Tissue Viability and Wound Management, Challenges Faced by Nurses in Wound Management - Essay Example

Running Head: Wound Management Wound Management [Writer’s Name] [Institution’s Name] Wound Management Introduction NHS released a report in the year of 1998 that included the fact that the wound management has been failing in the past because of the limited knowledge in its management. The limited knowledge has been in the range of healing process and the limited range of dressing materials available. These days knowledge relating to wound management is in full circle and the dressing materials are available in a better quantity. The quality of the dressing material is maintained in such a way that the dressing can easily do its work in the environment provided. Normal Intact Skin The function of normal and intact skin is to prevent the microbial population in the surface of the skin from entering the underlying tissue. In the case of a wound, tissues are in an open form and the warmer environment in the tissue provides the opportunity for microbes to enter the tissue. The microbial effects on the wounds depend on the depth of the wound, the type, location and the quality of the wound. Wounds There are two main kinds of wounds, acute and chronic. Acute wounds include minor cuts and abrasions, cuts, surgical wounds. Chronic wounds are the ones which are more serious as compared to the acute wounds. However it has been seen that the severity of the acute wounds may cause the medical treatment intervention as the surgical procedures. These are caused by a diseased condition in the body which in turn affects the dermal and the epidermal tissues. The conditions are inclusive of leg ulcers, foot ulcers and impaired venous drainage. Acute wounds are the ones that heal within the expected period of time and they are just the ones on the surface of the skin. However, chronic wounds are the ones that make their way into the tissues and thereby take longer times to heal. Tissue Viability and Wound Management This is the field of study that deals with all areas of soft tissue and all wounds that are caused to the soft tissues. It deals with the healing processes, the knowledge of all the biochemical processes that are related to it including the soft tissue ulcers. Thereby, it just not covers the wound management but also seems to encompass within itself the professional aspects of nursing related to the wound care. Wound Healing Process Chronic wound healing process is different from that of acute wounds. If the chronic wounds are seen to be in non healing mood then that indicates that the tissue healing process are impaired. The healing process, if normal, leads to the fats healing in the chronic wounds, in the case of acute wounds these are the healing processes that become stuck therefore, the normal healing process cannot be resumed. Wound Bed Preparation This is the educational management tool and along with this, issues of wound management, tissue management are considered to be of prime importance. These issues include the wound bed preparation, analysis of the environments if the chronic and acute wounds, cellular components of the wound preparation. The most important part of wound management is to realize the dangers that are associated with wound infection. 1 to 5% of the risk is associated with the surgery and if the matter is ignored then there is a 27% chance that the infection will spread to other tissues. Infection occurs in the human body when the human immune system fails to combat the microorganisms’ virulence. The human immune response has a responsibility of responding to the attack of microbes at the tissue level and the systemic level. Presence of pathogens and infectious microbes in the body also delays the process of wound healing. The other bodily diseases states that might contribute to the state include hypoxia, tissue necrosis, and ischemia whereas these are the processes that impair the cell activity. Nursing Perspectives From the nursing perspective, management and treatment of infections is the most important part. It is one of the most complex areas to deal with in nursing. For this detailed knowledge is needed. Pain is one factor associated with a wound. It has to be realized that whether the pain has any association with the wound healing. A rather important perspective in wound management is wound bed preparation. Wound bed preparation is one of the new innovations in the wound care management as this is the method of treatment that focuses on wound healing and patient care. The relationship that occurs between abnormal cells is studied in wound bed preparation. This list also includes biochemical messengers and bacterial load in the body, impaired wound matrix components. These are the entire situation that so dependent upon the patient’s physiological and physical condition of the body. The main aim and goal of wound bed preparation is to ensure proper wound healing so that the best optimal environment for wound healing is provided. The five main aspects of wound bed preparation include the reinstatement of bacterial balance, necrosis management, exudates management, repair of the cellular dysfunctioning and most importantly the restoration of the biochemical balance. It has been noticed that infection, exudates, co morbidity include the factors that make wound assessment more complex. Challenges Faced by Nurses in Wound Management The main challenges are faced by rehabilitations nurses in terms of some of the issues as they work with the vulnerable patients who are inflicted with the wounds. These issues include the poverty, culture, literacy and the payment for care. A nurse is to be aware of the fact that a patient’s skin integrity is to be maintained at all costs and this can be one of the most difficult tasks for the nurse. There are many issues that are being faced by the nurses in the case of wound management and wound bed preparation and these issues include the collection and application of coherent knowledge if the biochemical processes in the wound healing which lead to better planning and programming of the wound management. In this case other than the knowledge the role of technology cannot be ignored. The severity of the wounds can be of different kinds and can take different shapes and here the call for the best management is needed. So the severe wounds can be a challenge to the nurses. The kinds of wounds that are a challenge to the nurses include fungating wounds as these are the kinds that deal with pain, a lot of bleeding as well as the exudates. These are the wounds that require a lot of sensitivity from the nursing management. For better administration of vulnerable patients the main thing that the nurses need to do is to work in partnerships with patients so as to meet the requirements of the patients that include clinical and the patients’ psychological requirements. Cost effectiveness is another challenge that is being faced by nurses. This is the challenge that is in need of an evaluation of cost in relation to the outcomes of the treatment that has been given. If higher cost effectiveness is taken into consideration then there are two cases that occur. The first case can be that the same number of patients can be treated at a lower cost and the other case can be defined by saying that more of patients can be treated for the same financial output. The major challenges being faced by nurses these days in wound management include the management of pain, pathogens and infection, provision of cost effective treatment, following the rules of clinical governance provision of the quality of care and the most important of these being healing and reduction of the rates of mortality in wounded patients. The importance of clinical governance needs to be realized in the wound management as there are many dimensions to this that are practically applicable in wound management. One of the dimensions of clinical governance apply to the quality of care that is being provided to patients. The gaining of newer knowledge in the case of wound management needs to be increased so that it makes better changes in wound management for patients and for nurses. Healthcare interventions are increasingly needed in professional wound management. A challenging issue in the case of wound management is pain reduction that is relayed to the wound as it has been discussed earlier. Several changes are still needed in this case and there are many researches that need to be conducted in this regard. Conclusions Nurses need to be more innovative in gaining better knowledge in the case of gaining knowledge that is required for better wound management. In addition to this, wound bed preparation is one of the main aspects that need to be emphasized as this is the factor that provide an environment for proper wound healing. The challenges that are to be faced by nurses in wound management need integration of more knowledge and innovation. It is required that these are applied in wound management. References Irion, G. (2002). Comprehensive wound management. SLACK Incorporated. Read More