Wound Care
Chronic wounds represent a devastating health care problem with significant clinical, physical and social implications. Evidence suggests that consistent, meticulous and skilled care provides the primary means by which successful wound care and healing is promoted. The occurrence of wounds has plagued humankind throughout recorded history and remains a major source of morbidity and mortality in several disciplines of clinical medicine. Within this thesis, an effort will be made to address the basics of appropriate and potentially successful nursing in wound care and the promotion of healing. Section 1 will provide introductory information on the problem of wound care. In Section 2, the relevant literature will be reviewed while Section 3 will present the research methodology used within the thesis. In Section 4, the results of the thesis will be provided, offering a framework that can be used for insuring that the essential basics in wound care are provided…...

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References

Allman, R.M. (1989). Pressure ulcers among the elderly. New England Journal of Medicine, 320,850.

Allman R.M., Larade C.A. & Noel, L.B. (1986). Pressure sores among hospitalized patients. Annals of Internal Medicine,105, 337-342.

American Hospital Association (2003). Curative Health Services. Found at  http://www.curative.com 

Anonymous (1997). Wound dressing prices holding steady. Hospital Materials Management, 22(6), 1-10.

In this regard, the documentation should include the four main assessment components; which are, nutrition, wound etiology, wound appearance and pain (Assessment and Documentation Issues in Wound Care).
In other words a careful written as well as visual record should be kept of all the possible factors and variables relating to the patient's condition and to the progression or otherwise of the healing process.

There are two further reasons that are important to note with regard to the issue of documentation. These are, firstly, that thorough documentation serves as a legal record of the quality of care and wound management; and secondly, it also provides invaluable information relating to the environment and surroundings that impact the healing process. As one study notes, "….we have seen that the environment of the patient may cause profound difficulties in wound healing. Identifying and understanding these co-morbidities will help you bring in important interventions and…...

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References

Assessment and Documentation Issues in Wound Care. Retrieved from  http://www.vnaa.org/vnaa/g/?h=html/wound_center_march 

Flanagan M. Barriers to the implementation of best practice in wound care. Wounds UK.

Retrieved from  http://www.woundsinternational.com/pdf/content_87.pdf 

Phases of Wound Healing. Retrieved from  http://www.clinimed.co.uk/Wound -

This highlights the seriousness of the need for proper wound care in long-term care facilities, demonstrating the extent to which the nurse must define and provide oversight to standards in this area.
What steps should be taken to ensure proper wound care?

The first and most important aspect of ensuring that wound care is attended with proficiency is the provision of comprehensive training for nurse professionals. There are an array of strategies which can be applied to help hasten the process of healing or which can have the impact of lessening the likelihood or severity of recurrence. Indeed, the study by O'Meara et al. (2000) recognizes that such high risk individuals as diabetics are particularly vulnerable to recurrence and that 'secondary wound care' is a central part of reducing this likelihood. Accordingly, O'Meara et al. indicate that "the prevention and treatment of chronic wounds includes many strategies, including the use of…...

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Resources:

American Academy of Dermatology (AAD). (2009). Causes of Aging Skin. Aging Skin Net. Online at  http://www.skincarephysicians.com/agingskinnet/basicfacts.html 

Ayello, E.A.; Baranoski, S.; Cuddigan, J. & Sibbald, R.G. (2007). Wound Debridement. Wound Care Essentials: Practice and Principles; Lippincott, Williams & Wilkins.

Braun, R.P.; Vecchietti, J.L.; Thomas, L.; Prins, C.; French, L.E.; Gewirtzman, a.J.; Saurat, J. & Saloman, D. (2005). Telemedical Wound Care Using a New Generation of Mobile Telephones. Arch Dermatol, 141(2), 254-258.

Gardner, a. & Gardner, G. (2004). A trial of nurse practitioner scope of practices. Journal of Advanced Nursing, 49(2), 135-145.

