Chronic Wound Care Essays

Chronic Wound Care Essays Chronic Wound Care Essay Chronic Wound Care Essay The management and care of persons with severe or chronic wounds with their extensive effects have a challenge to both practitioner and patient. The challenging bit is the paucity of the treatment based on evidence strategies for the care of chronic wounds. After going through numerous databases, this paper will try to review chronic wound care and its management articles. Applying this available information, this literature review will be based on evidence concepts relating to the treatment of the chronic wounds while focusing on the basic principles for treatments. Chronic wound management According to Srensen (2012), a wound is a distraction of the normal functioning of the skin or skin structure. An acute wound damage caused by trauma inflicted on skin cells. This can be intentional as in cases where doctors conduct surgical procedures or by accidents such as blunt objects, chemicals, electricity or heat. The best approach to the study was through classification and treatment to wound care. In his findings he concluded that; An acute wound is expected to heal progressively through the normal wound healing stages and with time the wound will close up. Srensen (2012), further recommend that; It is important to recognize that, different causes of wound determines the length of time the skin would heal, the higher the level of trauma the longer the time the skin cells would take to have a quick recovery. Romanelli (2014), establishes that chronic wound in his study found out thata chronic wound; is one that fails to respond to normal treatment or does not progress as other normal wounds over the normal expected healing time frame (usually four weeks). Instead, the healing process stagnates at the inflammatory phase. Chronic wound care the essentials Chronicity of wounds can be attributed to a series of intrinsic and extrinsic factors which include poor nutrition and inappropriate dressing. Other factors such as diabetes also lead to chronicity of a wound, poor nutrition and improper dressing alone do not determine the wound healing process. Medical interventions such as a boost of the immunity should be able to reduce the chronicity of a wound. Dettmers, Brekelmans, Leijnen, Ritchie (2016)found out that there are numerous causative types of wounds; acute surgical wounds: during surgical procedures, a sharp object may be used to deliberately cut through the skin tissues. Acute wounds normally undergo a natural process of healing where the damaged tissues and cells will undergo restoration and body anatomy, and functioning will ultimately achieve their integrity. An acute wound that fails to heal within a period of 6 weeks might end up becoming a chronic wound. Acute wounds require proper dressing, it also needs the patient to watch over their nutrition at the time. Medical interventions alone is not enough to help absolve the problems of chronic wounds. Trauma wounds are as a result of a stressful event caused by mechanical or chemical injury that leads to damage of tissues. Trauma can have a serious short term and long term effects based on its level. It is important to treat each level of trauma with utmost care to avoid would chronicity. Chronic wound care management and research According Jeschke Rogers (2016)Burns are injuries sustained by skin tissues due to heat, electricity, friction or radiation. Heat causes rug burns while friction cause rope burns. Chemicals, on the other hand, cause caustic burns when one comes into contact with them. Chronic wounds usually fail to heal orderly and within the expected times. There are different environments for chronic and acute wounds. Some of the clinical signs of chronic wounds include lack of reduction of the size of the wound as time progresses, frequent and recurrent breakdown of the wound, and the granulation tissue is unhealthy. Burns should therefore be handled through the use of heat dissipation mechanism in order to reduce any inflammatory conditions. Pressure injuries according to Melbourne 2016,are injuries to the skin and the underlying tissues mostly on a bony surface as a result of friction or pressure, or a combination of both. Infected wounds: pathogenic microorganisms can invade wound tissues, causing additional damage to cells and tissues through secretion of toxic substances. It is valid to say that pressure injuries need more attention as they can turn to be inflammatory and swellings are a common part of it. Protection against festurization of the wound is important. Dickinson Gerecht (2016)study have generated sufficient evidence to show that a moist environment is ideal for the healing process of wounds. As a result of this, there has been a proliferation of wound dressings that have higher acquisition costs than standards dressings, leaving wound care providers in a state of confusion as to when be the appropriate time to use these relatively more expensive methods. Burn