The management of wound dressings whilst on placement

The management of wound dressings whilst on placement This reflective piece will look at the management of wound dressings whilst on placement in the community. I will use the Gibbs model of reflection this will allow me to describe the event, explore my thoughts and feelings, make an evaluation on the event and then analysis different components which can be explored separately including different dressings and why they are used, finally I will conclude and action plan looking at if this happened again what I would do differently. Whilst on placement in the community I visited a lady who had chronic leg ulcers on both legs and the district nursing team had been visiting this lady for a number of years. The lady had oedematous legs and poor mobility and sat in a recliner chair although the chair was never reclined. I had visited the lady previously on a number of occasions and had applied her dressings and documented what I had done and the dressings used in her district nursing records. On this occasion the lady requested that I didnt put the K-lite dressing on and allows the other nurse do this, as previously when I had dressed her legs she stated the dressing had become loose. I mapped the dressing so that the notes had an up to date record of the size of the wounds and washed and redressed the legs as per the plan of care. The plan of care stated to wash the legs apply aqualcel ag silver this is used for wounds that have a high level of exudates, then atruman was applied covered by mesorb, comfifast yellow then K-soft and then I passed over to the Registered Nurse (RN) to apply the final layer, whilst she applied the final layer I documented the notes that the leg had been mapped, washed and redressed as per the plan and noted that strikethrough was on the dressing prior to removal I also noted the patients level of pain at the time of the cleaning and mapping of the wounds and also after the legs had been redressed. I documented the patients records that the patient had been advised to elevate the legs when resting to aid healing. When the patient advised me that she would prefer the RN to do the top layer I felt like my confidence had been knocked. The patient had never said this before and always stated not to wrap the dressings too tight as she found it very uncomfortable. I told her that I didnt do them too tight as she always stated not to do so and apologised to her that they had fell down and in future would ensure that they werent too tight but would not fall down either. When I left the patients house with the RN she told me that this lady does this to all the new nurses that visit her and not to worry about it. Pressure sores and leg ulcers are classed as chronic wounds and are defined as slow healing wounds with the likely hood of reoccurrence and the pain that a patient feels may be severe and ongoing (Dealey 1999). The dressing plays a major part in the reduction of pain and by choosing the wrong dressing this can cause discomfort when removing the dressing and the nurse needs to avoid this by using careful assessment prior to administering the dressing (Dealey 1999). For a wound to heal the key is to have successful wound management, the nurse should use a wound assessment tool this will ensure that there is valid reliable and also consistent information documented. Wounds need to be regularly reassessed to ensure that evaluation is given on the treatment that the patient has received. When making a wound assessment this should include the location of the wound, the cause, etiology, tissue type the size and the exudates and finally the level of pain the patient is experiencing (Prescribing Nurse Bulletin). To achieve optimum healing the role of the nurse is to be able to select the most appropriate dressing for the wound, this is to be based on the most up to date evidence, and recent development of new dressings makes this a challenge for the nurse (Lansdown 2004). The wound should be assessed for slough and necrosis, signs and symptoms of infection and wound malodour. The patients records need to be documented to state if the wound is healing, e.g. granulisation and epithelisation (White 2005). The ideal wound dressing that will meet the treatment objective and promote the wound from further injury would be a moist wound healing dressing, that manages excess exudates and prevents the wound from maceration and further wound breakdown, ensure that it prevents the exit and entry of organisms, it will cause minimal trauma at the time of removal and is cost effective (Northern Health and Social Services Board NHSSB 2005). One important factor in wound dressings is to ensure that dressings get the maximum exposure to the wound bed. This can be achieved by a dressing that decreases the voids and spaces where bacteria can thrive (Jones etal 2005). Aquacel Ag dressings contain Hydro fibre Technology and it gels on contact with the exudates and micro-contours to the wound bed this helps to eliminate voids or spaces where bacteria and fluid can collect it maximising exposure of the wound to antimicrobials. It is presented as a soft sterile, non-woven pad and is impregnated with ionic silver (Aquacel Ag 2006). This dressing can absorb a large amount of fluid and helps to prevent exudates leakage onto the periwound skin. The