Summary of Recommendations
|
|
- Archibald Brooks
- 1 years ago
- Views:
Transcription
1 Summary of Recommendations *LEVEL OF EVIDENCE Practice Recommendations Assessment 1.1 Conduct a history and focused physical assessment. IV 1.2 Conduct a psychosocial assessment to determine the client s goals and IV their ability and motivation to comprehend and adhere to the treatment plan of care options. 1.3 Assess quality of life from the client s perspective. IV 1.4 Ensure adequate dietary intake to prevent malnutrition or replace existing III deficiencies to the extent that this is compatible with the individual s wishes. 1.5 Prevent clinical nutrient deficiencies by ensuring that the patient is provided Ia-IV with optimal nutritional support through one or more of the following: Consultation with a Registered Dietitian for assessment (IV) Consultation with a speech language pathologist for swallowing assessment (IV) A varied, balanced diet to meet clinical requirements for healing and co-existing diseases (e.g., renal failure and diabetes) (IV) Nutritional supplements if needed (Ia) Multivitamin and mineral preparations (Ib) Enteral tube feeding (IV) Parenteral nutrition (IV) Ongoing monitoring of nutritional intake, laboratory data and anthropometric data (IV). 1.6 Assess all patients for pain related to the pressure ulcer or its treatment. IV 1.7 Assess location, frequency and intensity of pain to determine the presence IIb of underlying disease, the exposure of nerve endings, efficacy of local wound care and psychological need. 1.8 Assess all patients with EXISTING PRESSURE ULCERS to determine their IV risk for developing additional pressure ulcers using the Braden Scale for Predicting Pressure Sore Risk. 1.9 If the patient remains at risk for other pressure ulcers, a high specification Ia foam mattress instead of a standard hospital mattress should be used to prevent pressure ulcers in moderate to high risk patients Vascular assessment (e.g., clinical assessment, palpable pedal pulses, IV capillary refill, ankle/brachial pressure index and toe pressure) is recommended for ulcers in lower extremities to rule out vascular compromise. Management of 2.1 Choose the support surface which best fits with the overall care plan for the IV causative/contributing client considering the goals of treatment, client bed mobility, transfers, factors caregiver impacts, ease of use, cost/benefit, etc. Ensure ongoing monitoring and evaluation to ensure that the support surface continues to meet the client s needs and that the surface is used appropriately and is properly maintained. If the wound is not healing, consider the total care plan for the client before replacing the surface. * Refer to page 17 for the Interpretation of Evidence 10
2 Nursing Best Practice Guideline 2.2 Pressure management of the heels while in bed should be considered III independently of the support surface. 2.3 Use pressure management for clients in the Operating Room to reduce the Ia incidence of pressure ulcers post operatively. 2.4 Obtain a seating assessment if a client has a pressure ulcer on a sitting surface. IV 2.5 Refer patients at RISK to appropriate interdisciplinary team members IV (Occupational Therapist, Physiotherapist, Enterostomal Therapist, etc.). Utilize those with expertise in seating, postural alignment, distribution of weight, balance, stability and pressure management when determining positioning for sitting individuals. Ensure support surfaces are used appropriately and are properly maintained. 2.6 A client with a pressure ulcer on the buttocks and/or trochanter should IV optimize mobilization. If pressure on the ulcer can be managed, encourage sitting as tolerated. Local Wound Care Assessment 3.1a To plan treatment and evaluate its effectiveness, assess the pressure ulcer(s) initially for: IV Stage/Depth; Location; Surface Area (length x width) (mm 2, cm 2 ); Odour; Sinus tracts/undermining/tunneling; Exudate; Appearance of the wound bed; and Condition of the surrounding skin (periwound) and wound edges. 3.1b Conduct a comprehensive reassessment weekly to determine wound progress IV and the effectiveness of the treatment plan. Monitor for variances from assessment with each dressing change. Identification of variances indicates need for reassessment. Debridement 3.2a Lower extremity ulcers or wounds in patients who are gravely palliative with IV dry eschar need not be debrided if they do not have edema, erythema, fluctuance or drainage. Assess these wounds daily to monitor for pressure ulcer complications that would require debridement. 3.2b Prior to debridement on ulcers on the lower extremities, complete a vascular IV assessment (e.g., clinical assessment, palpable pedal pulses, capillary refill, ankle/brachial pressure index and toe pressure) to rule out vascular compromise. 3.2c Determine if debridement is appropriate for the patient and the wound. IV 11