wounds, chronic wounds and pressure wounds require specialized dressing, other wounds such as sharp object wounds do not need any specialized care. Chronic wound treatment Ubbink et al. (2013) found thatadvanced wound dressing, using foam, for instance, has more control of the wound surface through the retention of moisture and absorption of exudates; in the process, the wound base and the surrounding tissues are protected. Maintenance of optimal moisture content ensures that the patient remains comfortable before, during and after the wound dressing process. The choice of which dressing to use will vary depending on the nature of wound base and the exudates. The selection of the dressing to be used therefore calls for training, experience and a level of expertise in wound care. Wound dressing using foam should be used in cases where a patient has experienced a high level of trauma on the skin such as a burned skin. This mechanism of dressing works best for wounds that are highly septic and require multiple change of dressing. Paul (2015)established that; the inflammatory phase takes up to three days from the point of infliction of injury. It is characterized by the bodys natural reaction to injury and is characterized by vasodilation that leads to increased blood flow that leads to swelling, pain and redness. At times wound ooze may be experienced which is a normal function of the body response. The proliferation phase takes between 3 to 24 days and is the phase when the wound is undergoing healing. The body generates new blood vessels and tissues that cover the wound surface. It is the reconstruction phase, and the wound will ultimately become smaller as the healing process progresses. The maturation phase takes between 24-365 days is the final phase of healing and is characterized by the formation of scar tissues. At this phase, the wound is still at risk and should be adequately protected. In many other cases, wound healing takes a shorter time that the projected 24 days, the level of trauma and chroni city of the wound can push the healing period past the 24 days mark. Inconclusion chronic wound care and management based on evidence should recommend the following healing mechanisms; Primary intention: this is where surgical wounds and recent traumatic injuries are dealt with by primary closure- the edges of the wound are secured by staples and minimal tissue loss and scarring occurs. Delayed primary intention is the surgical closure of a wound that is performed 3 to 5 days after a thorough cleaning of the wound bed has been done. Skin graft: this is the removal of a partial or full segment of the epidermis and the dermis, removing it from its blood supply source and transplanting it on another site to expedite the healing process and prevent infections. Skin grafts can be a perfect mechanism of hastening the healing process but it is important to be highly careful when selecting a skin graft section as a mismatch can create another wound due to poor match of the skin parts. A skin graft can be a perfect cure but it is a risky measure in wound heali ng process. References Dettmers, R., Brekelmans, W., Leijnen, M., Ritchie, E. (2016). Negative Pressure Wound Therapy With Instillation and Dwell Time Used to Treat Infected Orthopedic Implants: A 4-patient Case Series | Ostomy Wound Management. O-wm.com. Retrieved 18 September 2016, from o-wm.com/article/negative-pressure-wound-therapy-instillation-and-dwell-time-used-treat-infected-orthopedic Dickinson, L. Gerecht, S. (2016). Engineered Biopolymeric Scaffolds for Chronic Wound Healing. Frontiers In Physiology, 7. http://dx.doi.org/10.3389/fphys.2016.00341 Hirsch, T., Limoochi-Deli, S., Lahmer, A., Jacobsen, F., Goertz, O., Steinau, H. et al. (2011). Antimicrobial Activity of Clinically Used Antiseptics and Wound Irrigating Agents in Combination with Wound Dressings. Plastic And Reconstructive Surgery, 127(4), 1539-1545. http://dx.doi.org/10.1097/prs.0b013e318208d00f Jeschke, M. Rogers, A. (2016). Managing severe burn injuries: challenges and solutions in complex and chronic wound care. Chronic Wound Care Management And Research, 59. http://dx.doi.org/10.2147/cwcmr.s86762 Melbourne, T. (2016). Clinical Guidelines (Nursing) : Wound care. Rch.org.au. Retrieved 18 September 2016, from rch.org.au/rchcpg/hospital_clinical_guideline_index/wound_care/ Paul, J. (2015). Wound pruritus: pathophysiology and management. Chronic Wound Care Management And Research, 119. http://dx.doi.org/10.2147/cwcmr.s70360 Romanelli, M. (2014). Chronic wound management and research. Chronic Wound Care Management And Research, 1. http://dx.doi.org/10.2147/cwcmr.s57937 Srensen, L. (2012). Wound Healing and Infection in Surgery. Annals Of Surgery, 255(6), 1069-1079. http://dx.doi.org/10.1097/sla.0b013e31824f632d Ubbink, D., Lindeboom, R., Eskes, A., Brull, H., Legemate, D., Vermeulen, H. (2013). Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study. International Wound Journal, 12(5), 531-536. http://dx.doi.org/10.1111/iwj.12149