dressing can be left in place for up to 7 days however should strikethrough be evident on the dressing then the dressing needs to be changed (NHSSB 2005). It has been recognised that silver is an effective antimicrobial agent (Thomas and McCubbin 2003). It has proved that it is effective against methicillin and vancomysin-resistant strains of bacteria (Lansdown 2002) Atrauman dressings are made of a fine mesh of hydrophobic, polyester fibres and have mesh pores with a smooth surface this effectively counteracts adhesion to the wound by preventing new tissue from penetrating the dressing and allowing the exudates to pass through, this means that the dressing is easy to remove and causes minimum discomfort to the patient and also to the wound. The dressing is highly permeable to air and water vapour and has been found to be very well suited to the management of infected wounds (Hartmann 2010). In recent years Honey has been found to benefit wound healing, clinically topical honey treatment has been found to possess antimicrobial properties, promote autolytic debridement, deodorise wounds and stimulate the growth of wound tissues to quicken healing, it also stimulates anti-inflammatory activity helping to reduce pain, oedema and exudates (White 2005). A fast rate of healing has been reported in wounds treated with honey (Ahmed 2003) it helps the developing of a clean granulating wound bed (Stephen-Hayes 2004) It is clear that wound management is a complex area and the it is the nurses responsibility to ensure that they give the correct care to the patient and they use the dressings that are selected on their knowledge and understanding of what the dressing will achieve they need to be constantly aware of new products available to treat the wounds. By regular assessment of the wound they will be able to see if the dressing selected is helping to promote wound healing. I am aware that if I wish to work in the community I would need a good knowledge of dressing that is used in wound management. I know that I am likely to meet patients who try to make me doubt my ability however this is something that I know I will over come as my confidence builds and I become more used to working in the community.

Historical Perspectives on Curriculum Development Essay

The development of curriculum in history is basically founded on five outstanding motives: : The development of curriculum in history is basically founded on five outstanding motives: The religious The political The utilitarian The mass education motive The traditional versus modern dimension of the curriculum : Traditional Schools : Traditional Schools Traditional Schools defined curriculum as a group of subjects arranged in a certain sequences peculiar to the subject filed for the purpose of instruction. Unique needs and interests have been placed second to the â€Å"common needs of all† Modern Dimension of Curriculum : Modern Dimension of Curriculum Modern Dimension of curriculum consists of all experiences for learning which are planned and organized by the school. It is composed of the actual experiences and activities of learners inside or outside the classroom under the guidance of the teacher and or which the school accepts responsibility. Definitions of Curriculum : Definitions of Curriculum Some authors define curriculum as â€Å"the total effort of the school to bring about desired out-comes in school and out-of school situations† or â€Å"a sequence of potential experiences set up in school for the purpose of disciplining children and youth in group ways of thinking and acting†. Curriculum Planning : Curriculum Planning Curriculum plan is the advance arrangement of learning opportunities for a particular population of learners. Curriculum guide is a written curriculum Curriculum planning is the process whereby the  arrangement of curriculum plans or learning opportunities are created. Curriculum Planning : Curriculum Planning Curriculum planning It is the process of preparing for the duties of teaching, deciding upon goals and emphases, determining curriculum content, selecting learning resources and classroom procedures, evaluating progress, and looking toward steps. Curriculum Development : Curriculum Development It is defined as the process of selecting, organizing, executing, and evaluating learning experiences on the basis of the needs, abilities, and interests of learners and nature of the society or community. Curriculum Laboratory : Curriculum Laboratory Curriculum Laboratory is a place or workshop where curriculum materials are gathered or used by teachers or learners of curriculum. Curriculum Laboratory : Curriculum Laboratory Resource Unit is a collection or suggested learning activities and materials organized around a given topic or area which a teacher might utilized in planning, developing, and evaluating a learning unit. Curriculum Laboratory : Curriculum Laboratory Parts of Resource Unit Introduction or short explanation of the importance of the topic; Objective or anticipated outcomes; Content of the unit: Unit activities; Evaluation; and Bibliography Course of the study : Course of the study It is an official guide prepared for use by the administrators, supervisors, and teachers of a particular school system as an aid to teaching a given subject or areas of study for a given level or grade, combinations of grades or