REFLECTIVE-REPORT ON PRESSURE SORE

Introduction:

Reflective practice could be defined as the extraordinary capability to reflect on actions for the purpose of sustainable learning i.e. making learning a continuous process “REFLECTIVE-REPORT ON PRESSURE SORE”. Reflective practices are capable of generating knowledge insights. Reflective practice is methodical way of learning from practical experience. In the process new insights are gained through self introspection.

In this assignment I will be presenting my understanding of Bedsores. I have learnt that Bedsores are also called pressure sores or pressure ulcers. These are injuries to skin and underlying tissues resulting from prolonged pressure. Bedsores are common on the portion of skin that covers bony areas of the body such as heels, ankles, hips and tailbones. People suffering from medical conditions that limit mobility are most vulnerable to bedsores. These are difficult to treat and may spread quickly. In worst case infected bed sores could spread the infection to the rest of the body leading to the patient’s pre-mature expiration (McGregor, 2012).

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Aims:

To study what is pressure sore
To understand the causes of pressure sore, its signs and symptoms of pressure sore
To find out the prevention measures and treatment procedures

Thompson and Pascal (2012) opined that Gibbs’ reflective cycle is a popular model of reflection. There are six distinct stages that lead to learning through reflective analysis. Description is the first stage where an explanation has to be provided to the readers regarding the pressure sore that is being reflectively analyzed. This was introduced which stated it as a type of injury in skin that breaks down under pressure. I came to realize that in medical terms bedsores have been defined extensively. The common definition of bedsore accepted worldwide is that bed sores are type of skin injury that breaks down the skin and associated tissues when an area on the skin is put to prolonged pressure arising from the limited mobility of the subject being treated. “REFLECTIVE-REPORT ON PRESSURE SORE”.

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The information provided on Pressure sore was relevant and precise that also further elaborated as to why it happens. Background information was included for appropriately conveying the subject matter that is being reflected. Bedsores are called decubitus ulcers surfacing in the form of tender or inflamed patches when the skin covering a weight bearing part of the body is squeezed between bone and another body part, bed, chair, splint, or other hard object (Longe, 2009). Bedsores is a common phenomena of medical conditions that exerts constant pressure or pinches tiny blood cells that are responsible for delivering oxygen and nutrients to the skin (Yamamoto et al. 2007). If the skin is deprived of oxygen and nutrients for more than hour the skin tissues may die and bedsores may creep in. Constant rubbing or friction against the skin may causes pressure ulcers. They may also develop when patient stretches or bends blood vessels by slipping into different position in bed or chair. “REFLECTIVE-REPORT ON PRESSURE SORE”.

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Penning down the feelings and thoughts experienced is the second stage of Gibbs’ model (Harford and MacRuairc, 2008). Urine, faeces or other kind of excess moisture content enhances the risk of skin infections. People who are unable to move or require cues to shift position have higher chance of developing bedsores. It was clear that the visible signs and symptoms are swelling, redness, blisters, hard skin, patches and cracks in the patient.

In the evaluation stage is becomes to have discussion on how things fared up for the pressure sore presentation. The good and bad points will be highlighted here. The presentation did not follow the basic ground rules. The interesting part was that the aims and objectives which were laid out were sketchy and was not covered by the lesson plan adequately. The presenter did not check the knowledge of the students prior to the start of the course, which would have led to focus on areas during presentation. During the presentation the communication skills were not adequate, as the presenter was too quiet and should have taken the charge of the discussion from the audience. The suggestion for improvement is the presenter to be loud enough which can be tested by asking the last line of audience. The attitude was not confident enough where the lacuna in learning was evident in the delivery of content on pressure sore. Indepth discussion and engagement of class participation to clear doubts could have been done. “REFLECTIVE-REPORT ON PRESSURE SORE”.

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Analysis stage requires showed the typical situations patients are likely to face, while the preventive practices and role of health care was highlighted. Following Gibbs, practical experience with the theories was highlighted and explained. In addition, I came to know that chances of bedsore increases from malnutrition, anaemia, douse atrophy i.e. muscle loss or weakness from lack of usage. Elderly people above the age of 60 are more susceptible to bed sores. Medical science has identified some common medical conditions that may cause bed sores. These are atherosclerosis i.e. hardening of arteries, diabetes, diminished sensation or lack of feeling, cardio-vascular disorders, incontinence i.e. inability to control bladder or bowel movements, malnutrition, obesity, paralysis, and injury to spinal cord.

