wound care education powerpoint

Hemostasis 2. Time constraints are one of the greatest barriers to applying MI within clinical settings.15 The pressures of a busy schedule can restrict provider ability to engage in detailed conversations with patients. J Wound Ostomy Continence Nurs 2017;44(3):2416. Wound care for nurses. It's a costly lesson. Kivela K, Elo S, Kaariainen M. The effects of health coaching on adult patients with chronic diseases: a systematic review. On a serious note, how important is the look of this boot compared with your ability to continue to work while your foot heals? Shear, friction and pressure will all affect the wound tissue and periwound condition. Proliferation (Granulation) 4. 2003. Features: super-adsorbent, self-adhesive, cushioned, breathable. There are now six classifications of pressure injury. - 1ry - dressing which touches the wound - 2ry - dressing used to cover the primary dressing ; Ideal wound dressing Dressings are applied to wounds for the following . wound care specific to the type of wound. A comprehensive infection prevention program is critical to the safety and compliance of any healthcare facility. Callender, Lynelle F. DNP, RN; Johnson, Arlene L. DNP, RN; Pignataro, Rose M. PhD, DPT, PT, CWS, CHES, Vice Chair, Nursing Online, Advent Health University, Orlando, Florida, Coordinator, Nurse Practitioner Program, Advent Health University, Orlando, Florida, Associate Professor, Assistant Director, Physical Therapy Program, Emory & Henry College, Marion, Virginia. Dressing Pressure Injuries and Ulcerations 5. Mrs H.: Well, it would depend on how hard it is to get the boot on by myself. Urgotul, At McKesson Medical-Surgical, we understand that providing the best care is top of mind. Important: Without a doubt, removal of necrotic tissue and management of infective tissue are two priorities in wound care. 2. Should the body decide to separate the eschar from the tissue below it, the eschar then usually provides a well-demarcated edge from which to work. London F. Teaching patients about wound care. 'Separation of the layers of a surgical wound, it may be partial or only superficial, or complete with separation of all layers and total disruption. May develop thin blister or eschar over dark wound bed. . Therefore having a knowledge of the characteristics of venous and arterial ulcers is imperative to ensure appropriate decision-making regarding management of these wounds. The skin is the body's largest organ and is responsible for protection, sensation, thermoregulation, metabolism, excretion and cosmetic. Leaper, DJ, Schultz, G, Carville, K, Fletcher, J, Swanson, T & Drake, R 2012, 'Extending the TIME concept: what have we learned in the past 10 years?'. Diabetes Care 2010;33(4):7513. Greene J, Hibbard J, Alvarez C, Overton V. Supporting patient behavior change: approaches used by primary care physicians whose patients have an increase in activation levels. Even if patients are reliant on caregivers to examine their skin, the ability to recognize problems and seek appropriate treatment fosters independence.23 In addition, patients and caregivers often require instruction regarding proper hygiene and skin care.23 As with other types of chronic wounds, patients with PIs benefit from education regarding behavioral risks, such as tobacco use, nutrition, hydration, exercise, and medication adherence.23, Patients with peripheral arterial disease often underestimate their risk of serious complications.24 This may stem from lack of knowledge or denial about the impact of nonadherence.24 Providers can address these issues by reviewing factors that mitigate risks, such as tobacco cessation, exercise, and proper diet.25 Further, providers should encourage patients to engage in proper self-management of common comorbidities, such as hypertension and type 2 diabetes.25 Adherence and self-care can be enhanced by teaching patients how to interpret their own test results (eg, total cholesterol and total triglycerides).25, Depending on the severity of circulatory insufficiency, it may be best to keep arterial wounds dry pending revascularization. Wound Bed Preparation is a paradigm to optimize chronic wound treatment. After a thorough assessment, a small, simple laceration is generally managed with antiseptic cleansing, The goal here is to disturb the tissue as little as possible, in order to allow the body to heal itself. Some medications are known to delay healing and increase lower leg oedema. The aim here is to preserve the tissue intact for as long as possible and await what the body can do if the pressure is removed. Sep 2004 - May 20105 years 9 months. Most clinicians take a watch-and-wait approach. Because most lower extremity venous return results