immediate concern. The major challenge is the A major challenge is the lack of knowledge and skills in wound identification, management, treatment and prevention. This, along with other factors, creates poor patient care and vast costs to the pertinent facilities. The solution is to have interprofessional collaboration. The utilization of current advanced practice nursing staff as a resource for floor nurses and other involved healthcare workers is a must. This would obtain certification in wound care and be responsible for the ongoing continued education for wound prevention, monitoring and maintenance. The staff will be educated and trained at quarterly intervals on wound identification, staging, prevention, maintenance and monitoring. Key words: wound care, evaluation, pressure ulcers, multidisciplinary, specialist, evidence The Significance of Having a Multidisciplinary Team 4 Problem Identified The Centers for Medicare & Medicaid Services (CMS) declared in October of 2008 that it will no longer provide reimbursement for hospital acquired pressure ulcers (HAPUs) because it is a preventable occurrence (CMS, 2014). Even though the percentages of occurrences have declined since then, HAPUs continue to cause financial strain on institutions (estimated $9.1- $11.6 billion dollars loss annually)...
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...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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...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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...Forensic Significance of Radiography in Evaluation of Gunshot Wounds to the Spine Samantha Lawson Introduction Gunshot wounds cases are continuing to increase across the country. One of the most severe cases of gunshot wounds is the spinal injuries as a result of penetration of bullet fragments towards the spinal column. Determining the projectile of the bullet and its position is vital for physicians to treat such an injury. Forensic Radiography is a technique that can be used in medical facilities to determine the exact position of the bullet fragments. Forensic Radiography is quite useful in the medical profession. Understanding the right type of radiography is vital in ensuring that physicians are able to make sound decisions in treating patients with spinal injuries as a...
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...use of HGF seems to be the direction some skin-care companies are taking, and because there is a large body of research showing its efficacy for wound healing (but not for wrinkles), it does deserve comment. HGFs make up a complex family of hormones that are produced by the body to control cell growth and cell division in skin, blood, bone, and nerve tissue. Most significantly, HGFs regulate the division and reproduction of cells, and they also can influence the growth rate of some cancers. HGFs occur naturally in the body, but they also are synthesized and used in medicine for a range of applications, including wound healing and immune-system stimulation. HGFs are chemical messengers that bind to receptor sites on the cell surface (receptor sites are places where cells communicate with a substance to let them know what or what not to do). HGFs must communicate with cells to instruct them to activate the production of new cells, or to instruct a cell to create new cells that have different functions. Another way to think of HGFs is that they are messengers designed to be received or “heard” by specific receptor sites or “ears” on the cell. HGFs, such as transforming growth factor (TGF, stimulates collagen production) or epidermal growth factor (EGF, stimulates skin-cell production), play a significant role in healing surgical wounds. The main task of HGFs is to cause cell division, which is helpful; however, at certain concentrations and over certain durations of application...
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...Wounds are injuries that break the skin or other body tissues. They include cuts, scrapes, scratches, and punctured skin. The skin of the elderly may degenerate on its own and sometimes even without the presence of an injury. Elderly wound care is a significant and important part of the duties for nursing staff. Bedsores, ulcers and other types of wounds require lots of treatment and attention, which is a major responsibility for licensed nursing staff (Bock, M. (2003). However, there are instances when improper elderly wound care can result in further health complications or even early death. There are a number of types of chronic wounds that may require to be treated in a nursing facility. The different types of wounds are lacerations, abrasions, contusions, and avulsions. There are a lot of factors that determines wound closure, the type of wound, size, the location of wound, how long-standing the wound is, condition of the patient, whether infection is present, and urgency of closure. Pressure ulcers often occur because of limited mobility and confining physical structures such as wheelchairs and bed rails. With elimination of pressure, a good blood supply, and adequate nutrition, the pressure ulcers will generally heal. With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation...
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...Nurses’ mission is “to promote excellence in medical-surgical nursing.” They wanted to improve knowledge, skills and professionalism by educating and providing new materials to enhance learning. The organizations purpose is to improve patient care, advocate for the specialty of medical-surgical nurses, and being able to connect to others who has compassion and commitment. To improve patient care, they focused on their actions and voice, and provided evidenced-base practice, research and knowledge. Membership is open to everyone who is interested in the care of adults. Annual membership fee is $84.00 but students, seniors, new grads and associates can also become a member at a different fee. The benefits of being an AMSN member includes free journals and newsletters, free online continuing education, discounts on AMSN study resources, conventions, and application for scholarships, awards, and grants. Its professional culture and values of the organization is to improve patient care. AMSN could assist me with my professional development and lifelong learning by continuing to provide me with information on evidence-based practice for better quality patient care and safety. It also enhances my knowledge through the continuing education they offer for their members. American Association of Diabetes Educators (www.diabeteseducator.org) I chose American Association of Diabetes Educators as one of the organizations that I’m interested in because...
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... Submission Date | 30.04.2013 | Word Count | | Discuss The Factors Which Influence The Processes Involved In Wound Healing 1. Introduction A wound is defined by its aetiology, anatomical location, acute or chronic stages, and the method of closure by its presenting symptoms and predominant tissue types in the wound bed. Injury to the skin or underlying tissues/ organs caused by surgery, a blow, a cut, chemicals, heat/ cold, friction/ shear force, pressure or as a result of disease, such as leg ulcers or carcinomas, Infectious (bacterial, Virus); Immunologic (Autoimmune disease; Genetic derangement e.g. Sickle cell anaemia); Nutritional (Vitamin deficiency; Oxygen imbalance) and Metabolic imbalance (ATP depletion) breakdowns the protective function of the skin by losing the continuity of epithelium, with or without the loss of underlying connective tissues (i.e. muscle, bone, nerves). Hence, the immune system initiates to recover wounds through complex pathways. Wound healing consists of four stages which are in the order hemostasis...