3 Local Wound Care 3.2d If debridement is indicated, select the appropriate method of debridement IV considering: Goals of treatment (e.g., healability); Client s condition (e.g., end of life, pain, risk of bleeding, patient preference, etc.); Type, quantity and location of necrotic tissue; The depth and amount of drainage; and Availability of resources. 3.2e Sharp debridement should be selected when the need is urgent, IV such as with advancing cellulitis or sepsis, increased pain, exudate and odour. Sharp debridement must be conducted by a qualified person. 3.2f Use sterile instruments to debride pressure ulcers. IV 3.2g Prevent or manage pain associated with debridement. Consult with a member of IV the healthcare team with expertise in pain management. Refer to the RNAO Best Practice Guideline Assessment and Management of Pain (Revised) (2007). Control Bacteria/Infection 3.3a The treatment of infection is managed by wound cleansing, systemic antibiotics, Ib and debridement, as needed. 3.3b Protect pressure ulcers from sources of contamination, e.g., fecal matter. IIa 3.3c Follow Body Substance Precautions (BSP) or an equivalent protocol appropriate IV for the healthcare setting and the client s condition when treating pressure ulcers. 3.3d Medical management may include initiating a two-week trial of topical Ib antibiotics for clean pressure ulcers that are not healing or are continuing to produce exudate after two to four weeks of optimal patient care. The antibiotic should be effective against gram-negative, gram-positive and anaerobic organisms. 3.3e Medical management may include appropriate systemic antibiotic therapy for Ib patients with bacteremia, sepsis, advancing cellulitis or osteomyelitis. 3.3f To obtain a wound culture, cleanse wound with normal saline first. Swab wound IV bed, not eschar, slough, exudate or edges. 3.3g The use of cytotoxic antiseptics to reduce bacteria in wound tissue is not IIb usually recommended. Wound Cleansing 3.4a Do not use skin cleansers or antiseptic agents (e.g., povidine iodine, iodophor, III sodium hypochlorite solution, hydrogen peroxide, acetic acid) to clean ulcer wounds. 3.4b Use normal saline, Ringer s lactate, sterile water or non-cytoxic wound cleansers IV for wound cleansing. 3.4c Fluid used for cleansing should be warmed at least to room temperature. III 3.4d Cleanse wounds at each dressing change. IV 12
4 Nursing Best Practice Guideline Local Wound Care 3.4e To reduce surface bacteria and tissue trauma, the wound should be gently IV irrigated with 100 to 150 milliliters of solution. 3.4f Use enough irrigation pressure to enhance wound cleansing without causing IIa trauma to the wound bed. Safe and effective ulcer irrigation pressures range from 4 to 15 psi. Pressure of 4 to 15 psi is achieved by using: 35 milliliter syringe with a 19 gauge angiocath, or single-use 100 milliliter saline squeeze bottle. Management Approaches 3.5a For comprehensive wound management options, consider the following: IV Etiology of the wound; Client s general health status, preference, goals of care and environment; Lifestyle; Quality of life; Location of the wound; Size of the wound, including depth and undermining; Pain; A dressing that will loosely fill wound cavity; Exudate: type and amount; Risk of infection; Risk of recurrence; Type of tissue involved; Phase of the wound healing process; Frequency of the dressing change; Comfort and cosmetic appearance; Where and by whom the dressing will be changed; Product availability; and Adjunctive therapies. 3.5b Moisture-retentive dressings optimize the local wound environment and Ia promote healing. 3.5c Consider caregiver time when selecting a dressing. Ib 3.5d Consider the following criteria when selecting an interactive dressing: Ia-IV Maintains a moist environment (Ia) Controls wound exudate, keeping the wound bed moist and the surrounding intact skin dry (IV) Provides thermal insulation and wound temperature stability (IV) Protects from contamination of outside micro-organisms (IV) Maintains its integrity and does not leave fibres or foreign substances within the wound (IV) Does not cause trauma to wound bed on removal (IV) Client/patient preference (IV) Is simple to handle, and is economical in cost and time (IV). 3.5e Monitor dressings applied near the anus, since they are difficult to keep intact. Ib Consider use of special sacral-shaped dressings. 13
5 Local Wound Care Adjunctive Therapies 3.6a Refer to physiotherapy for a course of treatment with electrotherapy for Ib Stage III and IV pressure ulcers that have proved unresponsive to conventional therapy. Electrical stimulation may also be useful for recalcitrant Stage II ulcers. 3.6b Chronic pressure ulcers may be treated by: Ib-IV Electrical stimulation (Ib) Ultraviolet light C (IIa) Warming therapy (Ib) Growth factors (Ib) Skin equivalents (IV) Negative pressure wound therapy (IV) Hyperbaric oxygen (IV) Surgical Intervention 3.7 Possible candidates for operative repair are medically stable, adequately nourished IV and are able to tolerate operative blood loss and postoperative immobility. Discharge/Transfer of 4.1 Clients moving between care settings should have the following information provided: IV Care Arrangements Risk factors identified; Details of pressure points and skin condition prior to transfer; Need for pressure management/mobility equipment (e.g., support surfaces, seating, special transfer equipment, heel boots); Details of healed ulcers; Stage, site and size of existing ulcers; History of ulcers, previous treatments and dressings (generic) used; Type of dressing currently used and frequency of change; Any allergies to dressing products; and Need for on-going nutritional support. 4.2 Use the RNAO Best Practice Guideline Risk Assessment and Prevention IV of Pressure Ulcers (Revised) (2005). Patient Education 5.1 Involve the patient and caregiver, when possible, in pressure ulcer treatment IV and prevention strategies and options. Include information on pain, discomfort, possible outcomes and duration of treatment, if known. Other areas of education may include patient information regarding appropriate support surfaces, as well as roles of various health professionals. Collaborate with patient, family and caregivers to design and implement a plan for pressure ulcer prevention and treatment. 14
