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Discharge Checklist and Patient Information

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Ideal Discharge Planning Overview Process and Checklist

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Title

"To achieve practice development through implementation of Discharge checklist and patient information about care of vacuum assisted dressing”.

Objectives:

  • To understand the use of vacuum assisted dressing
  • To identify the issues and challenges in practice concerning vacuum assisted dressing
  • To analyse the significance of patient discharge checklist and patient education about care of vacuum assisted dressing
  • To recommend strategies through which practice improvement can be brought regarding care of vacuum assisted dressing

Chapter 1

Rationale

People face different types of injuries where some may be serious and some may not. In health care organizations, there are diverse set of things that have to be considered so that care providers will be able to deliver proper services to patients (Johnson, Jefferies and Nicholls, 2012). With advancement in technology, there are many improvements that have taken place. In this context, for the cases of second or third degree burn or any other type of serious injuries, professionals make use of Negative- pressure wound theory (NPWT). This is a type of therapeutic technique in which vacuum dressing is used to promote healing chronic wounds. More specifically, it is used to remove wound waste material and fluid. Further, it is also used for healing of wound and this is done by drawing edges together. There are different types of parts that are included and it consists of pump to generate vacuum in order to create negative pressure in the area in which wound has caused. Further, it consists of dressing material that is helpful to pack up the wound and to seal it. Moreover, it includes tubing that enables to remove all fluid that occurs around the wound (Harris and Holloway, 2012). Lastly, it also consists of a container in which all waste material get collected up. There are different set of cases in which they have been identified where there many deaths are reported because of NPWT. It is important that there is certain level of pressure that is approximately 125 mm Hg. In this, professionals need to use alternative pressure cycle after every 5 minutes and that has to be followed by 2 minutes off suction. In other words, there are certain set of orders and procedures that have to be followed by the care providers and if it is not done properly, then it causes serious issues to the patient. and in worse case scenario care taker can also die. This is the major issue that is faced by health care providers. Further, there are different types of procedures that stuffs has to considered by patient himself/herself so as to overcome the problem effectively. Moreover, nurses need to have proper knowledge and information so that they will follow the procedure properly. In this context, patient should be trained in such a way that he will be able to overcome the pain and injury that has caused (Wukich, Armstrong and Pinzur, 2013). When NPWT is given, then it is essential to have checklist that will help to determine the list of procedure which is left out. As per the findings, it has been identified that there are many serious issues and deaths that have occurred due to lack of improper care taken by nurses. When amount of pressure that has to be given by care providers is not given properly, then it raises the issues because of which injury can get more serious. All these can be avoided if proper care is taken by patient and care provider with the help of which injury can be cured quickly.

Government Drivers

There are many laws that are imposed by the government in order to make sure that the interest of people are maintained. When the change in time, there are many implementations that has applied and it is the responsibility of people to make sure that it is being followed. The awareness and litigations for NPWT is increasing. In this therapy, there are different stages and it increases as per the rate of issues that have been faced and seriousness of the injury (Albert, Rock and Landis-Erdman, 2012). It was in the year 1990s, when new device was formed for AVC Therapy System. This was made with an aim to reduce the impact of wound through negative pressure with pump ranging 60 to 199 mmHg. In other words, it is the source to promote wound healing. In the past 16 years, there has been significant raise in this equipment in healthcare and it has been now widely accepted by people. Further, there have been many other related products that were introduced in the market. These equipments make use of number of mechanisms that are helpful to improve wound healing. The concept behind this is that when the blood flow increases, then the rate of cure will increase. This equipment is used to increase the blood flow and this is helpful as they feel less pain. During a wound, there are blood, fluid, etc. and it becomes important to dress it frequently but with the help of NPWT, it becomes helpful to reduce the times for dressing. A per the law, it is essential that the patient is properly informed about the use, benefits and negatives that are caused. As per the finding, it has been identified that there are cases in which people get services to their home (Kaufman-Rivi, Hazlett and Seid, 2013). In this context, care providers make sure that all the services that has to be provided at hospital are given at their home. According to the government policies, it is essential that the nurses who are providing with NPWT should have proper information so that they will be able to make patients understand about the things that has to be taken by them in case of emergency. Moreover, it is also important that checklist made. When a patient is to be discharged, then it requires many factors that has to be taken into consideration. Care providers need to be aware of all the accountabilities before that discharge any patient. There are conditions in which the issue for which they were admitted was not fully cured because of early discharge. In this context, there are certain laws that has been made in which patient should be discharged only when care providers have developed checklist and all the complications are solved (Williams, Edwards and Avery, 2015). As per the policies made by government, it is important that patient should be discharged in 7 days of proper canisters and dressing. The rent that has to be paid will be stopped after 5 days when patient leaves the hospital.

