Proposal for Nursing Practice Change Using Best Evidence Sourced - Assignment Example

Introduction: The Burns scenario presents the nursing care scenario where the patient requires multiple interventions in terms of medical and emotional schematics. Such types of deep and variable injuries require a combination of health services along with bio-medical technologies to provide the best possible combination of healing in both physical and emotional state. Any individual action that may not be linked to the other may not be functional and provide results. It may be a better scope to relate bio-medical technology with the nursing practice to make a proper care program for the patient. The co-existence in the care methodologies along with the use of proper medication and tools to help the patient may not have had the proper implementation where the a patient may have had the opportunity to be nursed with better combinations of interventions. This rising concern in the increasing number of the patients in the hospitals that may have had medication errors in their care program is of a major concern. An in-depth analysis and approach will be needed to tailor the nursing practice to help in providing better methods of treatment and prevent errors that may result in death and injuries . There are a considerable number of patients that fall to second and third degree burns every year. In these severe burn cases, especially those who face deformities in the visible areas of the body, helping the patient live is just one of the concerns in the treatment process but using the proper care intervention may be more effective than just saving lives as the social life of the patient may have the chance to be destroyed all together. This issue may be addressed by using the PICO method of building case questions that may be more efficient in tailoring treatment process for the patient. The PICO method makes the research process guided in practice being studied in these categories: Population of interest, Intervention of interest, Comparison intervention and outcome of interest. This method promotes evidence based learning and helps any research on a nursing practice be guided through a focused question. In the case specific of Kevin Lewis, the PICO may be applied to the case in order to understand the concerns that the patients may have in order to keep their social life intact. The issue may be addressed by the following question: When treating burned patients, what practices may be tailored in terms of interventions and nurse care practices to enable them to function normally in their daily lives that may be in another way hindered by any deformations that may arise from the burns? The above question based on the PICO method will evaluate the importance of proper and the best method of treatment available to patients with burns and scars that impair their capacity to live a normal acceptable life again. Research in sociology and nursing that is based on the values of such patients is imperative in the findings of a tailored nursing program that adapts to the needs of the patients to value their lifestyle than just saving the life. Discussion: Hypertrophic scars are the forms of abnormal and prominent type of scars that have been known to be the core reason of psychological and functional hindrances in the lives of the subjects. This type of scarring is more problematic in light toned skin colours and if mainly followed by surgery. The scars that are made on the lower face, neck and upper arms areas of the body along with other similar regions are more likely to have the tendency to be deformed. Silicon Gel sheeting is designed and used predominantly to decrease the effects of Hypertrophic scars. These applications are in the form of a self-adhesive sheeting that makes the treatment process adaptable to prolonged use. The method is designed to be used on intact skin where it may not be used on wounds that have not closed yet. Another constraint in the use of the Silicon gel sheets may be any of the dermatological conditions such as Acene that may prevent the use in the nurturing of the procedure. Silicon and Pressure garments share the same incidence in the reduction or prevention of burns and scars as both have not been scientifically narrated on their actual effect on the burns. Pressure garments have been used to the use as a better substitute for the nursing procedure and make the deep scars of the patients that are on the visible areas to be minimised and controlled over time. The use of these garments has been around since the 1970s and the developments have been adopted in the field to use them constructively with other aligned treatments to give the maximum benefit to the patient. Social norms are set as a standard in societies to be made as a standard of emotion, vision and behaviour of people. There may be a few cases in the masses that may deviate form the standard norms, however, all the access and contact points (such as schools, workplace, parks, grocery shops, opposite sex etc) in the daily lives adhere generally to the perceptions that are generalised in the structure of the society (Lawrenece et al, 2004). The main issues that are dealt in delivering healing to patients with severe burns are related to the way skin is treated at the earlier stages of the burns. The interventions’ success are dependent upon not just the nature of the wounds and the closure of the skin but are also related to elasticity, development and regeneration of underlying structures and cosmetic appearance of the region. A wide array of treatments are there in the form of silicon gels, topical moisturisers, surgery, and other forms of interventions. The success of these interventions are only hindered by the way they may be tolerated by the subjects. The effectiveness of the treatment does not balance on how well they are manufactured of how much they are used. The effectiveness of the treatment however, is dependent upon how well the medical practitioners are able to match the interventions according to the needs of the wounds and scars of the patient along with the tolerance and the comfort of the patients in the use of interventions. Research has shown that the scars have been able to be controlled from hardening or forming other deformities in the patients through applying pressure on the affected areas. The pressure is associated with human system in such a way that it is studied to affect the blood flow of the part where pressure is applied to limit the access of oxygen and other nutrients to the scarred area. This process helps in regeneration of existing affected cells in the burnt area to minimise the formation of new skin that may look deformed over the burned and make a permanent hideous scar (Weinstock-Zlotnick et al, 2004). The chosen RCTs have extensively compared the use of silicon gels to and with pressure garments. The results were obtained through making several trials ranging a high frequency of people aged between two and eighty one years. In these RCTs the subjects were studied as trials in different forms of interventions in testing the burns. The RCTs in review have compared the use of Silicon gel adhesives to formulate the