Description
The purpose of this reflective clinical paper is to reflect on a personal experience during my clinical rotation at Jackson hospital orthopedics unit. In This Journal I will discuss effective Wound Infection Treatment and Management, as well as excellent nurse communication skills that helps create a positive patient experience. Wound Infection Treatment is an important care component in health care. Most patients with wound infections are managed in the hospital. Management usually takes the form of dressing changes to optimize healing, which usually is by secondary intention. Proper wound drainage management improves the patient's quality of life, promotes healing, and enhances health care effectiveness. According to John Geibel increased hospital stay due to surgical site infection (SSI) has been estimated at 7-10 days, increasing hospitalization costs by 20%. Occasionally, further intervention in the form of wound debridement and subsequent packing and frequent dressing is necessary to allow healing by secondary intention.
On June 25th at Jackson hospital/Orthopedics unit at 6:30 am the clinical preceptor and I met at the nurses’ station to received report from the night shift nurse and the SCIP protocol for the six floor. At Jackson hospital/Orthopedics 6 floor, antibiotics should be on board within 24hrs of the time the procedure ended, Anticoagulant should be on board within 24hrs from end procedure time and foley should be discontinued within 24hrs from time procedure ended without an order. I was assigned to the care of S.J, an 88 years old male patient presented to the emergency department with a PUH of BPH because of a mechanical fall that resulted in t11/t12 fracture, complaint of wound drainage and pain at the meatus. Ms. S.J was transferred to the orthopedic floor, his past medical history revealed he’s hypertensive and has occasional constipation.
On meeting Mr. S.J for the first time, I noticed he was calm, alert, oriented, awake, no acute distress. I introduced myself as a nursing student, confirm patient ID, using two identifiers. Assessed patient pain intensity, quality, location, radiating elements, aggravating and alleviating factors. In healthcare nurses must evaluate patients pain experience in order to effectively manage their pain (Resource & Management?, 2019). Patient reports pain at a level of 7 on a 0 to 10 rating scale. At 0700 20 mg of oxycodone administered as ordered using the five rights of medications and educate patient about possible side effects of medication. 0730 patient pain reassessed: Patient reported being more comfortable and reports pain at a level of 5 on a 0 to 10 rating scale. At 0800 patient pain reassessed: Patient was calm, reports pain at a level less than 3 on a 0 to 10 rating scale and verbalized acceptable level of pain. Since patient was able to manage her pain, I performed a head to toe examination, administered his 9:00am medications as ordered famotidine 20 mg/ oral BID, Labetalol, 10 mg=2ml IV push, lisinopril, 40 mg oral, daily, acetaminophen, 650 mg/2tab oral/prn and Flexeril 10 mg/tab, TID. I also checked the surgical incision site for recurrent signs of infections. Checked dressing label (date and time). Patient was complaining of constipation during physical examinations. At 0900 stool softeners Senna administered as ordered.
Effective wound drainage management will improve a patient's quality of life by reducing dressing change frequency, shortening healing time and reducing problems with infection. Effective wound drainage management requires comprehensive assessment of the region of the wound and current dressing, assessing the nature and amount of exudate, the wound base, peri wound skin and edge of the wound and choosing an appropriate dressing for an optimal moist wound environment. The nurse role in patient wound infection is to work toward a goal of patient comfort. It is very significant for nurses to understand the pathological causes of the infection to ensure positive outcomes. While caring for Mr. S.J I focus mainly on wound infection management, medication administration, comfort level and therapeutic communication to provide best quality care.
As a newly graduated BSN I will be evaluating the wound drainage at regular intervals. Educating the patient and family concerning their role in wound infection management, clarify the plan management and expected outcome. Instructing the patient of infections management method that has been ordered, including medication administration, side effects, and complications.
References
CCN: Critical Care Nurse. (2019).
Resource, T., & Management? W. (2019). What is a Nurse’s Role in Pain Management? | NurseChoice.
Pain_Management_Nursing_Role_Core_Competency_A_Guide_for_Nurses (2019).
Wound Infection Treatment & Management: Approach Considerations, Antibiotic Prophylaxis, Risk Assessment. (2019). Retrieved 31 July 2019, from https://emedicine.medscape.com/article/188988-treatment
Wound Infection Treatment & Management: Approach Considerations, Antibiotic Prophylaxis, Risk Assessment. (2019). Retrieved 31 July 2019, from https://emedicine.medscape.com/article/188988-treatment