Luddites

Luddites Luddites Luddites By Maeve Maddox The word Luddite originated in the nineteenth century as a label for an organized group of English workers and their sympathizers who set out to destroy manufacturing machinery in the midlands and north of England between 1811 and 1816. These enemies of the new technology were called Luddites, Ludds, and Ludders. Luddite is the term that has survived. The noun Luddite has come to mean anyone who opposes the introduction of new technology, especially the kind that results in the loss of jobs. The abstract noun Luddism refers to the type of thought that questions the commonly held belief that unfettered technological progress is inherently good for the human race. In current usage, the word Luddite is used disparagingly. The term neo-Luddite is sometimes applied to modern thinkers who question the belief that unfettered technological progress is a good thing. An explanation published in 1847 asserted that the term Luddite originated in the name of Ned Ludd, â€Å"a person of weak intellect,† who broke into a house â€Å"about 1779† and destroyed two weaving frames. As the OED puts it, â€Å"The story lacks confirmation.† I think a more likely source than mythical Ned Ludd may be the mythical King Lud. According to Geoffrey of Monmouth, King Lud was the founder of London and was buried at Ludgate, one of the major entrances to London. In 1378, a prison for petty offenders- such as debtors- was established in the gatehouse at Ludgate. Prisoners there came to be known as Ludgathians. Note: The connection between Ludgate and King Lud persisted until the late 17th century. When the gatehouse was rebuilt following the Great Fire of 1666, a statue of King Lud and his two sons was placed on the eastern side. When this gate was deliberately demolished in 1760, Lud’s statue was moved to the church of St. Dunstan-in-the-West in Fleet Street, where it may still be seen.    In the seventeenth century, Ludgathian was a synonym for debtor. Ben Johnson uses the word in his comedy Every Man Out of His Humor (1600): Always beware you commerce not with bankrupts, or poor, needy Ludgathians. The OED etymological note points out that during the 1811-13 riots, the nickname â€Å"Captain Ludd† or â€Å"King Lud† was commonly given to the ringleaders of the Luddites. It’s a roundabout connection between Ludgathians and Luddites, but the Luddites feared that the mechanization of their crafts could reduce them to penury. Imprisonment for debt continued to be a possibility for the jobless in England until 1869. Note: I recently heard a speaker on NPR pronounce the word â€Å"LOOD-ite.† The lud in Luddite is pronounced with a short u, as in mud. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:Apply to, Apply for, and Apply withConnotations of 35 Words for Funny PeopleThe Difference Between "Shade" and "Shadow"

EPISODIC and Analysis Essay Example | Topics and Well Written Essays - 1250 words - 1

EPISODIC and Analysis - Essay Example He is also complaining of shortness in breath, stuff nose and persistence of cough. On the other hand, T.M. denied smoking cigarettes, taking prohibited drugs and drinking alcoholic beverages. He has no allergic reactions to any food, any drug or medication, or any environmental factors. As a patient, he had not complained of pains or of any past hospitalizations. But he is sexually active and had undergone AIDS test. His two other brothers also tested negative of the AIDS test last year. He has had vaccination for milestones completed. He had no previous medications taken or OTC drugs. His parents are positive for hypertension. This seventeen (17) years old African American male was a mesomorph. His physique could be characterized to be predominantly muscular. He was alert being very much aware of his surroundings when he was oriented three times. He had low grade fever at 990F. This was way below the margin of 100.40F or 380C. He was positive for adenopathy for some swelling on the perineal area because of the yellow perineal discharge present. However, he does not have inflamed eyes. He had also no visible wounds, not even rectal rashes. His lungs were clear. This means his respiration was normal. His heart rate was normal at P: 58; RR: 18; T: 99.1 and BP is 139/91. Finally, his nose drainage was clear, but, his voice was hoarse (+). Subsequently, the following plan was designed and suggested for an assessment of the patient after consulting with school clinic: 1) Gonorrhea/ Chlamydia Test – for Urethral Infection – a Non-culture detection of N. gonorrhea – b. Culture positive for N. gonorrhea, with or without confirmation tests; 2.) Test for Rectal/Pharyngeal Infection; 3.) Test for HIV from the patient’s blood collected sample; 4.) DNA probe test must be done to rule out Chlamydia; 5.) Immunodiagnostic test must be done for the antigen-antibody reaction (Engelkirk and Burton, 2007); 6.) For medication, the patient must take: Rocephin 125mg

Strategic Perspective - Zara Report Essay Example | Topics and Well Written Essays - 3750 words