6 Nursing Best Practice Guideline Education Recommendations 6.1 Design, develop and implement educational programs that reflect a IV continuum of care. The program should begin with a structured, comprehensive and organized approach to prevention and should culminate in effective treatment protocols that promote healing as well as prevent recurrence. 6.2 Develop educational programs that target appropriate healthcare providers, IV patients, family members and caregivers. Present information at an appropriate level for the target audience, in order to maximize retention and facilitate translation into practice. 6.3 Include the following information when developing an educational program IV on the treatment of pressure ulcers: Role of the interdisciplinary team; Etiology and pathology; Risk factors; Individualized program of skin care, quality of life and pain management; Uniform terminology for stages of tissue damage based on specific classifications; Need for accurate, consistent and uniform assessment, description and documentation of the extent of tissue damage; Principles of wound healing; Principles of cleansing, debridement and infection control; Principles of nutritional support with regard to tissue integrity; Product selection (i.e., support surfaces, dressings, topical antibiotics, antimicrobials); Principles of postoperative care including positioning and support surfaces; Principles of pressure management; Mechanisms for accurate documentation and monitoring of pertinent data, including treatment interventions and healing progress; and Principles of patient education related to prevention to reduce recurrence. 6.4 Update knowledge and skills related to the assessment and management IV of pressure ulcers on an ongoing basis. Organizations should provide opportunities for professional development related to the best practice guideline and support its use in daily practice. 15
7 Organization & Policy Recommendations 7.1 Guidelines are more likely to be effective if they take into account local IV circumstances and are disseminated by an active ongoing educational and training program. 7.2 Practice settings need a policy with respect to providing and requesting IV advance notice when transferring or admitting clients between practice settings when special resources (e.g., surfaces) are required. 7.3 Practice settings must ensure that resources are available to clients and staff, IV e.g., appropriate moisturizers, barriers, dressings, documentation systems, access to equipment and clinical experts, etc. 7.4 Practice settings need a policy that requires product vendors to be registered IV as a regulated healthcare professional if they provide assessment and/or recommendations on any aspect of pressure ulcer related practice. 7.5 Practice settings need an interdisciplinary team of interested and knowledgeable IV persons to address quality improvement in pressure ulcer management. This team requires representation across departments and programs. 7.6 Nursing best practice guidelines can be successfully implemented only where IV there are adequate planning, resources, organizational and administrative support, as well as the appropriate facilitation. Organizations may wish to develop a plan for implementation that includes: An assessment of organizational readiness and barriers to implementation. Involvement of all members (whether in a direct or indirect supportive function) who will contribute to the implementation process. Dedication of a qualified individual to provide the support needed for the education and implementation process. Ongoing opportunities for discussion and education to reinforce the importance of best practices. Opportunities for reflection on personal and organizational experience in implementing guidelines. 16
MANAGEMENT OF DIABETIC FOOT COMPLICATIONS WITH ULCERATION
MANAGEMENT OF DIABETIC FOOT COMPLICATIONS WITH ULCERATION Establishing an interdisciplinary approach is an optimal way to improve clinical outcomes of prophylaxis and treatment of all types of problem
Initial Admission Date: Interviewable: Yes No Resident Room: Care Area(s):
Facility Name: Facility ID: Date: Surveyor Name: Resident Name: Resident ID: Initial Admission Date: Interviewable: Yes No Resident Room: Care Area(s): Use Use this protocol for a sampled resident having,
Wound Care: The Basics
Wound Care: The Basics Suzann Williams-Rosenthal, RN, MSN, WOC, GNP Norma Branham, RN, MSN, WOC, GNP University of Virginia May, 2010 What Type of Wound is it? How long has it been there? Acute-generally
Pressure Ulcers: Facility Assessment Checklists
Pressure Ulcers: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to managing pressure ulcers in the facility, in
CLPNA Pressure Ulcers ecourse: Module 3 Quiz II page 1
CLPNA Pressure Ulcers ecourse: Module 3 Quiz II 1. Healthcare organizations should have procedures in place to identify at risk patients and residents as soon as possible after they enter their facility.