There are different type of guidelines that are followed by diverse government drivers (Soong, Daub and Bell, 2013). In this context, as per the NHS business plan, there are guidelines which are followed by them for vacuum assisted dressing. With this respect, below given are the guidelines that are followed:

  • Highly trained staff who is trained carry out wound assessment is selected to examine the patient. There is proper assessment and it is then properly documented in Trust's Wound Assessment and Care Plan.
  • As stated above, there are certain wounds that can be operated with the help of vacuum assisted dressing. Proper assessment is done through which it is identified whether the wound can be cured with the help of this therapy or not. As per the wound type, these are of two type which are acute and chronic (Daniello, Rayhill and Otis, 2014). In part of acute, it includes surgical, skin flaps, Tauma, skin grafts, etc. On the other hand, chronic wound includes leg ulcers, pressure ulcers and diabetic foot ulcers.
  • VAC therapy should be given only when the patient has agreed. Further, all the information and reasons for this use should be conveyed. Moreover, that information should be included in the patients medical records. Further, discussion also need to take place with relatives and the prescriber is accountable towards the outcomes of therapy.
  • Then Tissue Viability Team is develop which guide staff within the ward so as to ensure safe therapy to patients (White, Jacolbia and Nasir, 2013).
  • Further, there are different type of pumps and foam that are applied in this therapy and health care professionals should have adequate knowledge regarding all.
  • For dressing one or more than one foam of piece that should be used and if required silicone should be used.
  • Bridging technique can be used in case there are wounds at different places.
  • First dressing should be removed after 48 hours. Further, there needs to have subsequent dressing changed (Harrison, Greysen and Auerbach, 2016). More specifically, it is important to change the dressing twice or thice in a week.
  • Apart from this, it is important for proper monitoring, managing fistula, pain, bleeding and skin reaction. Moreover, therapy should be stopped when the aim is met. Situations when there is not improvement even after 2 weeks, then it should be stopped. Further, it includes active bleeding or deterioration in wound.

Patient Education

There are different set of things that a patient has to determine so that they will be able to avoid the risk factor that is involved in it. There are various procedure that is taken place in order to provide proper care (Aslam, Rehman and Sayyar, 2015). In this context, it is essential that the care provider that has been select for NPWT should have proper knowledge about the instrument that has been used (Dougherty and Lister, 2015). When selected professional has adequate information only then they will be able to make sure that they share information are reduced the risk factor. There are different set of issues or problem that are faced by patient when they are given NPWT. In case of issues there are many important areas that has to be considered by the patients. In this context, it includes an alarm system. In this the care taken can press it when they feel any kind of issue related with NPWT. There is a minimum pressure of temperature that is set and it has to be continued for every 5 minutes (Thomas, Cook and Stephenson 2014). In this context, there are cases in which overheating or improper monitoring can make the wound more serious. Proper information should be provided to patient so that they know how it has to be used. Further, there are life threatening issues that can be caused in care there is some blood found in canister or tubing. In such situation, it is important that medical assistance should be called immediately (Panzarella, 2012). Moreover, issues or complications care arise during the time of dressing. There are chances that blood or infection can be caused. It essential that proper precautions are then so that risk can be reduced (Ousey, Milne and Gillibrand, 2014). There are certain details that should be considered as there are certain cases in which NPWT is not suitable. It is no proper for wound that has caused because of skin cancer, osteomyelitis, necrotic and fistulas. Further, there are different type of issues that are faced by patient and it is essential that proper steps are taken so that they will get to know about it before any type of serious issue arise Among which few of issues that are faced by care takers are as follows:

  • Injury to the skin which is around the wound.
  • There is growth of granulation tissue at the wound and the dressing (Smith and Franzwa, 2015).
  • Risk or getting skin cancer and this is due to increase in blood flow.
  • Formation of fistula

Similarly, there are certain more issues that has to be considered so that one will be able to overcome the issues that has been faced by the patient. On the other hand, there are many advantages that one get with the help of NPWT. In this context, it includes early discharge from hospitals and the rate of getting cure will raise. The need for surgery can be eliminated and it also saves the cost for nurses. If one get to know who NPWT is operated, then they can do it own their own. Lastly, it helps to improve quality of life.

