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Problem/Issue
Nurses and other healthcare providers face several obstacles when trying to deliver quality care to patients. One of the most common issues faced by nurses is wound care identification, assessment, and management (Lumbers, 2019). While nurses are professionally prepared to manage all types of wounds, it becomes challenging for those who lack experience and poor handling of wounds can cause devastating effects. In my healthcare organization, not every nurse knows how to handle wounds and sometimes recognizes the type of wound and type of care required. The result is the postponement of patient care and poor management of wounds, especially pressure ulcers which causes problems for patients (Karadag & Sengul, 2021). Because of the poor outcomes observed, there is a need to implement a quality improvement program that can improve the nurses’ ability to identify, assess, and manage wounds.
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Theoretical and Scientific Foundations of Nursing Research: Qualitative Research
Setting
The presence of wounds is a common event in acute hospitals because of the number of patients handled and surgical procedures performed. In a typical healthcare setting, most wounds will be observed in the medical, surgical, and intensive care units. Research establishes that these departments have high patient acuity and harbor high-risk patients who easily develop wounds (Mahmoudi & Gould, 2020). Secondly, these units have so many comorbidities that increase the risk of acquiring wounds. Surgical wounds are the most common type observed in any healthcare setting and if not well-managed, the wounds cause serious problems to patients. Worldwide, there are an estimated 4511 operations that occur out of 100,000 people translating to the many wound observed in surgical units (Gillespie et al., 2020). In my healthcare organization, the most commonly observed wounds include pressure ulcers, colostomy wounds, diabetic wounds, and those that arise due to infection.
Description of the Problem
Wound identification, assessment, and management is a skill that not every nurse possesses. Wound care is a significant nursing responsibility that requires knowledge about the type of wound and management options to minimize complications (Karadag & Sengul, 2021). According to research evidence, wound dressing accounts for 20% of all procedures performed by nurses (Aldousari et al., 2021). The main problem in the selected healthcare setting is that not all nurses understand wound management. This means that most patients will require an experienced nurse to assess and direct care while others have to wait for hours or days before their wounds are dressed. These nurses have issues with their level of knowledge about wound dressing, practices related to wound care, and poor attitudes toward wound dressing. Implementing an evidence-based initiative can greatly address this challenge and improve patient outcomes.
Effect of the Problem
Poor wound care is associated with adverse patient outcomes like prolonged hospitalization, infection, and even death. Poorly managed wounds are likely to be infected and cause serious health problems to patients. For instance, surgical site infections are linked to 38% of patient deaths worldwide (Monahan et al., 2020). poor wound management also increases costs by affecting the hospital’s length of stay and increasing the number of resources required for wound management (Shi et al., 2020). Apart from these effects, poorly managed wounds can affect the patient’s mood, lower self-esteem, and lead to permanent organ loss like in the case of amputation.
Significance
The issue of wound management is important because it is a measure of quality care. This aspect of care influences patient satisfaction and reduces costs associated with patient care (Cudeney et al., 2021). To nurses, proper wound care provides an opportunity to improve quality and patient satisfaction. It also provides nurses a chance to advance their practices and utilize evidence-based approaches to care for patients.
Proposed Solution
The proposed solution to address the challenge of wound care in the organization is the education and training of nurses. This intervention will improve nurses’ knowledge about the types of wounds, wound assessment techniques, and treatment measures (Welsh, 2018). With education and training, nurses could more accurately identify wounds and make appropriate dressing decisions.
References
Aldousari, N. Y., Mersal, N. A., & Alharazi, R. M. (2021). Scoping review nurse’s knowledge and practices regarding wound dressing at primary health care center. OAJBS, 3(1), 000246. https://doi.org/10.38125/OAJBS.000246
Cudney, E. A., Murray, S. L., & Kueny, C. R. (2021). Determining Patient Satisfaction Indicators in a Rural Wound Care Center. In Advances in Human Factors and Ergonomics in Healthcare and Medical Devices: Proceedings of the AHFE 2021 Virtual Conference on Human Factors and Ergonomics in Healthcare and Medical Devices, July 25-29, 2021, USA (pp. 499-506). Springer International Publishing.
Gillespie, B. M., Walker, R., Lin, F., Roberts, S., Nieuwenhoven, P., Perry, J., … & Chaboyer, W. (2020). Setting the surgical wound care agenda across two healthcare districts: A priority setting approach. Collegian, 27(5), 529-534. https://doi.org/10.1016/j.colegn.2020.02.011
Karadag, A., & Sengul, T. (2021). Challenges faced by doctors and nurses in wound care management during the COVID-19 pandemic in Turkey and their views on telehealth. Journal of Tissue Viability, 30(4), 484–488.
https://doi.org/10.1016/j.jtv.2021.09.001
Lumbers M. (2019). Challenges in wound care for community nurses: A case review. British Journal of Community Nursing, 24(Sup3), S25–S27.
https://doi.org/10.12968/bjcn.2019.24.Sup3.S25
Mahmoudi, M., & Gould, L. J. (2020). Opportunities and challenges of the management of chronic wounds: a multidisciplinary viewpoint. Chronic Wound Care Management and Research, 7, 27.
https://doi.org/10.2147/CWCMR.S260136
Monahan, M., Jowett, S., Pinkney, T., Brocklehurst, P., Morton, D. G., Abdali, Z., & Roberts, T. E. (2020). Surgical site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PloS one, 15(6), e0232960. https://doi.org/10.1371/journal.pone.0232960
Shi, C., Wang, C., Liu, H., Li, Q., Li, R., Zhang, Y., … & Wang, J. (2020). Selection of appropriate wound dressing for various wounds. Frontiers in Bioengineering and Biotechnology, 8, 182. https://doi.org/10.3389/fbioe.2020.00182
Welsh L. (2018). Wound care evidence, knowledge and education amongst nurses: A semi-systematic literature review. International Wound Journal, 15(1), 53–61. https://doi.org/10.1111/iwj.12822
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