In conclusion, it becomes necessary to acknowledge the things that could have been done differently to improve the positives and thwart the negatives along with the knowledge gained from experience. The treatment plan summed-up the needful steps for pressure sore treatment process so that better response from patients is obtained. The National Pressure Ulcer Advisory Panel has pioneered awareness on the treatment and prevention of bedsores (Haleem et al. 2008).

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Action plan for better treatment procedures show that the nurses may take extra care to reposition bedridden patients at least once in every two hours while awake. In case of persons using wheel chair the concerned nurse should shift the patients weight every 10 or 15 minutes or help to reposition at least once in every hour. Nurses should be encouraged to lift the person rather than dragging while repositioning the person (McGregor, 2012). Nurses should ensure that the head of bedridden patient is never lifted above 30 degrees because it may cause the patient to slide thereby causing damage to the skin and tiny blood vessels. Nurses need to take care that the patient seated up straight. They need to place pillows behind the head and leg for preventing bedsores. Prompt medical attention is the foreword for patients whose clinical condition is susceptible to bedsores. “REFLECTIVE-REPORT ON PRESSURE SORE”.

Adopting the best practices from the different hospitals worldwide is also a method which can enable to remove the risks for the disease to aggravate in patients further. I have firm conviction that Bedsores may be prevented from worsening into serious infections. In case of mild bedsores relieving pressure keeping the wound clear and moist is crucial. The area around the infected skin needs to be kept clean and dry; saline solution should be extensively used for dressing the wounds. The patient’s doctor may recommend topical antibiotics to control the spread of infection. Usage of special drying agents and dressing package along with application of lotions or ointments three or four times a day is mandatory (Cushing and Philips, 2013).

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I understand that treatment of bedsores in arm, hand, foot, or leg is easier as warm whirlpool treatments are available. I have learnt that debriding is a process that is extensively useful for removing dead tissues and debris from the wound by using a scalpel. I am astonished to know that bedsores may reach a stage where the wound may reach a point where skin grafting or plastic surgery is the only option. Oral treatment of bedsores is possible during initial stages involving application of dietary contents or supplements reach in vitamin A, C, E, B and Zinc (Defloor, 2009). I have came to know that during early stages of bedsore a poultice made of powered slippery elm, marsh mallow, and Echinacea mixed with hot water may relieve minor inflammation. Effective infection curing rinse could be prepared by mixing two drops of essential tea tree oil in eight ounces of water. “REFLECTIVE-REPORT ON PRESSURE SORE”.

Conclusion: REFLECTIVE-REPORT ON PRESSURE SORE

So the reflection of pedagogy approach and style for pressure sore needed to match the programme outlay and student expectations from the teacher. The learning process followed here can be considered a composite of theories, examples, statistics to reason out the principles. Amidst the learners perspectives, the learning environment needs adequate support while the assimilation of learning requires adequate amount of reflection and reasoning which helps to bind theories and practices together. The future sessions can be made more scientific with a pre-test and post test that will confirm the learner’s ability to absorb the course material. Reflecting upon the course thus will help to find the lacunae in the teaching content, teaching style and delivery effectiveness which goes a long way in contributing to the knowledge assimilation. “REFLECTIVE-REPORT ON PRESSURE SORE”.

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References

Cushing, C. a, & Phillips, L. G. (2013). Evidence-based medicine: pressure sores. Plastic and Reconstructive Surgery, 132, 1720–32. doi:10.1097/PRS.0b013e3182a808ba
Defloor, T. (2009). The risk of pressure sores: a conceptual scheme. Journal of Clinical Nursing, 8, 206–216. doi:10.1046/j.1365-2702.1999.00254.x
Haleem, S., Heinert, G., & Parker, M. J. (2008). Pressure sores and hip fractures. Injury, 39, 219–223. doi:10.1016/j.injury.2007.08.030
Longe, R. L. (2009). Current concepts in clinical therapeutics: pressure sores. Clinical Pharmacy, 5, 669–681. doi:Clin.Pharm.
McGregor, J. C. (2012). Pressure sores: a personal comment. Paraplegia, 30, 116–117. doi:10.1038/sc.1992.37
Singh, D. J., Bartlett, S. P., Low, D. W., & Kirschner, R. E. (2012). Surgical reconstruction of pediatric pressure sores: long-term outcome. Plastic and Reconstructive Surgery, 109, 265–269; quiz 270.
Yamamoto, Y., Tsutsumida, A., Murazumi, M., & Sugihara, T. (2007). Long-term outcome of pressure sores treated with flap coverage. Plastic and Reconstructive Surgery, 100, 1212–1217. doi:10.1097/00006534-199710000-00021
Thompson, N., & Pascal, J. (2012). Developing critically reflective practice. Reflective Practice. doi:10.1080/14623943.2012.657795

 

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