from muscle activity, exercises, such as walking and ankle pumps, are very helpful.18 Providers should tailor exercise recommendations to patients individual fitness levels and any physical impairments. Uses: pressure ulcers, venous ulcers, surgical sites. Zetuvit. Uses: Surgical wounds, cuts, abrasions, low to moderately exuding wounds. Keyword Highlighting In evaluating the effectiveness of a treatment regime, the healthcare professional should be able to clearly state the wound type and what the treatment aims were. The secondary dressing on this mesh is generally a light absorbent adhesive pad, such as Simple abrasions, in particular, if not managed by a healthcare professional, form a scab that eventually drops off, revealing a healed area beneath. Examples: Lets have you put on the sneakers you brought in when you came for your last visit. Mefix. Stud Health Technol Inform 2017;240:284302. "Education is a vital component in the treatment of pressure injuries." What is the nurse's role in educating the patient and . Topical antibiotics may be used in specific circumstances - for more information, refer to Pictures may help patients identify how good tissue should look as their wound begins to heal. Australian and New Zealand Clinical Practice Guideline for Venous ulcer prevention and management. Mrs H.: Well, I do feel a little uneven when I walk in this thing, like one leg is longer than the other. Ichthopaste. Naturally, all of these aforementioned methods require a thorough assessment of the patient and their pain both during and after the dressing procedure. Chemical agents for debridement are no longer available in Australia. Self-management can also feel overwhelming because of the number and complexity of treatment recommendations.5, The likelihood of adherence is improved when clinicians link recommendations to individual outcome expectations and goals.17 Despite patient willingness to follow recommendations, unintentional nonadherence may still occur, particularly if provider instructions are not clear.18 Collaborative communication strategies, such as MI, can help providers detect and address problems with comprehension or other unforeseen barriers. DPT: Well, the type of boot I am thinking of slides on and closes with Velcro. Mesorb, DPT: I am sure that must be very frustrating for you. Bandura A. Surgical debridement may leave large cavities or areas of raw tissue, which can ideally be managed with a A secondary waterproof dressing is generally not recommended for this first dressing due to the risk of infection the excessive heat and moisture will create an environment conducive to bacterial growth. The classic signs and symptoms of each of these ulcer types can be found in the European Wound Management Association 2019. SlideServe has a very huge collection of Wound care education PowerPoint presentations. These are just some of the questions many first-time or novice clinicians may ask when faced with a complex instance of wound care. Therefore, protective interventions are critical. Flaminal. Once an agreement has been reached, a written action plan promotes adherence. Wound digital imaging improves the documentation which may protect agency against a complaint or a lawsuit, improves coordination of careamong clinicians and serve as a tool for patient and family education. Mrs H.: I think that would really help. Forte, Chen Y, Wang Y, Chen W, Smith M, Huang H, Huang L. The effectiveness of a health. Health promotion by social cognitive means. Is that something you might be interested in? If the patient is in otherwise good health, then surgery and topical negative pressure devices would be used. J Wound Ostomy Continence Nurs 2012;39(6):598606. Cellular growth is dependent on adequate intake of protein, vitamin C, zinc and iron. A stage one pressure injury is an intact area of damage, so protection of the tissue and providing an environment for recovery is the aim. Both of these processes will affect new cellular growth and hence must be addressed. Mefix. DPT: Good point; one leg is essentially longer than the other because of the height difference between your clog and the walking boot. Aquacel Foam non adhesive, May also present as an intact or ruptured serum-filled blister. This wound care vacuum cleaner will remove excess exudate and contain it in a canister, away from the wound surface. DPT: Mrs H., thank you for agreeing to meet with me to discuss your plan of care. 26. Infective tissue is best removed when possible by employing the same methods as with necrotic tissue. DPT: Yes, there are definitely other changes we can talk about. Our wound care certification courses offer: Up to 60 CE/CME hours The most up-to-date wound management content created by