Lower Extremity Arterial Disease (LEAD)
Lower Extremity Arterial Disease (LEAD) Lower Extremity Arterial Disease (LEAD) Lower extremity arterial disease May also be referred to as: Peripheral vascular disease (PVD) Peripheral arterial obstructive
Treatment of Infected Pressure Ulcers. Dr. Hasan Syed Ahmedullah Clinical Fellow Infectious Disease HMC
Treatment of Infected Pressure Ulcers Dr. Hasan Syed Ahmedullah Clinical Fellow Infectious Disease HMC Content 1. Introduction 2. Pressure Ulcer Classification 3. Strength of Evidence 4. Strength of Recommendation
Introduction to Wound Management
EWMA Educational Development Programme Curriculum Development Project Education Module: Introduction to Wound Management Latest revision: October 2012 ABOUT THE EWMA EDUCATIONAL DEVELOPMENT PROGRAMME The
Appendix G: Skin and Wound Care Program Training Presentation. Educational Resource for Clinical Staff Release Date: November 26, 2010
Appendix G: Skin and Wound Care Program Training Presentation Educational Resource for Clinical Staff Release Date: November 26, 2010 Outline Training Objectives Skin Care Management Skin Care Assessment
Diabetic Foot Ulcers and Pressure Ulcers. Laurie Duckett D.O. Plastic and Reconstructive Surgeon Oklahoma State University Center for Health Sciences
Diabetic Foot Ulcers and Pressure Ulcers Laurie Duckett D.O. Plastic and Reconstructive Surgeon Oklahoma State University Center for Health Sciences Lecture Objectives Identify risk factors Initiate appropriate
Critically evaluate the organization of diabetic foot ulcer services and interdisciplinary team working
Rationale of Module Accurate nursing assessment is the key to effective diabetic foot ulcer prevention, treatment and management. A comprehensive assessment identifies ulcer aetiology and the factors which
Wound Classification Name That Wound Sheridan, WY June 8 th 2013
Initial Wound Care Consult Sheridan, WY June 8 th, 2013 History Physical Examination Detailed examination of the wound Photographs Cultures Procedures TCOM ABI Debridement Management Decisions A Detailed
F. PRINCIPLES OF TREATMENT BASED ON ETIOLOGY (TREAT THE CAUSE)
F. PRINCIPLES OF TREATMENT BASED ON ETIOLOGY (TREAT THE CAUSE) F.3. PRESSURE ULCER (PU) 3.1. PU Background and Extent of Etiology (from the SWCCAC Wound Management Program March 2011) A pressure ulcer
A simple guide to the prevention and treatment of Diabetic Foot Ulcers
References: 1. Diabetes, foot care and foot ulcers. Available from http;//www.patient.co.uk. Diabetes foot ulcers. Available from http://www.nlm.nih.gov/medlineplus/ency/ patientinstructions.000077.htm
Wound Healing. Healing is a matter of time, but it is sometimes also a matter of opportunity. Hippocrates
C HAPTER 9 Wound Healing Healing is a matter of time, but it is sometimes also a matter of opportunity. Hippocrates As the above quote suggests, conduct regular and systematic wound assessments, and seize
7/30/2012. Increased incidence of chronic diseases due
Dianne Rudolph, DNP, GNP bc, CWOCN Discuss management of wound care in older adults with focus on lower extremity ulcers Identify key aspects of prevention Explain basic principles of wound management
APPLICATION OF DRY DRESSING
G-100 APPLICATION OF DRY DRESSING PURPOSE To aid in the management of a wound with minimal drainage. To protect the wound from injury, prevent introduction of bacteria, reduce discomfort, and assist with
NR33 WOUND MANAGEMENT
Page 1 of 7 Critical Thinking Strategies Scenario 1 NR33 WOUND MANAGEMENT Jane Smith, a 30-year-old obese female had a cholecystectomy (gallbladder removal) 3 days ago. Her gallbladder symptoms began 6
Topical Oxygen Wound Therapy (MEDICAID)
Topical Oxygen Wound Therapy (MEDICAID) Last Review Date: September 11, 2015 Number: MG.MM.DM.15C6v2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or
Pressure ulcers: prevention and management of pressure ulcers
Pressure ulcers: prevention and management of pressure ulcers NICE guideline Draft for consultation, November 2013 If you wish to comment on this version of the guideline, please be aware that all the
Pressure Ulcers: Assessment & Treatment. E. Williams, MD, Assistant Professor, University of Toronto
Pressure Ulcers: Assessment & Treatment Learning Objectives Understand physician responsibilities for assessment and management Accurately stage and describe pressure ulcers Prescribe topical treatments
CHAPTER V CONCLUSION AND RECOMMENDATIONS. findings are presented, implications for nursing practice and education are discussed,
CHAPTER V CONCLUSION AND RECOMMENDATIONS In this chapter, a summary of the findings and conclusion drawn from the findings are presented, implications for nursing practice and education are discussed,
Pressure Ulcers ecourse: Module 5.6 Quiz I
Pressure Ulcers ecourse: Module 5.6 Quiz I 1. What does assessment of a wound infection involve? a. Assessment of patient s overall condition b. Measurement of the pressure ulcer c. Observation of wound
PRESSURE SORES INTRODUCTION OBJECTIVES. When the student has finished this module, he/she will be able to: WHAT IS A PRESSURE SORE?
PRESSURE SORES INTRODUCTION Pressure sores (also known as bed sores, decubitus ulcers, or pressure ulcers) are open wounds in the skin that are caused by immobility. People who cannot move perhaps because
Neonatal Wound Management
Neonatal Wound Management Dr. Rene Amaya Pediatric Wound Care Center of Houston Objectives Discuss common wounds which arise in the NICU patient Review key components of wound management Discuss importance
What to do with what you see.continued Wound Care Overview Dynamics 2012 Vancouver, B.C.