Certification for wound care are available but wound care is not typically addressed as an area of specialization for nurses. There is a corresponding lack of wound care training for nurses in key fields including those who work with diabetics. Research shows that proper wound care can minimize complications related to lack of mobility including bed sores, and reduce the rates of amputations. Comprehensive wound care training is therefore essential for nurses working with the elderly, diabetics, and burn victims.
Second, organizational issues stymie effective wound care interventions. One of the organizational issues cited most frequently in the literature is a lack of standardization of wound care procedures. A lack of standardization is one of the most often-cited reason for the ineffective implementation of wound care treatment, as nurses with varying levels of training employ wound care strategies sporadically and without guidance. Dressing, re-dressing, use of antimicrobial agents, and environmental…...

Chronic Wound Care: Nursing Assessment
And Intervention

Chronic Wound Care: Nursing Assessment and Intervention

Chronic Wound Care: Nursing Assessment and Intervention

Chronic wounds are a challenge for both the clinician and the patient. For the nurse, issues of chronic wound care include the type of wound, the condition of the patient, and presence of infections, possible antibiotic therapy, and patient education on chronic wound care management. For the patient, issues revolve around how the patient will provide for their own long-term chronic wound care, compliance, cosmetic issues, effects on quality of life, potential self-esteem issues, and other factors related to the overall health of the patient. The following paper discusses the topic of chronic wound care for the nurse and for the patient. A nursing assessment for chronic wound care is provided using two approaches: the NANDA diagnostic approach, and the PICO process. In order to properly illustrate the issue, a vignette case study…...

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References

Beckert, S., Konigsrainer, A., & Coerper, S. (2007). The physiology of wound healing. Therapeutische Umshau, 467-472.

Bryant, R., & Nix, D. (2007). Acute and chronic wounds: current management concepts . St. Louis: Mosby, Inc.

Buluta, H., Hisara, F., & Guler Demir, S. (2010). Evaluation of mentorship programme in nursing education: A pilot study in Turkey. Nurse Education Today, Available online 1 April 2010, ISSN 0260-6917, DOI: 10.1016/j.nedt.2010.01.019.

e Laat, E., Scholte op Reimer, W., & van Achterberg, T. (2005). Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature. Journal of Clinical Nursing, 464-472.

Clinical Pactice Guideline - Sugical Infection Issue
Sugical Infection Issue

Clinical Pactice Summay:

National Collaboating Centee fo Women's and Childen's Health. (2008, Octobe; eaffimed in 2011). Sugical site infection: pevention and teatment of sugical site infection. Lodnon (UK): National Institute fo Health and Clinical Excellence (NICE).142 p. [256 efeences].

Scope and Pupose

The scope and pupose of the clinical pactice guideline entitled "Sugical site infection: pevention and teatment of sugical site infection, is to povide guidance fo sugical site infections (SSI). A sugical site infection is a wound that occus when an invasive sugical pocedue has taken place. The sugical site infection guideline does not addess management of the opeating theate envionment and envionmental factos, no does the sugical site infection guideline addess pophylaxis and management of antibiotic-esistant bacteia. Anesthetic factos elating to the sugical site infection (SSI) ae also not addessed by the sugical site infection guideline.

The objectives of the sugical site infection guideline…...

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references]. Retrieved from   [Original document contains cost analyses].http://www.nice.org.uk/guidance/CG74 .

Preventing and treating surgical site infections. Understanding NICE guidance. Information for other people who use NHS services. (2008, October). London (UK). National Institute for Health and Clinical Evidence. (Clinical guideline; no. 74). Retrieved from

Healthcare
As standard procedure warranted in this case, her obstetrician injected her with varicella zoster specific immunoglobulin. The injection did occur too late, but this is a special case warranting attention and was a prophylactic to protect the baby. A few days later the N developed chickenpox anyway. The reasons why the vaccine did not take could have been the fact that the N had already been exposed, and the situation is referred to as "breakthrough varicella," (National Centre for Immunisation, 2009, p. 3). Breakthrough varicella is a mild form of the infection, and yet is still contagious. Varicella vaccine should not be given to the baby until it is twelve months of age, but it may not be necessary at all due to the potential in vitro exposure to the varicella zoster virus. Infants "should receive no specific treatment or vaccination after exposure to Varicella zoster virus (VZV) but can…...