wound-certified professionals 100% online study with unique and interactive learning tools The ability to proceed at your own pace 24/7 course access "Until-You-Pass" risk-free guarantee DPT: Would it be all right if I explained a little more about why I think the walking boot will be so helpful? Staff training program improves wound care. Stage three injuries involve damage through to the subcutaneous tissue, with the presence of slough and soft, tenacious necrotic tissue, which will require debridement. Wound care providers can apply SCT to build self-efficacy and match the benefits of treatment recommendations with the patients personal goals.2 Long-term adherence also requires that the patient have knowledge, skills, and the ability to self-assess and respond to changes in their condition.9 These changes may include signs of infection, delayed healing, and the need for further consultation. With continued best-practice interventions, these signs indicate that the wound will most likely go on to heal. Primapore. Latimer S, Chaboyer W, Gillespie B. Mrs H.: [makes a face and shakes her head] I think I would rather stick with my clogs. Aquacel Ag or Conveen Critic Barrier Cream is one appropriate example. 2. Inammation 3. Granulation tissue (firm, beefy red tissue) requires some exudate management and protection. Aweko J, De Man J, Absetz P, et al. Swanson, T, Ousey, K, Haesler, E, Bjarnsholt, T, Carville, K, Idensohn, P, Keast, DH, Larsen nee Angel, D, Waters, N & Weird, D 2022. Factors that shape intentions include patients attitudes toward provider recommendations, as well as outcome expectations, or the anticipated results of adherence.8 Like the HBM, the TPB also includes self-efficacy.2 Low self-efficacy diminishes adherence even when patients strongly value the outcome.8 Providers can apply the TPB to investigate and address factors that influence self-efficacy and outcome expectations. Get new journal Tables of Contents sent right to your email inbox, www.who.int/chp/knowledge/publications/adherence_full_report.pdf, Patient-Centered Education in Wound Management: Improving Outcomes and Adherence, Articles in PubMed by Lynelle F. Callender, DNP, RN, Articles in Google Scholar by Lynelle F. Callender, DNP, RN, Other articles in this journal by Lynelle F. Callender, DNP, RN, Putting the 2019 Nutrition Recommendations for Pressure Injury Prevention and Treatment into Practice. Because you are coming back in 2 days, lets see how the walking boot works for you first. Important factors include:18, Education concerning specialized nutrition requirements is particularly important for patients with underlying comorbidities, such as diabetes, renal disease, anemia, or difficulty eating.19 Dietary advice and information concerning the use of supplements can enhance patients sense of control over the wound healing process. The RDI of iron is greater in women during the menstrual years, with 18 mg per day advised to support healthy functioning. If this is not possible, then dressings known to aid autolytic debridement should be selected and used according to manufacturer's instructions. If the wound has been present for a considerable length of time, then some bacterial involvement is likely, and so an antimicrobial is suggested, such as However, the most important signs to measure wound healing include improvements in tissue quality, and reduction of odour and exudate volume. Being too thin or obese, will delay healing. LINK aims to provide a platform for healthcare professionals to learn and exchange knowledge worldwide. The pale, pink/mauve tissue usually found at the edges of wounds, healing by secondary intention, requires protection. When your assessment reveals that the wound is heavily soiled, necrotic tissue is present, and/or there is the potential of bacterial colonisation, then more regular dressings will be required. 2 Instrumental self-management skills include wound cleansing, dressing changes, and recognizing signs and symptoms of infection . Determine which method is Therefore, patient education should be directed toward strategies that promote venous return and reduce edema. Intact skin with non-blanchable redness of a localised area, usually over a bony prominence. Adhesive foams are generally appropriate here, unless the wound is located very close to the anus, in which case a thick barrier cream is often used. Full thickness tissue loss with exposed bone, tendon or muscle. Whilst there are some being used overseas, none of these have yet been approved for use in Australia. 