effectiveness of pressure garments. These interventions have been reflected upon other different forms of interventions. The studies have shown that the reduction in scarring due to burns had substantially decreased in the patients that were studies with the additional intervention of silicon gel application and pressure garments. Although the studies had been perceived to be not scientifically proven, the interventions did provide with a remarkable difference in colour amelioration and decrease in thickness of the scarred tissues and muscles. Furthermore, it has been extensively studied that the pressure garments or the use of pressure in the burns gives an affect that no other method of treatment may be bale to provide. Where all the other interventions may just be able to smooth out the burns superficially, the burns may not be able to reduce that well without the usage of pressure garments. This method makes the eventual cosmetic surgery (if needed) a much more convenient and reduced task where the patient may be able to attain most of their body functions and features and the surgery may just enhance the natural contours and tones. The use of the pressure garments in the reduction of scarring or the healing process may be debateable because their affect has not been scientifically proven. However, in many studies the use of such garments has been praised to be effective when it is properly administered and worn for the longest of the time periods every day. The ineffectiveness of the garment may also be related to the capacity of the patient in terms of the number of hours in a day s/he may be able to wear it properly throughout the day. This may further be elaborated on the fact that the effectiveness of pressure garments is dependent upon how perfectly they are made to fit the patient and that the other care processes compliment the entire system. Many researchers have argued that pressure garments, although they may not have been scientifically proven to work and their source of effectiveness may still be unknown, it however may be as better explained in term sof many non-medical therapies and application of ointments that heal the patients but have no known explanations. These cases, however may be smaller in terms of numbers as compared to the medical research but their use in the under developed countries has given rise to interest even to science where researchers are still trying to explain their effectiveness but believe that it is effective (Weinstock-Zlotnick et al, 2004). Research in the healing process also focuses on the state of the mind of the patient and research has observed that although human psychology may not be able to play a scientific role in any form of the healing process but the environment and the state of mind of a patient affects the healing process. A similar case may be developed for pressure garments where the patient’s individual care may be based on not just the treatment but to the satisfaction of the relatively better visual impact of the scars that s/he perceives. The implications of such a method may be related to the figures of the year 2000 where hundreds of thousands of people every year suffer burn injuries. The use of pressure garments for these people as a form of intervention may be useful as this amount of human capital may be otherwise outcaste from the society every year. This impact will be not just on the life of the individual human but on the corporate systems and the over all global economy where many mature labour may not reach its potential for growth and employment. Many other forms of pressure garments where the concept has been the same have been always used in treatments of minor scars and burns. The use of wraps and bandage to be out on the small wounds to put pressure and control the blood flow is of a standard procedure in any treatment. These treatments coincide with the use of gels, therapy, exercise, surgery, and other forms of treatments to make the process less painful and quick for the patient (Weinstock-Zlotnick et al, 2004). Pressure garments’ use in the treatment process may also be of the same essence but on a much diverse level where the patient may be subjected to a decrease in the form of pains when used as an intervention in the treatment process of the burns patient. However, the use of the pressure garments does not only focus on the treatment to heal scars but to make the patient capable to not to look deformed in society and made feel unwanted and unacceptable. Plan for practice Change: Throughout the ages human societies have been basing their thoughts and influencing the course of success in terms of progress and needs in the shadow of the perfect human figure. Today, the companies with commercial values have used sex symbols and messages to sell their products and services. This innate nature of humans has evolved the thought of the race and its values to be subconsciously sensitive to the looks and the features of our overall appearance and how close we relate to these standards set by the society. There is substantial research available on hw important the role our appearance plays on the success of our lives and even actors and models have now hired image consultants to enhance not just their looks but their personalities and the way their bodies are shaped. A patient with sever burn marks may not be able to get the proper and the same uniform opportunities as the other people in today’s societies. This may result in a permanent depression or other psychological disorder that have been associated with homicide or suicide of the individual. Nursing processes may be based on the sole core of the treatment and care of the patient in the hospitals but it should be accepted that where a situation or cause such as the burns have more implication on the outside of the clinic ir the hospital the care module for such patients may be designed and changed to be tailored according to the specific needs of the individual do that the ongoing lifestyle may not be as advertently affected. The pressure garments may not be able to heal the burns entirely but can provide the subject with a layer of confidence that hides the deformities so that his/her functionalities in the society may not be hindered and a relatively normal lifestyle may be attained. The pressure garments used appropriately with other treatments and intervention can allow the patients to be more acceptable in the society and any hideous deformation may be hided or minimised by their used. The nursing practice may be used to deliver these comforts to the patient even though the actual burn may not be totally treatable. RCTs Keywords: Pressure garments, burns, image body Works: Weinstock-Zlotnick, Gwen, et al. Effects of pressure garment work gloves on hand function in patients with hand burns. Journal of Hand Therapy, July-September, pg. 368. 2004. Hermans, Michael. A general overview of burn care. International Wound Journal. Vol 2, No. 3, pg. 206-220. 2005 Lawrenece, John, et al. A test of the moderating role of the importance of appearance in the relationship between perceived scar severity and body-esteem among adult burn survivors. Body Image, vol. 3, pg. 101-111. 2006 Read More