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References

Centers for Disease Control and Prevention (2014). Preventing varicella in health care settings. Retrieved online:  http://www.cdc.gov/chickenpox/hcp/healthcare-setting.html 

Cheprasov, A. (2014). The spread of disease. Retrieved online:  http://education-portal.com/academy/lesson/the-spread-of-disease-endemic-epidemic-pandemic.html#lesson 

Children, Youth, and Women's Health Service (n.d.). Chickenpox. Retrieved online:  http://www.health.wa.gov.au/docreg/Education/Diseases/Communicable/Virus/HP8873_chickenpox.pdf 

"Descriptive Epidemiology," (2014). Retrieved online: http://www.med.uottawa.ca/SIM/data/Epidemiology_rates_e.htm

Evidenced-Based ecommendation: Pressure Ulcer PreventionProblem:The professional practice problem is the high incidence of pressure ulcers in elderly patients residing in long-term care facilities. Preventing pressure ulcers in long-term care facilities is crucial to maintaining the health and well-being of residents. Indeed, pressure ulcers can result in severe pain, infection, and decreased quality of life, making proactive care and regular monitoring essential to avoid these preventable injuries. Moreover, pressure ulcers are an indicator of patient neglect, placing long-term care facilities at risk of costly litigation. Consequently, pressure ulcer prevention is an increasingly important concern given the sustained increase of the elderly population in the United States, an increase that is projected to continue through mid-century.Unfortunately, current practice frequently lacks structured monitoring systems and preventive interventions that can facilitate the prevention of pressure ulcers. Besides being an indicator of patient care, the risks of not addressing this problem include increased patient suffering,…...

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ReferencesAbusalem, S., Polivka, B., Coty, M. B., Crawford, T. N., Furman, C. D., & Alaradi, M. (2021). The relationship between culture of safety and rate of adverse events in long-term care facilities. Journal of Patient Safety, 17(4), 299-304.Arisandi, D., Ogai, K., Urai, T., Aoki, M., Minematsu, T., Okamoto, S., ... & Sugama, J. (2020). Development of recurrent pressure ulcers risk factors in older patients: A prospective observational study. Journal of Wound Care, 29(Sup4), S14-S24.Elli, C., Novella, A., Nobili, A., Ianes, A., & Pasina, L. (2022). Factors associated with a high-risk profile for developing pressure injuries in long-term residents of nursing homes. Medical Principles and Practice, 31(5), 433-438. E., Stolt, M., Puukka, P., Korhonen, T., & Kielo?Viljamaa, E. (2022). Consistent practices in pressure ulcer prevention based on international care guidelines: A cross-sectional study. International Wound Journal, 19(5), 1141-1157. https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.13710Kilpatrick, K., Tchouaket, É., Jabbour, M., & Hains, S. (2020). A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities. BMC Nursing, 19, 1-14.Neziraj, M., Hellman, P., Kumlien, C., Andersson, M., & Axelsson, M. (2021). Prevalence of risk for pressure ulcers, malnutrition, poor oral health, and falls–a register study among older persons receiving municipal health care in southern Sweden. BMC Geriatrics, 21, 1-10.Ting, J. J., & Garnett, A. (2021). E-health decision support technologies in the prevention and management of pressure ulcers: A systematic review. CIN: Computers, Informatics, Nursing, 39(12), 955-973.Yun, H., & Park, J. (2020). Pressure ulcer risk factors and preventive intervention in long-term care facilities: A mixed-method study. Journal of the Korea Academia-Industrial Cooperation Society, 21(3), 147-155.  https://koreascience.kr/article/JAKO202009759222283.pdfhttps://karger.com/mpp/article/31/5/433/825151Haavisto,

com). A certain amount of errors is to be expected, but there should not be so many that it demonstrates a certain level of skewedness about the model in its entirety. Thus, if the NHI model is the one which is selected, then it needs to be tested against a range of different scenarios. The following demonstrate some truly relevant what-ifs: what if the doctors only move half the projected volume; what if medicare slashes rates; what if competitors open a comparable program (dgapartners.com).
There are a range of factors which can change or adjust once a healthcare facility opens their doors for business. And as much as this facility is attempting to engage in a solid humanitarian effort, at the end of the day, it's still a business and people need to get paid. Thus, before engaging in further developmental activities, one needs to determine in what ways the model…...