Strategic Perspective - Zara Report - Essay Example However, the company has been influenced by certain external factors throughout its dominant apparel retailing business. It has been found from the external analysis of Zara, it has been found that the company has been able to obtain substantial advantages within the global business environment. Moreover, the external analysis of Zara has revealed that in the fast fashion retail industry the bargaining power of buyers is quite high, therefore the company needs to constantly strive towards their varied and altering altering preferences. Additionally, the company has developed robust internal resources based upon its competent human resource capabilities. On the other hand, in relation to corporate social responsibilities, Zara follows certain ethical code of conducts in its business practices which facilitates the company to achieve sustainability. However, Zara in recent years has been dogged with certain public relations related crisis due to certain undesirable conducts. Therefore, certain strategic options and choices as well as recommendations such as expanding outsourcing activities and focusing on PR along with CSR initiatives have been advised to the company so that it is able to maintain its dominant position in the global fast fashion retail industry. Table of Contents Executive Summary 2 I. Introduction 5 II. External Environment Analysis 6 II. I. PESTEL Analysis 6 II. II. Five Forces Analysis 8 III. Internal Environment Analysis 9 III. I. SWOT Analysis 10 III. II. Internal Resources and Capabilities 11 III. III. Value Chain Analysis 13 III. III. I. Primary Activities 13 III. III. II. Support Activities 15 IV Corporate Social Responsibility (CSR) 16 IV. I. Ethics 16 IV. II. Public Relations (PR) Crisis 17 IV. III. External Stakeholders Issue 18 V. Strategic Options and Choices 18 V. I. Expanding Outsourcing Activities to Other Developing Countries 18 V. IV. Emphasising Upon PR Campaigns 19 VI. Implementation and Evaluation 20 VII. Recommendations 21 V II. I. Improvement of the CSR Initiatives 21 VIII. II. Emphasise Upon Greater Initiatives on PR Activities 21 VIII. Conclusion 22 References 23 I. Introduction According to the present increasing competitive business scenario witnessed in the fashion retail industry, Zara has been recognised as one of the renowned fashion brands. The company has been playing a leading role in the respective industry through expanding in different global regions across the world. Zara is the major brand of its parent company The Inditex Group, one of the dominant clothing retail organisations within the globe (Corporate Excellence, 2011). It can frequently be observed that the company highly seeks to represent unique fast-fashion clothing to the global customers. In accordance with the present day context, the company is performing its leading role in 86 countries through its more than 1750 stores across the different nations of the world (Inditex, 2013). Emphasising upon the present competitive glob al clothing retail segment, the primary objective of this report is to demonstrate an in-depth analysis of Zara in the global clothing retail industry. The discussion of this report will be focused on analysing external environment of Zara through incorporating PESTEL and Porter’s Five Forces framework. Moreover, the discussion of t

Experience At Work Speech Essay Example for Free

Experience At Work Speech Essay At McDonalds lines of communication are pretty open especially for the ones still in high school or college. They give whatever hours you request and how many days you want to work. If you need off one of the days just be sure to ask off two weeks in advanced and they will make sure you get the day off. The overall experience at McDonalds after being there for over a year now is outstanding. I know most people think hey its McDonalds, but the benefits they aren’t bad at all. For one they are lenient with their hours and give however many hours you want. Secondly, they allow you to have $6 of free food each time you work, but that is only good of course if you like McDonald’s food. Third, on thanksgiving and Christmas they give bonuses depending on the amount of time you have worked there. For example around Christmas last year Ms. Geneva, the manager, gave me a $100 bill. The pay starts at minimum wage but steadily increases, I am at $7.80 per hour at the moment. Once you get to know the managers and workers everyone becomes intriguing to talk too as they all have unique stories. The customers are the only thing bad about working at McDonalds. Some can be nice and understanding, but then there are always those customers that are rude and impatient. Consequently, they do not understand that sometimes it is difficult to get their order right when they change it 5 different times. And it takes time for the food to be made if we run out for the moment. Other than that the only thing McDonalds has control over that gets me trouble is not being allowed to have any sort of beard. I like having a chin strap so I keep it trimmed, but every now and then they still get onto me†¦ and I don’t even work with food. The thing about McDonalds is you are never bored because there is a constant flow of customers at every hour of the day. At other jobs if you are not busy they send people home, but at McDonalds you are always busy especially in the mornings. That is another perk of McDonalds, if you are not scheduled to work that day and you are available to work you can always go ask if they need anybody and more days than not, they will say yes and you can go get extra hours in. McDonalds will more than likely be my job until I leave for college where I will hope to find a new job based on my engineering skills. I would have probably left McDonalds by now if it were not for the great experience and overall  benefits I get at McDonalds.