What to do with what you see.continued Wound Care Overview Dynamics 2012 Vancouver, B.C. Things to Remember: Know your patient s history Goals for the wound Are you looking to cure, control, palliate Consider
Assessment of the Pressure Ulcer:
Unstageable Ulcer Slough Eschar Staging According to the National Pressure Ulcer Advisory Panel (NPUAP), pressure ulcers should not be down staged or reverse staged, however the RAI manual directs the
NPUAP PRESSURE ULCER ROOT CAUSE ANALYSIS (RCA) TEMPLATE National Pressure Ulcer Advisory Panel March 2014
Purpose: The development of a facility acquired pressure ulcer brings with it both a financial impact to an institution and a performance or quality of care impact that may be reportable to state or government
NPUAP PRESSURE ULCER ROOT CAUSE ANALYSIS (RCA) TEMPLATE
Purpose: The development of a facility acquired pressure ulcer brings with it both a financial impact to an institution and a performance or quality of care impact that may be reportable to state or government
INTERPROFESSIONAL WOUND MANAGEMENT COURSE:
INTERPROFESSIONAL WOUND MANAGEMENT COURSE: Part A Wound Management Principles and Wound Assessment. Part A: Sat. & Sun January 6&7, 2007 + Part B - Adjunctive Therapies including Electrical Stimulation
Pressure Ulcers/Altered Skin Integrity. Key Points
v2 Pressure Ulcers/Altered Skin Integrity Key Points Pressure ulcers are regions of localized damage to the skin and underlying tissues that usually develop over bony prominences such as the sacrum or
Electrical Stimulation and Electromagnetic Therapy for Wound Healing
Harmony Behavioral Health, Inc. Harmony Behavioral Health of Florida, Inc. Harmony Health Plan of Illinois, Inc. HealthEase of Florida, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance
PRESSURE ULCER GUIDELINES FOR TOPICAL TREATMENT
PRESSURE ULCER GUIDELINES FOR TOPICAL TREATMENT The following are suggested guidelines for treatment of pressure ulcers using products from Swiss-American Products, Inc. and are intended to supplement
WOUND MANAGEMENT PROTOCOLS WOUND CLEANSING: REMOVING WOUND DEBRIS FROM WOUND BASE
WOUND MANAGEMENT PROTOCOLS PURPOSE: Provide nursing personnel with simple guidance regarding appropriate dressing selection in the absence of wound specialist expertise Identify appropriate interventions
Assessment & Management of Stage I to IV Pressure Ulcers
Revised March 2007 Nursing Best Practice Guideline Assessment & Management of Stage I to IV Pressure Ulcers Shaping the future of Nursing Greetings from Doris Grinspun Executive Director Registered Nurses
Clinical guideline Published: 23 April 2014 nice.org.uk/guidance/cg179
Pressure ulcers: prevention ention and management Clinical guideline Published: 23 April 2014 nice.org.uk/guidance/cg179 NICE 2014. All rights reserved. Your responsibility The recommendations in this
4 Tissue Maturation: Epithelialization
Treatment of Sores Figure 1. Wound Healing Process Wound Blood Clot Blood Blood Vessel Fat Tissue The wound in the skin exposes deep tissue layers to the air. Scab Scab Exudate Granulation Tissue 3 Blood
APPENDIX 1: INTERDISCIPLINARY APPROACH TO PREVENTION AND MANAGEMENT OF DIABETIC FOOT COMPLICATIONS
APPENDIX 1: INTERDISCIPLINARY APPROACH TO PREVENTION AND MANAGEMENT OF DIABETIC FOOT COMPLICATIONS Template: Regional Foot Programs should develop a list of available health professionals in the following
Illinois Department of Public Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION. Statement of LICENSURE Violations
(X1) PROVER/SUPPLIER/CLIA ENTIFICATION NUMBER: (X3) SURVEY D NAME OF PROVER OR SUPPLIER (X4) SUMMARY REGULATORY OR LSC ENTIFYING INFORMATION) PROVER'S PLAN OF CORRECTION Final Observations Statement of
V.A.C. Therapy Patient Guide. Are you suffering from a wound? Ask your doctor about V.A.C. Therapy and whether it may be right for you.
V.A.C. Therapy Patient Guide Are you suffering from a wound? Ask your doctor about V.A.C. Therapy and whether it may be right for you. kci1.com 800.275.4524 Table of Contents Wound Healing is a Process...2
Wound and Skin Assessment. Mary Carvalho RN, BSN, MBA Clinical Coordinator Johnson Creek Wound and Edema Center
Wound and Skin Assessment Mary Carvalho RN, BSN, MBA Clinical Coordinator Johnson Creek Wound and Edema Center Skin The largest Organ Weighs between 6 and 8 pounds Covers over 20 square feet Thickness
Pressure Ulcers Risk Management and Treatment
Pressure Ulcers Risk Management and Treatment Objectives State reasons why individuals initiate lawsuits. Define strategies to reduce the risk of litigation. Determine appropriate treatment for the patient.
Ostomy Care And Management
RN.ET Ostomy Care And Management Clinical Best Practice Guidelines ET.Nurse Education 20-21 21 Nov. 2009 Pratin Chaisri Purpose and Scope Best Practice Guidelines are systematically developed statements
Managing cavity wounds Journal of Community Nursing March 1998 Author: Rosemary Pudner
Managing cavity wounds Journal of Community Nursing March 1998 Author: Rosemary Pudner It has been seen in recent years, that an increasing number of patients are being discharged early into the community,
Understanding Debridement of Sores
Understanding Debridement of Sores Introduction Some sores have trouble healing on their own. Sores that will not heal are also known as wounds or chronic wounds. A chronic wound is a sore that is having
(X2) MULTIPLE CONSTRUCTION ID PREFIX TAG G0000
CENTERS FOR MEDICARE & MEDICA SERVICES STATEMENT OF DEFICIENCIES (X1) PROVER/SUPPLIER/CLIA AND PLAN OF CORRECTION ENTIFICATION NUMBER: NAME OF PROVER OR SUPPLIER (X3) SURVEY G PROVER'S PLAN OF CORRECTION
MAPLES /PHOENIX REHABILITATION REFERRAL REFERRAL DETAILS:
MAPLES /PHOENIX REHABILITATION REFERRAL Each section must be completed by the treating health professional and goals for rehabilitation must be indicated. Once completed, please post the referral form
7/11/2011. Pressure Ulcers. Moisture-NOT Pressure. Wounds NOT Caused by Pressure
Assessment and Documentation of Pressure Ulcers Jeri Ann Lundgren, RN, BSN, PHN, CWS, CWCN Pathway Health Services July 19, 2011 Training Objectives Describe etiologies of pressure ulcers Discuss how to
What dressing for what wound. Prudence Lennox National Clinical Leader Healthcare Rehabilitation Ltd
What dressing for what wound Prudence Lennox National Clinical Leader Healthcare Rehabilitation Ltd Wound assessment Accurate wound assessment is a prerequisite to planning appropriate care & should adopt