other designated class or group of learners. Course of the study : Course of the study It is usually includes the following: Aims of the course; the expected outcomes; the scope and nature of materials to be studied; Suitable instructional aids; Course of the study : Course of the study Textbooks; Supplementary activities; Teaching methods; and Techniques of evaluation of achievements. Two schools of thought predominated throughout the history of curriculum development; : Two schools of thought predominated throughout the history of curriculum development; The essentialist school The progressive school The essentialist school : The essentialist school It considers the curriculum as something rigid consisting of discipline subjects. It considers all learners as much as the same and it aims to fit the learner into the existing social order and thereby maintain the status quo., Its major motivation is discipline and considers freedom as an outcome and not means of education. The essentialist school : The essentialist school Its approach is authoritative and the teacher’s role is to assign lessons and recite recitations. It is book-centered and the methods recommended are memory work, mastery of facts and skills, and development of abstract intelligence. It has no interest in social action and life activities. Its measurement of outcomes is standard tests based on subject matter mastery The progressive school : The progressive school It conceives of the curriculum as something flexible based on areas of interest. It is learner-centered, having in mind that no two persons are alike. Its factor of motivation is individual achievement believing that persons are naturally good. The role of the teacher is to stimulate direct learning process. The progressive school : The progressive school It uses a life experience approach to fit the student for future social action. Constant revision of aims and experimental techniques of learning and teaching are imperative in curriculum development in order to create independent thinking, initiative, self-reliance, individuality, self-expression and activity in the learner. Its measurements outcome is now devices taking into consideration subject matter and personality values. Slide 21: Curriculum Development in the Philippines The Pre-Spanish Curriculum : The Pre-Spanish Curriculum The Filipinos possessed a culture of their own. They had contacts with other foreign peoples from Arabia, India, China, Indo-China and Borneo. The Pre-Spanish Curriculum : The Pre-Spanish Curriculum â€Å"The inhabitants were a civilized people, possessing their systems of writing, laws and moral standards in a well-organized system of government. As shown in the rule of the barangay, their code of laws-the Code of Kalantiao and Maragtas-their belief in the Bathala, and the solidarity of the family were obedience and respect had been practiced. The Spanish-devised Curriculum : The Spanish-devised Curriculum The Spanish missionaries aim to control of the Filipinos, body and soul. The curriculum then consisted of the three R’s- reading, writing and religion to attain goals were the acceptance of Catholicism and the acceptance of Spanish rule. The schools were parochial or convent schools. The main reading materials were the cartilla, the caton and the catecismo. The method of instructions was mainly individual memorization. The Curriculum During the Commonwealth : The Curriculum During the Commonwealth The period of the Commonwealth (1935-1946) may be considered as the period of expansion and reform in the Philippine curriculum. The educational leaders expanded the curriculum by introducing course in farming, domestic science, etc. Commonwealth Act 586, also known as Educational Act of 1940, reorganized the elementary school system. This measured ushered the beginning of the decline of the efficiency of elementary education The Japanese-devised Curriculum : The Japanese-devised Curriculum They devised the curriculum for the Filipino to suit their vested interest. They introduced many changes in the curriculum by including Nippongo and abolishing English as a medium of instruction and as a subject. All textbooks were censored and revised. It causes a blackout in Philippines education and impeded the educational progress of the Filipinos The Liberation Period : The Liberation Period In 1945, during the liberation period, steps were taken to improve the curriculum existing before the war. Some steps taken were to restore Grade VII, to abolish the double-single session and most especially, to adopt the modern trends in education taken from the United States. The school curriculum remained basically the same as before and was still subject-centered. The Curriculum During the Philippine Republic : The Curriculum During the Philippine Republic Great experiments in the community school idea and the use vernacular in the first two grades of the primary schools as the medium of instruction were some of them. An experiment worth mentioning that led to a change in the Philippine educational philosophy was that of school and community collaboration pioneered by Jose V. Aguilar. The Curriculum During the Philippine Republic : The Curriculum During the Philippine Republic It is a source of gratification also to note that our schools are increasingly using instructional materials  that are Philippine-oriented. This policy been formulated by our educational leaders, the most recent example of which being Department Memorandum No. 30, 1966. The Curriculum During the Philippine Republic : The Curriculum During the Philippine Republic This particular memorandum sets the order of priority in the purchase of books for use in our schools as follows: a. Books which are contributions to Philippine Literature. b. Books on character education and other library materials. c. Library equipment and permanent features. Community in The New Society : Community in The New Society â€Å"To guarantee that the educational system would be relevant and responsive to the challenges and requirements of national, provincial and local development.