Motivation In The Workplace Essay -- Business Management

Motivation in the workplace is one of the major concerns that managers face when trying to encourage their employees to work harder and do what is expected of them on a day-to-day basis. According to Organizational Behavior by John R. Schermerhorn, James G. Hunt and Richard N. Osborn the definition of motivation is "the individual forces that account for the direction, level, and persistence of a person's effort expended at work." They go on to say that "motivation is a key concern in firms across the globe." Through the years there have been several theories as to what motivates employees to do their best at work. In order to better understand these theories we will apply them to a fictitious organization that has the following three types of employees: salespeople, production workers, and administrative staff. We will discuss which of these theories would or would not be most effective to motivate these employee groups and try to explain why. The motivation theories that will be discussed are: Maslow's Hierarchy of Needs, ERG (Aldefer), Two-Factor Theory (Herzberg), Equity Theory (Adams), and the Expectancy Theory (Vroom). Let's start with salespeople. Salespeople Maslow's hierarchy of needs theory says that there are five levels of individual needs from self-actualization and esteem at the top levels, to social, safety and physiological levels at the bottom. Maslow felt that some of these needs are more important than others and that the important ones must be satisfied before the rest of a person's needs can be satisfied. Since a salespersons basic responsibility is to sell merchandise this motivational theory would not be a good choice for an organization to use to motivate them. The reason for this is because s... ...nt from one culture to another and even from one individual to another. Clayton Alderfer's ERG theory emphasizes a unique frustration-regression component. This means a lower-level need can become activated when a higher-level need cannot be satisfied. This would not be a good motivation theory for administrative staff since their goal is to usually get ahead. Both the Equity and Expectancy theories focus on thought processes. The equity theory may or may not motivate administrative staff depending on how each individual perceives the fairness of their work outcomes relative to others. The Expectancy theory does not specify which rewards will motivate particular groups of workers. Individual motivation directly determines work effort, and the key to motivation is the ability to create a work setting that positively responds to individual needs and goals.

Hoaxes: Deception and Cardiff Giant

Hoaxes What is a Hoax? A hoax is something that is intended to deceive you or better described as a theory. They are many hoaxes in the world that have been developed over time. The two I have decided to tell you about are in the top 10 famous hoaxes in the world. These two are the Cardiff Giant and then the Cottingley Fairies. As you will out while you continue to read is both of these came out not to be completely true. George Hull who was a tobacconist created the hoax, Cardiff Giant. â€Å"He decided to create the giant after an argument at a Methodist meeting about a passage stating there were giants that once lived on the earth. The men he hired to carve the man, were instructed to make it long out of gypsum. Edward Burghardt was hired by Hull to carve the stone into a man and not tell anyone. To make the stone man look old and weathered, they used many stains and acids. By the time he was transported to a farm the United States has already spent 2,600 dollars trying to figure out the hoax, this was in 1868. In almost 1869, two men dug up a well and discovered the giant. One of the reporters said, â€Å"I declare some old indian has been buried here! Later some guy set up a tent and charged 25 cents for people who wanted to see the giant. Hull later sold his interest for 23,000 dollars to a man with the name of David Hannum. They moved it to Sycacuse, New York for an exhibit. It was so popular that a man named P. T. Barnum offered 50,000 dollars for the giant; he was turned down. He later hired a man to model the giants shape and cover it in wax and created a plaster replica. The replica was put on display at New York and claimed that it was real and the other one was fake.Barnum got sued by Hannum for calling his giant fake. Barnum got sued by Hannum for calling his giant fake. Hull eventually confessed to the press on December 10. On February 2, 1870, both of the giants were revealed in the court as being, fake. Barnum was ruled by the judge that he c ouldn’t be sued. The story of Cottingley Fairies is based off of a series of five pictures that were taken by Elsie Wright and Frances Griffiths. Elsie borrowed her dad’s 25 cent camera one day and toke pictures behind the family house. As Mr.Wright was developing the pictures, he saw fairies in them, but he said they were, fake. She was banned from taking anymore pictures, but her mom, Polly, was convinced they were real. In the summer of 1919, the whole situation became public and an author wrote an article saying these fairies were real. The next fifty years od there life was spent avoiding the public and is particular hoax continued to be believed by a lot of people. Frances and Elsie both admitted when they were about to die that the first four that were taken was fake, but the fifth photo was, authentic.