There are systematic and proper steps that has to be followed in NPWT and if these are not followed, then there are many negative reactions that patient has to face. More than half of the services are provided by staffs but it is important that patient also play their part of role effectively so different type of negative outcomes can be solved or the negative impact can be reduced (Farris, Petty and Flynn, 2015). At the initial stage, there are many doubts that a patient has over the treatment. In this context, proper information should be provided by the healthcare professional. NPWT is a type of theory which most of the people are not ware of. As per the analysis, it has been found that people would rather enjoy their visit to any place and try to remain healthy so as to be away from hospitals. However, when they get treatment, then it is the responsibility of care providers to make sure that proper information that includes details about the main reason for selecting this type of medication. What this therapy is all about and what all are the steps that should be taken in order to make sure that the process will be able to overcome the issue (Raj, Gill and Singh, 2016). Day to day activities should be discussed and they should be informed about the negative issues or problems that the patient may face. Basic problem that is faced by patient in NPWT is bleeding and skin rashes. Wound surrounding area causes skin rashes and it is important that information related with this issue should be provided to care provider. In addition to this, issue of bleeding can also cause one to lose their lives. In this context, it is essential that patient know about it and they take proper steps with the help of which wound can be cured. There are conditions in which even after proving therapy effectively, there is not improvement seen (Wu, Chew and Kuo, 2015). As per the guidelines that are fol;led for NPWT. In such conditions, the treatment should be stopped, and this information should have been conveyed to patient before itself when the treatment was begun. In simple words, it can be stated that, providing patient information help the care providers to make sure that effective information is given and they are above to overcome the issue.

Practice and professional development

When care is provided to patients, then it requires proper steps that has to be considered by care providers so that they will be able to make sure that adequate services are provided. In this context, there are certain risk factors that is required to be analysed so that no issues are faced by patient. At the initial stage, it should be understood by nurses that all type of wounds can be treated with the help of NPWT system (Lucas, Fuentes and Gualtieri, 2012). There are certain types of wounds which one can be cured. Further, all the risk factors should be considered by care providers. When the patient is selected for NPWT system, then they should be properly monitored that also by a trained practitioner. Condition of patient should be considered, that includes status of the wound, co-morbidities and location. There should be proper monitoring made in the condition of bleeding as it is a life threatening situation. Further, there are complication that are associated during dressing changes as it can cause bleeding and infection. Proper record is made for number of dressing pieces that has been used. Cutting of dressing should be done over the wound and this is done in order to avoid fragment.

When activities are planned with an aim to overcome any type of issue, then there are steps developed (Aviki, Batalden and Berkowitz, 2015). When these steps are followed, then people involved in it get to find out different set of other issues and according to the findings, people get to know the issues that are faced by people and developments are made so as to achieve the targets or objectives. In order to make improvement in the practices, it is important that all the people who are involved know their part of roles and responsibilities. For vacuum assisted dressing those professional are selected who have proper knowledge and inform about the equipments and steps that has to be taken (Seidel, Lawall and Neugebauer, 2014). When they know about their roles and responsibilities, then it becomes easy for them to make improvement in the services. For NPWT, there are three types of pumps and two different type of foams that has to be used. All these types should be known by professional so that they will be able to make improvement in the practices. There are different set of recommendation that has to be followed with the help of which proper treatment is provided. In this context, it includes proper planning. And that should include before and after the treatment is started and when it is finished. In this context, the aim, objectives and clinical endpoints should be discussed by the patients (Satteson, Crantford and David, 2015). Similarly, in any type of medical practise, there should have proper plan so that they will be able to develop the path on which they will be able achieve them. When the steps are followed, then it should be determined whether the plan is going on towards write directed or not. In case, it does not work on right direction, then it is important to makes sure that the barriers are identified and steps are taken to overcome them. On the other hand, for NPWT care providers should make a proper record and monitor them so that they will be able to determine the improvement or negatives that the patient is facing. In this context, there should also include effective interaction so that patient will share their issues and problems with professional (Sörelius, Wanhainen and Björck, 2013). There are conditions in which actual issue that is faced by then are not identified and professional fail to provide them treatment. One of the main reason for this is lack of proper communication. There should have adequate interaction with patients so that they will be able to share all type of problems and proper steps are taken in order to overcome them all.

