Wound Assessment In Nursing

1108 Words5 Pages
Working night shifts, I do not see doctors and therapists, thus I go by what was written on the resident’s chart. When it comes to therapists working with residents, I could say that they follow the reporting guideline of skin issues observed to the nurses in-charge of the resident. Doctors are made aware of the skin issues and sometimes they would give orders to change the treatment of the wound and lab tests when they deemed necessary.
Based on my interview of the nursing staff, I have learned that nurses’ aides have not seen nor read the wound assessment guideline. They do not know where to find it either. This is the same with the nurses. Nurses’ aides are quick to report to their respective nurses whenever they find skin
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They have different attitudes towards bruises and wounds. Some nurses do not like to write up an incident for bruises unless they are significant in measurement. One of the nurses, KR, voiced that it is a hassle to write up bruises and sometimes she would not write it up especially when her shift gets busy (Personal communication, March 1, 2018). ANA’s Code of Ethics (2015) has stated that “the nurse has authority, accountability, and responsibility for nursing practice…takes action consistent with the obligation to promote health and to provide optimal care” (p. 15). The nurse’s decision not to follow through with the resident’s skin issue is a failure when our ultimate goal is to provide optimal care. I have observed these attitudes towards bruises more often because most of the time I was the receiving nurse and consequently was the one to write up the bruise. When it comes to wounds, nurses differ in their opinions as to what appropriate treatment and dressing needs to be used. In the wound assessment guideline, it only states that we need to…show more content…
55). When Wanda asked this writer whether nurses have read the guideline, she was shocked that six of the nurses that I interviewed had not read it. She agreed when I made the comment that the guideline needs updating and the nursing staff, especially nurses, need training when it comes to wound assessment in order to promote optimal care and improve the documentation so that we can more closely adhere to the CMS guideline. I can say that the facility’s wound assessment guideline needs changing, not only with the inclusion of references, but also in ensuring that the references included are evidence-based. There will be perceived barriers to change, such as the lack of EBP knowledge, nurses’ attitudes towards EBP, and the administration’s support (Melnyk & Fineout-Overholt, 2014). One of the nursing home long stay quality measures is the percent of high-risk residents with pressure ulcers (CMS, 2017). Residents in the nursing home are at risk for pressure ulcers due to their mobility, nutritional status, and comorbidities, thus nursing staff should be alert in assessing the residents. Assessment skills and quick attention to wounds can help prevent nursing home acquired pressure
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