1. To provide the patient with an open air passage by preventing encrustation and obstruction.
I. Care of the Patient with A Tracheostomy A. Purpose: 1. To provide the patient with an open air passage by preventing encrustation and obstruction. 2. To aid in bronchial hygiene by facilitating removal
PRESENTATION ON COMMONLY USED PRIMARY WOUND DRESSING BY FELICITY ADU-MILLS APRIL 2008
PRESENTATION ON COMMONLY USED PRIMARY WOUND DRESSING BY FELICITY ADU-MILLS APRIL 2008 SOME COMMONLY USED PRIMARY WOUND DRESSINGS Wound dressing have a part to play in the management of wound. AIM: Looking
Sores That Will Not Heal
Sores That Will Not Heal Introduction Some sores have trouble healing on their own. Sores that will not heal are a common problem. Open sores that will not heal are also known as wounds or skin ulcers.
Algidex Ag. wet - moist - dry wound
Algidex Ag wet - moist - dry wound Algidex Ag is a unique combination of silver, alginate and maltodextrin. It provides immediate and sustained antimicrobial action against a broad spectrum of wound pathogens
Cutaneous Lymphoma How to heal your wounds
Cutaneous Lymphoma How to heal your wounds William G. Tsiaras, MD, PhD Instructor, Harvard Medical School Director, Angiogenesis and Wound Healing Center Brigham and Women s Hospital Introduction Wounds
CCME CNE Course Announcement
CCME CNE Course Announcement Activity Title: NoCVA Pressure Ulcer Webinar The Carolinas Center for Medical Excellence (CCME) is accredited as an approved provider of continuing nursing education by North
Wound assessment - Incorporating the WHASA wound assessment form
Wound assessment - Incorporating the WHASA wound assessment form Abstract Naudé L, BCur(UP), MCur(UP)(ZA), Cert Wound Care(UOFS)(ZA), Cert Wound Care (Hertfordshire)(UK) Wound Healing Association of Southern
As with all disorders of the mouth, an accurate diagnosis by a trained healthcare professional is required before treatment is started.
As with all disorders of the mouth, an accurate diagnosis by a trained healthcare professional is required before treatment is started. As with all disorders of the mouth, an accurate diagnosis by a trained
SECTION M: SKIN CONDITIONS. M0100: Determination of Pressure Ulcer Risk. Item Rationale Health-related Quality of Life.
SECTION M: SKIN CONDITIONS Intent: The items in this section document the risk, presence, appearance, and change of pressure ulcers. This section also notes other skin ulcers, wounds, or lesions, and documents
CHAPTER 5 THE USE OF LEPTOSPERMUM HONEY IN CHRONIC WOUND MANAGEMENT
The use of Leptospermum honey in chronic wound management CHAPTER 5 THE USE OF LEPTOSPERMUM HONEY IN CHRONIC WOUND MANAGEMENT Val Robson In recent years the use of honey to manage wounds has gained considerable
Cutimed PROTECT Medical skin protection. Protect Preserve Prevent
PROTECT Medical skin protection Protect Preserve Prevent PROTECT Ordering information PROTECT is available in foam applicators and spray bottle PROTECT REF No. Size Unit of Measure HCPCS Spray 7265300
483.25(i) Nutrition (F325) Surveyor Training: Interpretive Guidance Investigative Protocol
483.25(i) Nutrition (F325) Surveyor Training: 1 With regard to the revised guidance F325 Nutrition, there have been significant changes. Specifically, F325 and F326 were merged. However, the regulatory
Since its introduction almost 20
Guidelines for safe negative-pressure wound therapy Rule of thumb: Assess twice, dress once By Ron Rock MSN, RN, ACNS-BC Since its introduction almost 20 years ago, negative-pressure wound therapy (NPWT)
Position Statement: Pressure Ulcer Staging
Position Statement: Pressure Ulcer Staging Statement of Position The Wound, Ostomy and Continence Nurses (WOCN) Society supports the use of the National Pressure Ulcer Advisory Panel Staging System (NPUAP).
