However, when ad-hoc methods meant to maintain the former conflict with protocols necessary to ensure the latter, the consequences can be compounded by the anaerobic environment under the dressing that promotes more rapid bacterial infection instead of protecting the wound site from external bacterial contamination (Fitzpatrick 1997). Protocol Compliance Issues in Antisepsis of Intravenous Dressings: Wound dressings are provided in sterile packages and when applied with proper care and adherence to antisepsis protocol, help ensure that wound sites are protected from bacterial infection. However, when protocols are violated, whether accidentally, through oversight, or negligently, wound dressings represent significant vulnerabilities to infection via external contamination. Sometimes, techniques and procedures that are meant to solve other problems introduce increased risks to the antiseptic integrity of the wound site. For example, it is common practice to increase the absorbency of sterile gauze pads by simply doubling them over in half. While this does increase absorbency, it does so at the expense of significantly increasing the potential exposure of the wound to bacterial contamination. Whereas placing a full size gauze pad over a wound is easily accomplished without touching the wound-side surface of the pad, doubling...
Notwithstanding the protection of sterile gloves, virtually all change-of-dressing procedures involve coming into contact with the patient's skin and bedding, such as while rolling up a sleeve or straightening a limb for access. Even experienced practitioners underestimate the danger posed by Staphylococcus Aureus and Gram-Negative Bacilli transmission via this mechanism, for which the epidermis provides fertile ground, and which account for as many as one-half of all catheter devices infections, for example (NursingLink 2007).
As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached
(Sussman and Bates-Jensen, 2007) Assessment data is reported to enable the clear communication among clinicians about the wound and in making the provision for "continuity in the plan of care" as well as allowing for "evaluation of treatment modalities." (Sussman and Bates-Jensen, 2007) Wounds that are classified as red, yellow and black are those that require examination of deep tissue involvement. (Sussman and Bates-Jensen, 2007) The wound must be monitored
2004: 45). Recommendations Many recommend use of minimally invasive techniques including SEPS to treat and address problems related to chronic venous insufficiency (Kalra & Glovisczki, 2002). Multiple studies confirm the safety and efficacy of SEPS when used early, especially resulting from its low complication rates compared with other procedures including the formerly popular Linton procedures (Kalra & Gloiscki, 2002; Lee, et al. 2003; Tenbrook, et al., 2004; Bianchi, et al. 2003). More
Nursing Assessment Taking the history of a patient is a crucial aspect of patient assessment and treatment. A good history can mean the difference between a successful patient outcome and unsatisfactory outcomes. However, taking a complete and useful history is a skill that is developed by means of training and practice; it is not some talent that is innate (Bickley & Szilagyi, 2007; McKenna et al., 2011). According to Craig (2007)
Nursing (a) provides an account of your observations on the management of peripheral intravascular devices from your clinical practicum in NMIH202; Clinical practicum NM1H202 introduces nurses to the management of peripheral devices via scholarly inquiry and clinical practice. The practicum includes a thorough training in handling, inserting, replacing, and dressing peripheral intravascular devices including peripheral venous catheters. Because the primary risk associated with peripheral intravascular devices is infection, proper management of the
Nephrologists are expected to play a role in this determination, but all too often the nephrologist, like other physicians, must be prompted to deal with end-of-life issues. If no one is available to do the prompting, the patient's death may be needlessly prolonged. The amount to which the nephrologist takes on end-of-life care will be reflected in their approach to the patient. At one end of the spectrum, discomfort
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