1: https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html, In-Office Lab Testing for Respiratory Illnesses, Cleaning, Decontamination & Sterilization, Antibacterial Foam Dressing McKesson 4 X 4 Inch Square Adhesive with Border Sterile, Silicone Foam Dressing Mepilex Border 4 X 4 Inch Square Silicone Adhesive with Border Sterile, Thin Silicone Foam Dressing Allevyn Gentle Border Lite 4 X 4 Inch Square Silicone Gel Adhesive with Border Sterile, Transparent Film Dressing 3M Tegaderm Rectangle 4 X 4-3/4 Inch Frame Style Delivery With Label Sterile, Silicone Foam Dressing McKesson 4 X 4 Inch Square Silicone Adhesive with Border Sterile, Gauze Sponge McKesson Cotton 12-Ply 4 X 4 Inch Square NonSterile, Cohesive Bandage 3M Coban LF 2 Inch X 5 Yard Standard Compression Self-adherent Closure Bright Green / Bright Orange / Bright Pink / Purple / Blue / Black NonSterile, Adhesive Strip McKesson 1 X 3 Inch Fabric Rectangle Tan Sterile, Skin Protectant Thera Calazinc Body Shield 4 oz. 23. A dressing that maintains a minimally moist environment and protects the tissue, is generally required. 15. The patient is experiencing barriers to performing prior recommendations for wound cleansing, use of a hydrogel dressing, and left non-weight-bearing using a knee scooter. Home Healthc Nurse 2007;25(8):497500. Debris will promote the risk of infection and slow the growth of epithelial cells. Highlight selected keywords in the article text. Medicare and Medicaid Insurance Regulations, Efficient in Microsoft Office Programs (Excel (basic), PowerPoint, and Word), Enteral Nutrition, Wound Care Management, Urological Supplies, Trach . Fisher L, Polonsky W, Hessler D, Potter M. A practical framework for encouraging and supporting positive behavior change in diabetes. Wounds that generally do not heal unless surgical/medical intervention is possible include arterial ulcers, skin cancers and tumours, and wounds as a result of an autoimmune disorder. 32-3 Fistula, p. 1053. . Treatment outcomes for neuropathic ulcers are also heavily dependent on patients adherence to nutrition recommendations, blood glucose monitoring, physical activity, and weight management.27 Patient education that includes explicit steps for diet and exercise is more likely to achieve success than generic recommendations.27, Self-management is influenced by patients cognitive understanding, motivation level, and ability to troubleshoot problems and barriers.27 In patients with diabetes, low perceived severity of illness and its consequences may be influenced by family history and assumptions that diabetes is a natural part of genetics and/or aging.27 These assumptions can reduce outcome expectations and self-efficacy by creating the impression that diabetes and its consequences are unavoidable.27 Patients and providers should discuss these perceptions and promote skills that enhance self-care, including the ability to troubleshoot unanticipated problems and barriers.27 Other barriers to adherence may include the lack of measurable results for patients who are adherent yet still experience disease progression.27 These barriers can be mitigated by social-environmental support from family, friends, and community resources.28, From a cognitive perspective, the ability to record and interpret glucose measurements, calculate medication doses, and read nutrition labels requires a certain level of literacy and mathematical skill.27 Providers should also assist patients in understanding the difference between test results that show immediate glycemic control (plasma glucose level) versus long-range control (hemoglobin A1c; Table 1).27. This is referred to as autolysis. Sharp surgical is the gold-standard of mechanical debridement, and involves having a surgeon manually remove all of the necrotic tissue so that the vascular bleeding wound bed is exposed. Uses: fixing primary dressings, catheters and tubes. The best management of an abrasion is to stop the bleeding, give the area a good clean with an antiseptic and then apply a mesh dressing that will protect the superficial raw area and allow new tissue to form quickly without being damaged when the first dressing is attended. your express consent. 25. New York, NY: Guilford Press; 2013. Metronidazole Gel. 7. NCQA names hospital 1997 quality award winner. Wearing shoes or slippers with closed backs and nonskid soles, even when ambulating short distances within the home, reduces the likelihood of inadvertent trauma. Tubigrip or Suspected deep tissue injury (depth unknown): purple/maroon localised area of discolouration of intact skin or blood-filled blister. 4. By expressing empathy toward patient challenges and inviting opposing viewpoints, providers can promote patient ownership and control of their own health.10. Nutritional impediments to healing include inadequate protein and carbohydrate intake.19 Supplements, such as vitamins A, C, D, and E, and minerals, such as zinc, copper, selenium, and folic acid, may also be prescribed.19, Patients with mobility and/or sensory impairments have an elevated risk of pressure injuries (PIs). Mepore Pro. Medical professionals, medical facility employees 855.571.2100, Need help with SupplyManager?800.422.0280, Everything you need to help provide the best care for your wound & skin care patients. 