Best Practice Guidelines BPG 1 Pressure Ulcer Prevention & Management
Best Practice Guidelines BPG 1 Pressure Ulcer Prevention & Management DOCUMENT STATUS: Approved DATE ISSUED: 14.4.15 DATE TO BE REVIEWED: 13.10.17 AMENDMENT HISTORY VERSION DATE AMENDMENT HISTORY V 1 9.9.13
Working together to prevent pressure ulcers (prevention and pressure-relieving devices)
Working together to prevent pressure ulcers (prevention and pressure-relieving devices) Understanding NICE guidance information for people at risk of pressure ulcers, their carers, and the public Draft
Pressure Ulcer Passport
Pressure Ulcer Passport Information for patients This is a record of the treatment you are receiving for your pressure ulcer injury. Please bring it with you to all your healthcare appointments. This will
TAKING CARE OF WOUNDS KEY FIGURE:
Chapter 9 TAKING CARE OF WOUNDS KEY FIGURE: Gauze Wound care represents a major area of concern for the rural health provider. This chapter discusses the treatment of open wounds, with emphasis on dressing
Toenail Removal , The Patient Education Institute, Inc. po Last reviewed: 10/27/2014 1
Toenail Removal Introduction Toenail removal is often done for severe fungal nail infections or for ingrown toenails. Part or all of the toenail may be removed. The procedure can be done in your health
Policies & Procedures. Title: I.D. Number: 1160
Policies & Procedures Title: NEGATIVE PRESSURE WOUND THERAPY (NPWT) I.D. Number: 1160 Authorization: [X] SHR Nursing Practice Committee Source: Nursing Date Revised: March, 2010 Date Effective: November,
Management of Burns. The burns patient has the same priorities as all other trauma patients.
Management of Burns The burns patient has the same priorities as all other trauma patients. Assess: - Airway - Breathing: beware of inhalation and rapid airway compromise - Circulation: fluid replacement
Individualized Care Plans Fully Developed
Appendix Individualized Care Plans Fully Developed A Refer to Chapter 1 The Nursing Process: A Synopsis, p. 32: Two Individualized Care Plans Fully Developed; Care Plan 1 for Mr. John Walters, Care Plan
Clinical Guideline for: Aseptic Technique
Clinical Guideline for: Technique Summary This guideline provides the principles of, Non Touch, and Clean Techniques to be implemented in the hospital environment. Key Points The essential elements of
Silicone pressure-reducing pads for the prevention and treatment of pressure ulcers
S46 Product focus Silicone pressure-reducing pads for the prevention and treatment of pressure ulcers Abstract Pressure ulcers, a key quality of care indicator, cause emotional distress to the patient,
Inservice: Wound Care and Dressings. Friday, June 26, 2009. A. Closed Wounds tissue is injured but skin is not BROKEN
f Inservice: Wound Care and Dressings Friday, June 26, 2009 WOUNDS: Are injuries of the skin and underlying subcutaneous tissues and muscles (Nursing Manual by Lippincott) Are disruptions in the integrity
Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection
L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after
HOW MANY PATIENTS SUFFER FROM POST-OPERATIVE SEPSIS? WHAT IS SEPSIS?
SEPSIS: Information About Post-Operative Sepsis for Patients and Relatives WHAT IS SEPSIS? Sepsis is a life threatening condition that arises when the body s response to an infection injures its own tissues
Wound Healing Community Outreach Service
Wound Healing Community Outreach Service Wound Management Education Plan January 2012 December 2012 Author: Michelle Gibb Nurse Practitioner Wound Management Wound Healing Community Outreach Service Institute
Patient Safety Call to Action. Road Map to a Comprehensive Skin Safety Program
Road Map to a Comprehensive Program Road Map to a Comprehensive Program S A F E S K I N based on the ICSI Protocol, Adverse Health Event Learnings I n f r a s t ru c t u r e S Coordination and Team Approach
Vacuum Assisted Wound Closure for Management of Different Types of Wounds
Egypt, J. Plast. Reconstr. Surg., Vol. 34, No. 1, January: 77-81, 2010 Vacuum Assisted Wound Closure for Management of Different Types of Wounds MAMDOUH EL DAWI, F.R.C.S.*; IBRAHIM AL ZAHIR, A.B.M.S.**
Skin Tear Resource Kit
Skin Tear Resource Kit 136473_Broch.indd 1 10/16/13 8:55 PM Skin Tear: A Clinical Problem An Often Painful But Largely Preventable Health Care Issue Skin tears affect all ages and continue to be a common
Wound V.A.C. KCI Protocol Emergency General Surgery Service Vanderbilt University Medical Center 10 / 2004
Contributors: Sarah Debelak, APRN-BC Amanda Estapa, APRN-BC Ashlee Piercey, APRN-BC Dr. Jose Diaz, Jr., M.D. Wound V.A.C. KCI Protocol STATEMENT OF PURPOSE: Define process for implementation, application,
Provided by the American Venous Forum: veinforum.org
CHAPTER 13 COMPRESSION THERAPY FOR VENOUS DISORDERS AND VENOUS ULCERATION Original authors: Gregory L. Moneta and Hugo Partsch Abstracted by Teresa L. Carman Introduction: The first treatment used for
The use of MEDIHONEY in Palliative Wound Care and the Advanced Aging Patient
The use of MEDIHONEY in Palliative Wound Care and the Advanced Aging Patient Presenter: Angel Sutton, RN, MSN/Ed, CWCN, CFCN, CCCN Wound Care Nurse Consultant Agenda My clinical practice Why MEDIHONEY?
What is a pressure sore?
