NURS 170 Nursing

Ensure that  paper includes, in addition to your researched material, a title, introduction, and conclusion.
Be certain that you support your findings with literature. If the marking guide states that literature support is required you must include it or a minimal grade will be given. Literature supports should be directly applicable and credible (i.e. peer reviewed articles, journal, or texts in which the authors are identifiable). Most general websites are not credible sources of research.
Be certain to include a “Resources” section at the end of this part in which you cite at least three (3) current resources.
Briefly described the procedure or trend/issue that impacts the medical-surgical client 
Compared the procedure or trend/issue with previous practise in medical-surgical nursing 
Described best-evidence, supported by literature, to the procedure or trend/issue that promotes the health of the medical-surgical client in the hospital or following discharge 
Identified areas for health teaching that promotes the health of the medical-surgical client, supported by literature.

Answer:

Introduction

The possibility of skin breakdown presents a major challenge for the healthcare providers in any healthcare settings. Skin breakdown leads to costly and grave problems in skin care for patients who are immobile, contributing to hospital admissions for the treatment of skin breakdown and the related complications like septicemia, infection and potential death. Prevention of complication of skin breakdown is, therefore, necessary (Swafford et al., 2016).

Comparison of the previous and current practice

Previous practice pertaining to prevention of complication of skin breakdown in the immobilised acute care was underpinned by care delivery solely provided by physicians and nurses. The present care practise encompasses the involvement of a multidisciplinary team that in collaboration works to provide the best possible care and prevention strategies. The interdisciplinary team plays a key role in skin management and promotes open communication between the patient and the care providers. The team is made up of skin care coordinator, nurse, healthcare aide, registered dietician, enterostomal therapist, occupational therapist, chiropodist, physician, social work, pharmacist, dentist and chaplain. The complete team provides support to the patient for maintaining proper skin condition, provides consultation services and provides patient education. A complete range of services is, therefore, possible that was not probable previously. A timely assessment leads to the timely implementation of prevention and management strategies. Coordination of care based on best evidence is welcomed in the context of increasing needs of immobilised patient at the risk of skin breakdown (Collier, 2016).

Best evidence that promotes the health of the client in the hospital or the following discharge

A number of nursing strategies can be implemented, drawing from best evidence from the literature that can promote the health of the patient in the healthcare setting or after discharge. According to Kalra et al., (2014) for preventing skin breakdown in patients it is necessary to monitor the status of the skin if any wound is present. The patient’s skin care practices are to be monitored regularly. This approach prevents the further deterioration of patient condition regarding skin integrity. Sterile dressing technique reduces the chances of skin infection and thereby maintains skin integrity. In case the patient is incontinent, an incontinence management plan would be beneficial for preventing exposure to harmful chemicals. Administration of antibiotics aid in the management of wound infections. Encouraging patients to use foam wedges, pillows and pressure-reducing devices prevent pressure injury (Benbow, 2016). Patients are to be provided with a balanced diet after consulting with the dietician. This would address the patient centred needs of nutrition. A proper diet is beneficial for treating skin breakdown to a considerable extent. Drinking adequate fluids is necessary for keeping the body weight in a healthy range since individuals who are underweight or overweight have increased chances of having skin breakdown. Good nutrition helps in making the skin resistant to breakdown and chances of getting infections are less. The right foods are to be consumed with rich content of Vitamin C, Vitamin A, omega 3 fatty acids, zinc and protein. Additional calories are vital for repairing damaged tissue in case a patient is suffering from skin breakdown due to immobility (Berke, 2015).

Areas for health teaching that promotes the heath of the client

The patients are to be taught about the ways by which the skin can be kept healthy and the need for maintaining a daily routine for monitoring and caring for the skin. Regular complete inspection of the skin is needed, and the patient is to be educated in this regard. Maintaining a hygienic condition is vital, and the patients are to be taught about maintaining personal hygiene through washing and cleaning. Wound and skin assessment is to be taught for understanding signs and symptoms of infection, subsequent complication and proper healing. A healthy diet is pivotal for preventing skin breakdown. The client is to be educated about how a balanced diet can be maintained. The patient along with the family members are to be instructed to take proper care of any wounds. Patients are also to be educated to notify the nurse or physician in any need for preventing further complications. Accurate information on self-management increases the ability of the patient to manage the condition effectively (Potter et al., 2016).  

Conclusion

Skin breakdown in immobilised patients has often been overlooked in the past, and the suitable means of treating the issue have not been discussed adequately. It is important for care providers working wth immobilised patients to consider the latest evidence-based practice for delivering optimal care for all patients.

References

Benbow, M. (2016). Best practice in wound assessment. Nursing Standard, 30(27), 40-47.

Berke, C. T. (2015). Pathology and clinical presentation of friction injuries: case series and literature review. Journal of Wound Ostomy & Continence Nursing, 42(1), 47-61.

Collier, M. (2016). Protecting vulnerable skin from moisture-associated skin damage. British Journal of Nursing, 25(20).

Kalra, M. G., Higgins, K. E., & Kinney, B. S. (2014). Intertrigo and secondary skin infections. Am Fam Physician, 89(7), 569-73.

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing. Elsevier Health Sciences.

Swafford, K., Culpepper, R., & Dunn, C. (2016). Use of a comprehensive program to reduce the incidence of hospital-acquired pressure ulcers in an intensive care unit. American Journal of Critical Care, 25(2), 152-155.