Burns Wound Management
Burns Wound Management learning goal I have decided to focus on was my clinical skill of burns wound management. I chose to focus on this area, as I have not had much experience with wound management, therefore a placement on the Westmead Children’s Burns Ward was a perfect place for me to practice this skill. I was exposed to many different types of burns including thermal, chemical and electrical burns and had many opportunities to practice burns wound dressings. Not only was I able to physically practice burn wound dressings, but also I had learnt about assessment of wounds including depth, total percentage of the burn and barriers to healing. I feel that my learning goal was achieved and it was a great experience to be able to practice a new skill. A barrier to achieving this goal was that I was initially quite confronted with the sights of these burns and the evident pain it caused for the paediatric patients. However as I learnt more about the management of the burns I gained more confidence in being able to start practicing dressings. I am a hands-on learner therefore by getting involved in as many dressings as I could allow me to gain greater knowledge, confidence and experience in this skill. links as economics assignment help
At Westmead Children’s Hospital, I was able to identify aspects of this learning experience that reflected current evidence-based practice. The hospital follows the current Sydney Children’s Hospital Network Burns Policy and Agency for Clinical Innovation (ACI) guidelines to ensure safe and effective burns wound management. The Burns Management Policy provides guidance to burn management, analgesia, dressings and post-burn wound healing care (Sydney Children’s Hospital Network 2017). I initially read through this policy when I commenced placement as a foundation for what I will be learning and practicing over the weeks ahead. I can now identify that this ward closely follows these evidence-based practice guidelines. For example, the policy suggests using dressings including Acticoat, Biobrane and Meplix, which were all used significantly during my clinical placement (Sydney Children’s Hospital Network 2017). The Nursing staff often looked back onto policies and guidelines to ensure they were following evidence-based practice. Additionally, the ward followed the Burn Wound Depth Assessment table founded in the ACI Burns Management policy which allowed nurses to analyse the burn through depth, colour, blisters, capillary refill, healing and scaring when changing the patients dressings (ACI 2017). By referring back to policies and guidelines allowed me to become more familiar with correct practice. also looking for dissertation writing services
Burns Wound Management
Evidence shows that patients who suffer larger burns are susceptible to developing chronic inflammation, body mass wasting, altered immune status, infection and possibly sepsis. It is therefore imperative that evidence-based resources guide burns wound management in order to promote effective wound healing (Rowan et al. 2015). These policies were followed carefully, as the nursing staff was guided by the recommendations provided. The policies and evidence-based practice also included the social aspect of burns wound management including non-accidental burns. A social work review must be commenced within 24 hours as per the guidelines. A scenario where this was not followed resulted in an IIMS report (Royal Children’s Hospital Melbourne 2017). Therefore, these examples show how closely this ward works with evidence-based practice and relevant guidelines and policies to ensure safe and effective nursing care for patients. Potential barriers to implementing my improved skill in a clinical context area lack of experience and lower level of confidence. I found that some families did not want me to practice wound dressings on their child due to these factors, and also due to the nature of the injury, as it is a very painful and distressing experience for the child. Evidence shows that children are likely to develop anxiety, traumatic stress reactions, post-traumatic stress disorder and behavioural problems after a burn injury (Bakker et al. 2013). However, this did not stop my learning, as I was able to practice other burns management skills, observe the nursing staff attending the dressings and assessing the burn wound when it was revealed. Another potential barrier is the emotional impact and confrontation of some of the burns, in that I felt anxious and apprehensive to address it. However, with support from nursing staff, encouragement and education I was able to overcome these barriers. It is imperative that nursing staff show support and encouragement towards each other during difficult times, as this can create a more positive workplace environment, lead to improved morale and increase job satisfaction among the nursing team (Delaney 2018). Ultimately, it was a great learning experience and I was able to effectively reach my learning goal of burn wound management.
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I could have improved my learning experience to achieve my goal further through putting my fears and feelings aside. I felt very overwhelmed at times and therefore feel that I could have been more involved in some aspects of this learning goal. This was my first placement on a burns ward therefore I needed time to adjust and become more familiar with these types of injuries. In saying that, I was able to take myself out of my comfort zone and make the most of this placement. Some of the skills I wanted to learn were out of my scope of practice as a student Registered Nurse, however I had overcome this with being proactive in observing as much as I could, researching and asking questions in order to get the most out of this placement. visit for assignment help melbourne
After this placement, I can identify that my knowledge and skills have improved. I have also learnt the importance of addressing pain in burns wound management. Although pain is a significant observation and assessment, children continue to experience pain in hospitalizations(Royal Children’s Hospital Melbourne 2017). This was an area that I focused on and was able to become more familiar with paediatric pain assessment tools. I will now always take pain into consideration, even when it seems insignificant, and continually reassess pain scores in patients. This is significant in that unrelieved pain can cause hypoxemia, cardiac morbidity, increased stress hormones and anxiety in paediatric patients (Twycross et al 2014).
Agency for Clinical Innovation (ACI), 2017, Clinical Practice Guidelines: Burn Patient Management, NSW, Australia, accessed 16/10/18, https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0009/250020/Burn_Patient_Management_-_Clinical_Practice_Guidelines.pdf
Bakker, A., Maertens, K., Son, M., Loey, N., 2013, Psycholigical consequences of paediatric burns from a child and family perspective: A review of the empirical literature, Elsevier, vol. 33, no. 3, pp.361-371
Delaney, L., 2018, Patient Centered Care as an approach to improving healthcare in Australia, The Australian Journal of Nursing Practice, Scholarship and Research, vol. 25, no. 1, pp. 119-123 statistics assignment help
Rowan, M., Leopoldo, C., Elster, E., Burmeister, D., Lloyd, R., Rodney, C., Christy, R., Chung, K., 2015, Burn Wound Healing and Treatment: Review and Advancements, Journal of Critical Care, vol. 19, no. 233, pp. 1-8
Royal Children’s Hospital Melbourne, 2017, Burns Clinical Information, Victoria, Australia, accessed 15/10/18, https://www.rch.org.au/clinicalguide/guideline_index/Burns/
Sydney Children’s Hospital Network, 2017, Burns Management Practice Guidelines, Sydney, Australia, accessed 16/10/18, http://www.schn.health.nsw.gov.au/_policies/pdf/2006-8142.pdf
Twycross, A., Dowden, S., Stinson, J., 2014, Managing Pain in Children- A Clinical Guide for Nurses and Healthcare Professionals, 2nd edition, John Wiley and Sons Ltd, United Kingdom