† President Ferdinand Marcos pursuant to Proclamation No. 1081 issued last Sept. 29, 1972, Decree No. 6 known as the Educational Development Decree of 1972, to take effect immediately. Community in The New Society : Community in The New Society To advance its objectives, the Educational Development Decree has formulated a ten-year program based on a number of principle, among them: improvement of curricular programs and quality of instruction at all levels by upgrading physical facilities; adopting cost-saving instructional technology and training and retaining of teachers and administrators; upgrading of academic standards through accreditation schemes, admissions testing and guidance counseling; and democratization of access to education by financial assistance to poor but deserving students, skills training programs for out of school youth and a continuing educational program for illiterate adults. Community in The New Society : Community in The New Society The emphasis of the New Society is on moral values, relevance, proper methods of teaching, retraining of teachers, vocational and technical education, bilingualism, national consciousness and cultural values. Community in The New Society : Community in The New Society The curricular redirection of the New Society: 1. Should be redirected on development of moral virtues 2. As a means of integrating education and life 3. Should reflect the urgent need and problems facing the country today 4. Should be viewed in terms of learning to be acquired 5. All teaching shall seek to develop comprehensive under- standing of all subjects 6. Co-curricular youth programs shall be restructured and enriched 7. Non-formal education shall be recognized

The Benefits of Topics for Evaluation Essay

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Ethical Behavior at Bayview Free Essay Example, 2000 words

Ethical Behavior at Bayview Introduction. All the s of higher learning aim at attracting excellent as well as establishing honesty culture and standards, which are virtuous in all students (Bok, 2000). It is worth noting that different institutions have tried to curb this issue by adherence to some academic codes of hour, rituals of the institution or pledges of the students during their admission into the school in vain. This urge necessitated the discovery of technology that has made academic cheating easy to be realized and difficult to be identified by the faculty or dean of institutions (Bouville, 2010). As one of their duties, institutions expect the dean or members of the faculty to make sure that learners maintain academic integrity in their instruction process for their course work or syllabi. Thus, it has become a common practice for many institutions to make Academic cheating a rule of violation (Bouville, 2010). Ironically, many individual despise it, yet research shows that most of them have been involved in cheating at one instance or another during their academic activities. In the global year 2008 and 2009, there were different forms of accusations by financial managers, corporate officers, and street executive which involved the unethical cheating character (Bowers, 2004). We will write a custom essay sample on Ethical Behavior at Bayview or any topic specifically for you Only $17.96 $11.86/pageorder now One article that mostly featured in the public domain, argued out that, in the area of business, academic cheating is a chronic challenge which had escaped successfully without a lasting solution. This article came up with an estimate of 56% as a percentage ratio of students who study business that were claimed to be involved in academic cheating during their career. Additionally, the article states that, on approximation, 47% of the non business students were involved in the academic cheating of a certain type. This raised the concern that this might have been the case at Bayview University, more significantly affected wad the dean. Different members of the faculty have come to belief that academic cheating in this institution is more widespread than at other universities (Cole, 2000). A significant number of other faculty members argue that academic cheating can never qualify to be categorized to be a challenge in the institution (Keith-Spiegel, 2 008). In attempts to have this issue resolved satisfactorily, this report presents an analysis of the current ethical character of business students at the University of Bayview. In this study, we hypothesize that the proportion of Bayview University’s business students involved in a form of academic cheating is smaller than that of other institution’s business students.