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References

Brakatu Ofori-Adjei, a. (2007). Microfinance: An Alternative Means of Healthcare Financing for the Poor. Ghana Medical Journal, 193-194.

Burnstein, L., Harris, R., & Love, L. (2012, August 30). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com:  http://www.mondaq.com/unitedstates/x/194082/Healthcare/Estate+planning+is+important+step 

Burnstein, M., Harris, R.L., & Love, L. (2012, August 20). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com:

The penalties for being out of compliance when OSHA comes knocking should be enough to motivate any healthcare facility to devise a plan to make sure that they are in compliance with OSHA's regulations. The startling thing is that it took an initiative like NEP to wake these facilities up and get them thinking about being compliant. Since they deal with people and their well being on an everyday basis, these are things that they should have been doing all along and not just because there is an increased probability of getting into trouble by OSHA.

eferences

Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? etreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx

Healthcare workers. (2012). etrieved from http://www.cdc.gov/niosh/topics/healthcare/

New OSHA inspection initiative focuses on healthcare. (2011). etrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6EM

Occupational Safety and Health Administration ("OSHA") Targets Nursing and esidential

Care Facilities. (2012). etrieved from http://www.hancocklaw.com/p/OSHA_Newsletter_212_May_H1768037.PDF

Prepare Your Facility for the National Emphasis Program (NEP). (2012).…...

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References

Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? Retreived from  http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx 

Healthcare workers. (2012). Retrieved from  http://www.cdc.gov/niosh/topics/healthcare/ 

New OSHA inspection initiative focuses on healthcare. (2011). Retrieved from  http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6REM 

Occupational Safety and Health Administration ("OSHA") Targets Nursing and Residential

While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.

10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.

Like other highly trained professionals, experienced nurses develop a…...

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References

Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press

Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley

Starr, P. (1984) the Social Transformation of American Medicine.

New York: Basic Books

eferences

Aaron, H.J. 1994. Thinking About Medical Costs. Health Affairs, 13, 5 (winter): 8-13 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.

Acs, G. And John S. 1995. Trends in Out-of-Pocket Spending on Health Care, 1980-1992. Monthly Labor eview, 35-45 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.

Cote, J. And Latham, C. (2003). Exchanges between Healthcare Providers and Insurers: A Case Study. Journal of Managerial Issues. 15, 2.

Health, United States. (2003). Chartbook on trends in the health of Americans. HHS, Centers for Disease Control and Prevention (CDC). National Center for Health Statistics in Lesnik, J. (2006). Community Health Centers: Health Care as it Could Be. Journal of Law and Health. 19, 1..

IOM. (2003). Hidden Costs, Value…...

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References

Aaron, H.J. 1994. Thinking About Medical Costs. Health Affairs, 13, 5 (winter): 8-13 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.

Acs, G. And John S. 1995. Trends in Out-of-Pocket Spending on Health Care, 1980-1992. Monthly Labor Review, 35-45 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.

Cote, J. And Latham, C. (2003). Exchanges between Healthcare Providers and Insurers: A Case Study. Journal of Managerial Issues. 15, 2.

Health, United States. (2003). Chartbook on trends in the health of Americans. HHS, Centers for Disease Control and Prevention (CDC). National Center for Health Statistics in Lesnik, J. (2006). Community Health Centers: Health Care as it Could Be. Journal of Law and Health. 19, 1..

Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.

Past Health Care Services -- Early America

Health care in colonial America in the…...

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Works Cited

Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:

Springer Publishing Company.

Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.

McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care

Healthcare Economics
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of healthcare…...

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Bibliography

Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.

Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.

Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.

Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.