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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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...BEATRISA SHEKHTER NRS 433-V Literature Search Wound Care is very important topic in modern medical field. Pressure ulcers are the major problem in the long term facilities. Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the ‘health care time bomb’ in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. The present-day burden that wounds and current wound management practices place upon the health-care system are detailed and clarified, and the potential future implications of increasing wound prevalence on the current picture are explored. Possible opportunities to enhance current wound management practice as identified in the analysis are discussed. Declaration of interest: Alistair Biel by is a contractor for Smith & Nephew. Richard Searle is and employee of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew. As such, a pressure ulcer is defined as localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result...
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...Antibiotic in Surgical Patients Gretchen Smith Antibiotic in Surgical Patients Prevention of surgical infections is a highly significant issue to pre-op nursing care, as surgeons entrust nurses to carry out the procedure, of administration antibiotic prophylactic, which have a positive impact on patient outcome. When a surgeon determined that an antibiotic is going to be required for a particular case, giving the antibiotic at the correct time is “very important” (“Case example,” 2010, p. 27). Research has found that antibiotics that are administered (“to early or after surgery begins are not effective” (“Case example,” 2010, p. 27). It is important for nurse to be aware of the timetable and take steps to implement this in to their practice. It has been debated as to whether or not antibiotic prophylaxis is appropriate in preventing infections in surgical patients. (Easter, 2010). Zaidi, Tariq and Breslin (2009), addressed the topic of timing an antibiotic prophylaxis, the researches study 525 elective surgeries and the timing of antibiotic administration. Zaidi, Tariq and Breslin stated that the “antibiotic should be administered as near to the incision time as possible,” as the study found that “pre-incisional prophylaxis administration of antibiotics is more beneficial than post-incisional administration” (Zaidi, Tariq, & Breslin, 2009, p. 226) The most significant risk factor for delivery by cesarean section is post partum infection. As antibiotics...
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...Mindaugas Danilevicius, 2UAB ‘Apiterapija’, Vilnius, Lithuania, Audra Juzéniené, Indré Juzénaité-Karneckiené, Republican Vilnius University Hospital, Department of Infection Control, Vilnius, Lithuania Accepted for publication: July 2015 S36 I British Journal of Nursing, 2015 (Tissue Viability Supplement), Vol 24, No 15 © 2015 MA Healthcare Ltd Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections are an increasing problem worldwide with a high risk of severe illness and mortality in hospitalised patients. Patients with chronic wounds are at particular risk of developing MRSA infections. As octenidinebased products have shown promising success in decontamination in the past, the aim of the present study was to determine its efficacy, safety, and tolerability in decontaminating hospitalised MRSApositive patients. Methods: From 1 April 2011 until 9 November 2012, 36 patients were screened MRSA-positive at the Republican Vilnius University Hospital, Vilnius, Lithuania. At least three swab tests were performed for each patient to screen for MRSA, one from each nostril and one from the perineum. In patients with wounds, an additional swab was taken from the wound surface. In the affected patients octenidine-based products were used in one or two cycles of 7 days each. In addition, adverse events were recorded and the tolerability was assessed using a 4-point scale ranging from ‘very good’ to ‘poor’. Results: Complete decontamination...
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...and Huai, B.S., 2016. Calibration power of the Braden scale in predicting pressure ulcer development. Journal of wound care, 25(11), pp.655-659. Dougherty, L. and Lister, S. eds., 2015. The Royal Marsden manual of clinical nursing procedures. John Wiley & Sons. Dumville, J.C. (2015) 'Negative pressure wound therapy for treating pressure ulcers', Cochrane Database of Systematic Reviews, (6). Griswold, L.H., Griffin, R.L., Swain, T. and Kerby, J.D., 2017. Validity of the Braden Scale in grading pressure ulcers in trauma and burn patients. Journal of Surgical Research, 219, pp.151-157. He, W., Liu, P. and Chen, H.L., 2012. The Braden Scale cannot be used alone for assessing pressure ulcer risk in surgical patients: a meta-analysis. Hong-Lin Chen, Ying-Juan Cao, Zhang, W., Wang, J. and Bao-Sha Huai (2017) 'Braden scale (ALB) for assessing pressure ulcer risk in hospital patients: A validity and reliability study', Applied Nursing Research, 33, 169-174. Jaul, E., Rosenzweig, J.P. and Meiron, O., 2017. Survival rate and pressure ulcer prevalence in patients with and without dementia: a retrospective study. Journal of Wound Care, 26(7),...
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...UNIVERSITY OF THE WEST OF SCOTLAND NURSE PRESCRIBING V150 CASE STUDY COURSE: NURS09125 BANNER NUMBER: B00113677 DATE OF SUBMISSION 13/12/10 COURSE LEADER FRANCES DOWNER WORD COUNT: 3745 CONTENTS PAGE 1. INTRODUCTION & GENERAL OVERVIEW, Pgs3-4. 2. ASSESSMENT PROCESS, Pgs 5-8 3. TREATMENT OPTIONS, Pgs 9-12. 4. EVALUATION, Pgs 13-16 5. CONCLUSION. Pg 17 6. COPY OF PRESCRIPTION, Pg 18 7. REFERENCE SECTION, Pgs 19-23 8. BIBLIOGRAPHY, Pg 24. INTRODUCTION In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of prescribing in the community setting. The author a (trainee nurse prescriber) will display the need for a robust assessment, exploring all areas of health and well-being in order to achieve a safe outcome. The author will further follow current guidelines and be mentored by a senior nurse prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the...
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