18. Once the necrotic tissue has been removed and healthy granulation tissue is present, the aim dramatically changes to one of protection. Using the HBM also helps providers understand patient barriers to enacting treatment recommendations, including patients confidence in their ability to self-manage their condition (Figure 1). Patient Educ Couns 2012;87(3):39894. Consider these five principles when planning wound care 9: 1 2 3 Is the tissue necrotic? Steri-Strips, 2. 19. Venous ulcers can heal with compression therapy, however, conversely, some arterial ulcers may deteriorate if compression is used. There are many methods of wound debridement; some are readily accessible to the majority of clinical staff, however, others require specialist training or application and may only be found in specialty clinics or acute care facilities. This holistic approach examines the treatment of the cause and patient-centered . Scand J Caring Sci 2014;28(4):64856. Dressings that seal the area off can sometimes create more moisture and heat, making the tissue more vulnerable to further damage. Newer research is also indicating that hypergranulation is more than likely associated with biofilm and hence, microbial load (Swanson et al. If this is not possible, then a skilled clinician may be able to conservatively sharp-debride the tissue to just above the viable base. Additional factors that may influence healing include: If the patient has declining health, then it is unlikely any amount of therapy will influence wound healing. Arch Intern Med 2003;163(18):215762. If the wound is locally infected, the clinician may choose to manage the infective tissue with debridement and topical antimicrobials (not topical antibiotics) (Lipsky & Hoey 2009). DPT: Because this wound is on the bottom of your foot, one of the things that could help it heal is to take some of the pressure off the area with a special walking boot. Another mechanical method of debridement includes using a high-pressure irrigation device, which literally blows off the necrotic tissue. It is also important that patients can distinguish good versus bad tissue. Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors. Features: cut to size, adhesive, flexible, allows hydration. Reexamining reasons for nonadherence enables providers to respond productively.18 Patients may feel overwhelmed by the physical and psychological changes caused by chronic wounds. Normal RDI of zinc is 8 mg in healthy adult women, and 14 mg per day for adult men. The term used to describe pale, grey/white tissue found at the edges of a wound. For more information, please refer to our Privacy Policy. topical negative pressure device. The billing of wound care billing services usually involves a thorough evaluation of the patient's medical record for the wound, including wound dimensions, chronic diseases which includes diabetes, chronic ulcers, quadriplegia, etc. Exercise caution when debriding infected necrotic tissue as bleeding may occur; generally a few days of antibiotic therapy prior to debriding is ideal when performing in a community setting. Examples: The term adherence implies collaboration, in which patients actively choose to follow the providers advice based on shared responsibility for health outcomes, as opposed to compliance, which connotes submission to provider directives.5. The Theory of Planned Behavior: reactions and reflections. Green L, Ratcliffe D, Masters K, Story L. Educational intervention for nutrition, 20. Tube Scented Cream, Silver Foam Dressing Mepilex Ag 4 X 4 Inch Square Sterile, https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html, Consumers: Please visit SimplyMedical.com. Once again, protection is important, however, due to the break in the integument, the chosen dressing must also have some absorbent capabilities. Allevyn Life. Melolin, Primapore. Providers and patients should discuss barriers to adherence, including low perceived susceptibility and severity. These injuries are generally necrotic and malodourous. My husband leaves for work before I get dressed in the morning, and its hard for me to bend. Like the HBM and TPB, Social Cognitive Theory (SCT) stresses the importance of self-efficacy. Care of this simple suture line then involves continued support and hydration. Browse for the presentations on every topic that you want.

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