Workarounds in Healthcare Facilities
Workarounds refer to the alternative methods "of accomplishing an activity when the usual system / process is not working well" (Pennsylvania Patient Safety Advisory, 2013). In as much as workarounds may temporarily solve existing problems, they also indicate inefficiencies and deficiencies in the current system. Workarounds may at times be effective and more convenient, compared to the system in existence, but a regular use of the same could endanger both the safety of patients and the facility's reputation. A workaround can, therefore, be termed as an at-risk behavior that does not yield concrete long-term solutions to existing problems. Therefore, "workarounds perceived as necessary by the user for patient care, efficiency or safety, may be beneficial, neutral, or dangerous for patients' safety" (Koppel, Wetterneck, Telles & Karsh, 2008, p. 1).

A description of Workarounds in a Selected Facility

Workarounds can take a variety of forms. For instance, I know of…...

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References

Flanagan, M.E., Saleem, J. J., Millitello, L.G., Russ, A.L. & Doebbeling, B.N. (2013). Paper- and Computer-Based Workarounds to Electronic Health Record Use at Three Benchmark Institutions. Journal of the American Medical Informatics Association, 20(e1): e59-66.

Intel (2013). Workarounds in Healthcare, a Risky Trend. Retrieved from  http://www.intel.com/content/www/us/en/healthcare-it/workarounds-in-healthcare-risky-trend.html 

Koppel, R., Wetterneck, T., Telles, J.L. & Karsh, B. (2008). Workarounds to Barcode Medication Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety. Journal of the American Medical Informatics Association, 15(4), 408-423.

Merrill, M. (2009). Using Pen and Paper Workarounds Could Boost EMR Efficiency. Retrieved from  http://www.healthcareitnews.com/news/using-pen-and-paper-workarounds-could-boost-emr-efficiency

Infection may be the biggest health risk for people who have wounds, making wound care critical to ensuring a positive patient outcome.  Wound care not only improves mortality but can also impact social and physical expectations for a patient, which means that appropriate wound care can be one of the biggest issues impacting doctors or nurses who deal with any type of injury.  However, wound care focuses substantially on infection control, because infections present the greatest long-term hazards from wounds.

Generally, wound care is broken down into four or five basic steps.  Those....

Surgical site infections (SSIs) are a common complication following obstetrics and gynecological surgeries, leading to increased morbidity, mortality, and healthcare costs. Several factors have been identified that can affect the risk of developing SSIs in these patient populations.
One of the key factors affecting SSIs in obstetrics and gynecological postoperative patients is the presence of comorbidities. Patients with underlying medical conditions such as diabetes, obesity, and immunosuppression are at a higher risk of developing SSIs due to impaired wound healing and increased susceptibility to infections (1).
Surgical technique and perioperative practices also play a crucial role in preventing SSIs. Inadequate sterilization of....

Key Factors Contributing to Surgical Site Infections in Obstetrics and Gynecology Patients
Surgical site infections (SSIs) are a significant complication in obstetric and gynecological (OB/GYN) surgery, leading to increased morbidity, prolonged hospital stays, and healthcare costs. Understanding the key factors contributing to SSIs is crucial for implementing effective prevention strategies.
1. Preoperative Factors:
Diabetes and obesity: Impaired wound healing and immune function increase the risk of infection.
Smoking: Nicotine constricts blood vessels, reducing oxygen and nutrient delivery to the wound.
Malnutrition: Inadequate nutrition compromises immune function and wound healing.
Vaginal infections: Preoperative colonization of the vagina with pathogens can increase the risk....

Medical assistants serve as the backbone of the healthcare system, playing a crucial role in providing patient care and administrative support. To thrive in this demanding field, medical assistants require a comprehensive skillset that encompasses both technical proficiency and interpersonal abilities. Here are the essential skills that pave the way for success in the healthcare industry:

1. Clinical Skills: Medical assistants are often the first point of contact for patients, and thus, they need to possess a solid foundation in clinical skills. These include vital sign measurement, patient preparation for examinations, specimen collection, and assisting with minor procedures. Proficiency in these....