wound care case study

7/29/2019 Wound Care Case Study

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JULIA KENNEDY

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WOUND CARE CASE STUDY

Question 1. Interpret the impact of this wound on the client and his family:

PSYCHOLOGICAL

Loss of independence due to the impact of wound Inability to completely care for his dependent wife Inability to manage his high set family home on his own Socio-economic impact

PSYCHOSOCIAL

Social isolation due to wound Socio-economic impact

PHYSICAL

Delayed wound healing due to Type 2 diabetes Increase risk of infection because micro organisms thrive in a high

glucose environment

Inability to perform activities of daily living independently due to wound Decreased mobility due to wound

FAMILY

Inability to complete care for his dependent wife Inability to manage his high set family home on his own Unable to care for his wife and family home due to socio-economic

circumstances

Question 2. Provide at least three risk control measures you would implement

for this wound dressing in the hospital/ward environment to reduce infection

risk:

RISK CONTROL MEASURE 1: ISOLATION & NURSE COHORTING

I would implement isolation as a risk control measure to decrease the risk of

entering further micro-organisms into the infected wound and to interrupt

transmission of bacteria. I would also implement nurse cohorting (the physical

segregation of MRSA patients in one part of a ward, with nursing by designated

staff who care exclusively for these patients) to ensure that the mode oftransmission is not through nurses and to promote fast wound healing and to

avoid complications by not introducing new micro-organisms between patients.

RISK CONTROL MEASURE 2: ADDITIONAL PPE + GOOD HAND WASH

TECHNIQUE

I would implement additional PPE when caring for this patient to ensure you are

not the mode of transmission of micro-organisms/bacteria between patients and

other staff. Additional PPE would include, gloves, apron or gowns and facial

masks if need being. Regular and correct hand washing must be implemented to

ensure you are not introducing new micro-organisms to your patient and you are

not the mode of transmission between patients and staff. Staff and FAMILY

should be educated on when you should do a hand wash (before and after caring


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for a patient, before and after eating, after touching a patients belongings, after

going to the toilet, after handling money, after sneezing or touching face etc) and

also educate staff and FAMILY about the alcohol base gel that can also be used in

conjunction with hand washing.

RISK CONTROL MEASURE 3: ASEPTIC TECHNIQUEAseptic technique should be implemented when performing wound care to

ensure you are not introducing new micro-organisms into the wound.

Question 3. Factors I would consider in choosing a wound care product for this

client are:

1. Infection I would want to use wound care products thatll help fightinfection

2. Absorbent Due to the amount of exudate I would want to use anabsorbent dressing to avoid exudate from seeping

3. Size Due to the size of this wound I wound want to use appropriatesized dressings

4. Mobility A dressing suited too withhold movementQuestion 4. What type of product/s may be appropriate? Give rationales for

your product choice.

1. Hypertonic saline to fight infection and kill microorganisms with the aidof antibiotics (antimicrobial) ensuring not to get anywhere near good skin

and to clean/debride

2. Antimicrobial dressing - to assist fight infection and to killmicroorganisms thatll help clean/debride, promote granulation and

epithelium tissue growth

3. Absorbent dressing (mepilex) to promote granulation and epitheliumtissue growth and to decrease exudate from wound

4. Pressure band to aid with circulation5. Silver dressing to help fight infection6. Cadexomer iodine dressing highly absorbent, absorbs debris and can

therefore be used to remove it from the wound bed, making cadexomer

iodine a useful debriding agent, helps control exudate, kills bacteria and

pathogens.

7. Foam dressing highly absorbent8. Transparent films help prevent bacterial contamination, They help

maintain a moist wound environment, facilitate cellular migration and

promote autolysis of necrotic tissue by trapping moisture at the wound

surface, waterproof

Question 5. Please find attached Wound Assessment Tool for Mr. Brown


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Question 6. Education I would provide to this client in relation to his wound

would be:

1. Keeping legs elevated2. Managing diabetes3. Incorporate infection control into wound management4. Keeping the dressings clean and dry5. Wearing loose clothing to avoid constriction6. Referring client to a dietician Nutrition plays an essential role in wound

healing

7. Minimal mobility8. Ensuring the client is educated on when and what medication to

administer

Question 7. Discuss two other relevant resources you may use for your

management of this client in their long-term care:

RESOURCE 1: Dietician Nutrition plays an essential role in wound healing. Poor

nutrition before or during the healing process may delay healing and impair

wound strength, making the wound more prone to breakdown. Neglecting the

nutritional health of an individual with a wound can compromise the entire

wound management process. The following website is very useful and provides

knowledge and education about nutrition and wound healing

(http://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutri

tion%20Wound%20Healing_final_lr.pdf).

RESOURCE 2: Endocrinologist Regular check ups with the endocrinologist will

ensure youre monitoring and maintaining your diabetes correctly. Anendocrinologist has the most current information, treatment guidelines and

educational programs, that can help you successfully take control of your

diabetes.

Question 8. Three education topics I would include in educating the patient and

family member to care for the wound between formal wound care dressings so

as to prevent the risk of infection post discharge are:

1. Infection control measures Ensure good hygiene practices showering,washing hands. Ensure a clean environment (educate patient about

cleaning services available) and ensure clothing is clean to promote

wound healing.

2. Wound healing factors refer to dietician - Nutrition plays an essentialrole in wound healing. Poor nutrition before or during the healing process

may delay healing and impair wound strength, making the wound more

prone to breakdown. Neglecting the nutritional health of an individual

with a wound can compromise the entire wound management process.

3. Wear suitable clothing clothing too tight around the legs maycompromise circulation. Circulation is important to promote wound
http://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdfhttp://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdfhttp://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdfhttp://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdfhttp://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdfhttp://www.worldofwounds.com/Home/Portals/0/Expert%20Guide%20Nutrition%20Wound%20Healing_final_lr.pdf


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healing as red and white cells are transported to the wound site to help

fight infection and promote good wound healing process.

Question 9. Follow up care and/or discharge planning for this patient would

include:

1. Transport Does Mr. Brown drive or will he need transport provided?For example, taxi, social worker, family?

2. Caring for other family Mr. Browns wife is dependent on him to lookafter her

3. Cleaning and cooking Will Mr. Brown be capable of cleaning and cookingor will he need services provided?

4. Grocery shopping Is Mr. Brown capable of grocery shopping for him andhis wife or will be need other options available like shopping online and

getting the groceries delivered or grocery shopping with a social worker

for assistance?

5. Caring for pets Do Mr. and Mrs. Brown have any pets that theyre unableto look after anymore or will they need assistance in caring for their pets?

6. Home modifications Will Mr. Brown require home modifications toensure he is independently capable of performing activities of daily living

for him and his wife.

7. Mr. Brown will need to ensure he has regular visits to specialists topromote good wound healing and management. Specialists will include,

dietician, general practitioner, endocrinologist, and podiatrist.

8. Medications Will Mr. Brown be capable of administering and purchasingown medications or will he need his medications picked up and delivered

and/or put into webster packs to ensure correct and easy administration.


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