Inflammation
This is the second phase of wound healing where coagulation occurs. In this phase, the neutrophils white blood cells enter the wound to destroy and remove debris. The inflammation stage is associated with erythema, heat, edema and pain. The neutrophils leave after 48 or 24 hours and other specialized cell known as the microphages arrives to clear the debris where they secrete growth factors that attract the immune cells for wound repair (Kim, & Mauborgne, 2014).
This phase involves strategies to cover and filling of the wound. The epithelial tissues arise from the wound margins and migrate across the wound bed in the leapfrog and ensure that the epithelium covers the wound fully.
In the maturation stage, the newly formed tissue becomes flexible and strong. The formed tissue remodels, the collagen fibers are recognized and the tissue matures. When the local factors and the environment are favorable for healing, the body works in a way to heal the damaged tissue (Kim, & Mauborgne, 2014).
Question three
- Insufficient flow of the blood into the wound
- The treatment expenses of the wound.
- The type of the infection associated with the wound.
- The size of the wound.
- The body contours (Frykberg, & Banks, 2015).
Question four
Universal access to care. This principle gives a sense of indivisibility and equality qualitatively in delivering quantity and enough wound care, and everyone has a chance to get the service. As wound are sometimes emergency issues, this principle ensures that the primary healthcare services are affordable, available and equally provided to each person irrespective of their age, location, ethnicity or gender (Parahoo, 2014).
The involvement of the community in promoting health and addressing the health challenges from the grassroots level helps the community to be accountable for their health and wellbeing of the people in it (Parahoo, 2014).
This involves the collaboration of different sectors in promoting the wellbeing and general health of the community. The other sectors apart from the healthcare centers that must cooperate to ensure the diversity in the health of the people in the community include; governments, non- governmental organizations and other business organizations (Parahoo, 2014).
Governance for quality and safety in health services organizations
This standard involves the quality of the framework that is needed for the healthcare organization to improve on safety systems.
Partnering with the consumers
The standard describes the strategies of the systems to create a consumer-centered approach in the health system by involving the consumers in the design and the development of the healthcare (Goodman et al,2016).
Controlling and preventing associated healthcare infections
It describes the systems and the strategies involved in the prevention and control of diseases within the healthcare systems and also to manage all the infection immediately they occur to reduce the disease consequences.
This standard involves the systemic strategies which ensure the safety of clinicians, administrator, dispense and prescribe particular medications to the informed patients (Goodman et al,2016).
Procedure matching and patient’s Identification
It involves the strategies of the systems within the healthcare that correctly identifies the patie4nts and match the identity with the appropriate treatment.
This standard is useful to ensure effective communication and enhance responsibility and accountability for the patient’s care especially when handing over od shift of health professionals (Bryant & Nix, 2015).
Proliferation and granulation
These are the systems and strategies for effective, safety and proper management of both the blood and the blood products so as to ensure the safety of the patient and also the blood.
In this standard enables the prevention of pressure injuries development and describes the best management practices if any pressure injury occurs (Goodman et al,2016)
Recognizing and responding to clinical deterioration due to acute healthcare
It involves the processes that are to be implemented by the healthcare services providers so that to respond effectively when the patient’s clinical conditions deteriorate.
Preventing falls and harm from falls
This standard involves strategies that are planned to minimize the occurrence of the patient’s falls within the healthcare organizations and also describes the most appropriate intervention when the fall incident occurs (Bryant & Nix, 2015).
This first link which involves the microorganism that causes the disease and spread it from one person to another either directly or indirectly.
This is an exit point such as the skin cells, breadth, blood or body fluids where the microorganism leaves the reservoir to spread the disease.
The final link that describes the health status that puts an individual at risk of getting the illness.
- Maintenance of the sterile field throughout the procedural practice.
- Avoid exposing the wound for a long time in the air to prevent airborne contamination and to ensure optimum wound temperature (Carayon et al, 2014).
Shaving around the wound should be avoided
The intact hairy skin acts as the mechanical barrier to prevent the entry of germs. The timing of shaving influences the rate of wound infection. Patient waiting for surgery are advised not to shave the related part before the operation as it increases the infection risk.
The wound should not be left open while it is secreting fluids as research have shown that covered wound heals faster than the open wounds. The reason is that although the scab covers the wound and protect while helping in cleaning it, however, it impedes the growth of new cells in the skin to regenerate and cover the wound (Berndt, & Steffes, 2018).
There is no known direct assurance that gloves may leak the result leading to the transmission of the infection, but gloves are like to be damaged while in use. Also, gloves can be contaminated while in use through firm skin touching which leads to increased contamination. Forceps are the most appropriate for they are properly sterilized and there is no direct contact between the user’s hands and the patient (Berndt, & Steffes, 2018).
- Continual increase of pain from the wound
- Much swelling of the wound area
- Redness around the wound area
In the past Egyptians used honey to treat ulcers and wounds. During the rebirth, a French army Ambrose Pare mentioned the cure of the ulcers to be good nutrition, debridement and pain relief. The 19th century, when Pasteur discovered the bacteria, Roentgen through X-ray and Lister’s antisepsis altered the understanding of the ulcers disease in general. In the 20th century, antibiotics development changed the understanding further. The later discovery in the 20th century evidenced the studies on trace elements, biomechanics, nutrition and new methods to manage the pressure ulcers (Yusuf et al, 2015).
Key components of WHIA services
- High quality wounds prevention and research
- Wounds treatment and advice
- Wounds management, educations, and training
When having a client with a red, swollen leg ulcer and experiencing severe pain, as a nurse, I would refer the matter to surgical debridement specialist because such an acute swollen wound requires surgical skills to remove a large amount of eschar and necrosis (Bryant & Nix, 2015).
- Providing of the analgesics when pain is expected
- Involve the client in decision making during management and also give the patient a sense personal control in case of pain.
- Give the patient time to rest during the painful procedure and signal the client in advance.
- Dismiss the cultural myths and educate the client about pain and its management strategies (Carayon et al, 2014).
When the dressing is anticipated to be painful, the analgesics drugs are administered 45 minutes before manipulation of the wound bed to ease the procedure of both the nurse and the patient in wound management (Bryant & Nix, 2015).
Reference
Berndt, E., & Steffes, J. (2018). U.S. Patent Application No. 10/085,890.
Bryant, R., & Nix, D. (2015). Acute and chronic wounds-E-book. Elsevier Health Sciences.
Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), 14-25.
Frykberg, R. G., & Banks, J. (2015). Challenges in the treatment of chronic wounds. Advances in wound care, 4(9), 560-582.
Goodman, D., Ogrinc, G., Davies, L., Baker, G. R., Barnsteiner, J., Foster, T. C., … & Leis, J. (2016). Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V. 2.0: examples of SQUIRE elements in the healthcare improvement literature. BMJ Qual Saf, bmjqs-2015.
Kim, W. C., & Mauborgne, R. A. (2014). Blue ocean strategy, expanded edition: How to create uncontested market space and make the competition irrelevant. Harvard business review Press.
Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International Higher Education.
Yusuf, S., Okuwa, M., Shigeta, Y., Dai, M., Iuchi, T., Rahman, S., … & Sanada, H. (2015). Microclimate and development of pressure ulcers and superficial skin changes. International wound journal, 12(1), 40-46.
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