CHAPTER 5 Skin Care People with spinal cord injuries need to take particular care of their skin as sensation that would normally provide warning of possible skin damage, ie pain, discomfort and extremes
Guideline: Wound Bed Preparation for Healable and Non-Healable Wounds in Adults & Children 1
Developed by the BC Provincial Nursing Skin and Wound Committee in collaboration with Wound Clinicians from: TITLE Guideline: Wound Bed Preparation for Healable and Non-Healable Wounds in Adults & Children
National Association for Home Care 2014 Annual Meeting
National Association for Home Care 2014 Annual Meeting Presenters: Karen Utterback, MSN, RN VP Strategy and Marketing, McKesson ECSG Lois Glanz, BSN, RN Health IT Manager, UnityPoint at Home Karen S. Martin,
OFFICE OF THE STATE CORONER FINDINGS OF INVESTIGATION
OFFICE OF THE STATE CORONER FINDINGS OF INVESTIGATION CITATION: TITLE OF COURT: JURISDICTION: Non-inquest findings into the death of Ms C Coroners Court Brisbane FILE NO(s): 2012/4591 DELIVERED ON: 11
Use of a Pressure Ulcer Protocol: Benefits and Recommendations
Use of a Pressure Ulcer Protocol: Benefits and Recommendations Elizabeth L. Enriquez RN,BSN,MPH,CWOCN Wound Care Specialist/Infection Control Morningiside House 1000 Pellham Parkway, Bronx, NY 10461 Wound
Long-term urinary catheters: prevention and control of healthcare-associated infections in primary and community care
Long-term urinary catheters: prevention and control of healthcare-associated infections in primary and community care A NICE pathway brings together all NICE guidance, quality standards and materials to
EPIDEMIOLOGY COMPLICATIONS FROM PRESSURE ULCERS
CHAPTER 30 PRESSURE ULCERS EPIDEMIOLOGY COMPLICATIONS FROM PRESSURE ULCERS RISK FACTORS AND RISK-ASSESSMENT SCALES PREVENTION MANAGEMENT ANNOTATED REFERENCES Pressure ulcers are a serious and common problem
Case Series: The use of AQUACEL Ag Extra dressing on Chronic and Acute Wounds
Case Series: The use of AQUACEL Ag Extra dressing on Chronic and Acute Wounds Executive Summary ConvaTec, the company that brings you the anti-microbial dressing, AQUACEL Ag, has taken its Hydrofibe r
Plastic and Reconstructive Surgery Essential for Student. Associate Prof. Vichai Chichareon Division of Plastic Surgery Prince of Songkla University
Plastic and Reconstructive Surgery Essential for Student Associate Prof. Vichai Chichareon Division of Plastic Surgery Prince of Songkla University Reconstructive surgery Aesthetic Surgery Basic Principles
Skin & Wound Care Prevention & Treatment. By Candy Houk, RN Skin & Wound Program Manager
Skin & Wound Care Prevention & Treatment By Candy Houk, RN Skin & Wound Program Manager OBJECTIVES Classify Stage 1 and 2 pressure ulcers Recognize suspected Stage 3, 4, DTI, and unstageable pressure ulcers
Wound Care Pearls Kellie Dowell, RN, CWCN, CWS
Wound Care Pearls 2013 Kellie Dowell, RN, CWCN, CWS Functions of the Skin Thermoregulation Protection Sensation Water retention Synthesis of Vitamin D Expression of Emotion The Skin Overview Largest organ
Post-surgical V.A.C. VeraFlo Therapy with Prontosan Instillation on Inpatient Infected Wounds * COLLECTION OF CASE STUDIES
COLLECTION OF CASE STUDIES Post-surgical V.A.C. VeraFlo Therapy with Prontosan Instillation on Inpatient Infected Wounds * *All patients were treated with systemic antibiotics Post-surgical V.A.C. VeraFlo
Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89
Pressure ulcers Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89 NICE 2015. All rights reserved. Contents Introduction... 6 Why this quality standard is needed... 6 How this quality standard
Beverlin Allen, PhD, RN, MSN, ARNP
Pressure Ulcers & Nutritional Deficits in Elderly Long-Term Care Patients: Effects of a Comprehensive Nutritional Protocol on Pressure Ulcer Healing, Length of Hospital Stay & Health Care Charges Beverlin
RENFREW VICTORIA HOSPITAL SKIN AND WOUND CARE PROGRAM TRAINING RISK ASSESSMENT OF SKIN BREAKDOWN AND TREATMENT OF WOUNDS AND PRESSURE ULCERS
RENFREW VICTORIA HOSPITAL SKIN AND WOUND CARE PROGRAM TRAINING RISK ASSESSMENT OF SKIN BREAKDOWN AND TREATMENT OF WOUNDS AND PRESSURE ULCERS SELF-LEARNING MODULE For Registered Nurses and Registered Practical
Certified Pediatric Nurse Certification Exam. Detailed Content Outline
Certified Pediatric Nurse Certification Exam Detailed Content Outline Description of the Speciality This exam is for the nurse who has extensive experience in pediatric practice and who demonstrates knowledge
PT Modalities: Electrical stimulation & Ultrasound. Electrical Stimulation (EST)
PT Modalities: Electrical stimulation & Ultrasound Pamela Houghton, PT, PhD, MAPWCA Professor, School of Physical Therapy Western University London, Ontario, Canada Electrical Stimulation (EST) EST effect