In general terms, practice development can be determined as a process which is helpful to develop person-centred culture. It is recommended to insert creative imagination and personal qualities so that one will be able to perform the roles that one is expected to perform. However, it is important that one has skills and knowledge so that the basic responsibilities can be performed (Sörelius, Wanhainen and Björck, 2013). For the health and social care organization it is important that they provide their staff member with proper training and development so that they will be able to perform their set of responsibilities effectively. There are conditions in which people do not know their part of responsibilities effectively. In order to overcome this issue proper training is provided so that they will be able to clarify all their doubts and perform their roles effectively and efficiently (Soong, Daub and Bell, 2013). Further, improvements are made with the help of information that is provided by the people who get treatment. It is important that suggestion should be taken so that they will be able to identify the barriers and issues that are faced by them. Accordingly, adequate steps can be taken will be help to overcome the issues or problems. As per the NPWT, for each of the wound type, there is treatment that has to be given so that they will be able to make steps. Different set of strategies for each of the wound type and there should have professional who are required to have the information about the part of role that has to be played by them (Daniello, Rayhill and Otis, 2014). Further, there are many sets of precaution that has to be taken in order to make sure that the patient is not in danger zone. Further, it is also essential that professional know the skills that they have to develop in themselves so that they can deliver proper services to patients. Strong relationship should be developed among patient and the professional who are required to take care. This enables to make them understand about steps that as a patient they should take up. This will also be helpful for the care providers to make sure that they can develop their understand towards the issue that is faced by the patient (White, Jacolbia and Nasir, 2013). By following these type of steps, professional or any other care providers will be able to make sure that adequate services are provided and in case any type of changes needs to be implement, that can be made and this will be helpful to overcome the issues that is faced by patient.

Chapter 2

Practice development implementation

To implement the strategies and practices, it is important to make certain things. There should be proper efforts made by patient and care providers so that they will be able to implement the practices effectively and efficiently (Harrison, Greysen and Auerbach, 2016). In this context, below given are certain steps that will be helpful to implement the practices:

Proper information: It is essential for the management to make sure that all type of information is provided to professional. In this context, it includes information about the equipments. With time, there are many changes that take place in technology and it is essential all the changes that has been place ans equipment that are used to be conveyed to care providers (Aslam, Rehman and Sayyar, 2015).

They should be able to understand the all ways to make them use. Further, information about the health condition of patient should be conveyed so that they will be able to understand and develop plan that will be helpful to treat them effectively.

Training to care providers: Further, training should be provided by health and social care organization regarding the ways in which they can make use of their skills and capabilities in positive direction. Further, it requires training for them regarding the use of equipments that is used for NPWT. There are different way in which wounds has to be treated (Thomas, Cook and Stephenson 2014). This is because there different reasons due to which wounds can be caused and for each of it different treatment are provided. Covering all the areas, care providers should be provided with proper training.

Information to patients: AT initial stage itself, information should be provided to patient so that they will be able to understand the reasons why this type of treatment is given to them. Further, all the details about the day to day activities should be conveyed. This will enable them to know about the roles that they have to play (Ousey, Milne and Gillibrand, 2014). In this context, it includes information related to bleeding problem and skin rashes that is general problem that is faced in this type of therapy. This way patient will be able to know about steps or immediate action taken in time of serious situation.

Following guidelines: As per the guidelines, it is important that information is to be provided and professional should identify the type of wound that they are facing. Further, it also includes the type of strategies that has to be followed by them in order to make sure that the proper cure is provided. Moreover, there are many other areas that has to be considered and it includes and considered (Farris, Petty and Flynn, 2015). With this respect, it is essential that there is dressing done twice or trice in a week. There should be proper checklist made at the time when patients are discharged. When there is no improvement monitored, even after two weeks, then treatment should be stopped.

Monitoring: There is proper monitoring required in which day to day operations should be considered. In this context, it includes mental and physical improvement. Pressure that is given to patient, it reaction and steps that has to be taken for other day. These are the basic things, that should be followed by care providers (Raj, Gill and Singh, 2016). Bleeding should be checked as there are chances that patient can also die is this is not properly monitored.

Stakeholders involved

There are different type of stakeholders who are involved in order to implemented in the therapy. When all these stakeholders play their part of role, then they will be able to achieve their implementation effectively. In this context, below given are the stakeholders who are involved in it:

Management: They are the main stakeholders as they make sure that all the equipments that are required is provided to them on time (Wu, Chew and Kuo, 2015). Further, there are various guidelines that has to be followed and these are developed by management. Further, within an organization there number of employees who can perform the role but the most appropriate staff who can implement and provide meditation are very less of them. They make sure that duties are provided to them with effective training. This way, it can be stated that major part is played by management towards vacuum assisted dressing.

Professional: They are the one who identify the type of issue that is faced by the patient. In this context, it includes the past treatments that were taken by client. There are different type of wounds and for each of them and diverse set of treatment is provided for each (Aviki, Batalden and Berkowitz, 2015). In this context, these stakeholders are important to know the actual condition and type of services that they need to be provided to them. They make sure that all the information is conveyed to patient and nurse so that they can deliver adequate services and patient get proper services.

Nurses: They make sure that the guidelines which are given by management are implemented and information that is provided by professionals are followed so that proper treatment can be provided to patient (Seidel, Lawall and Neugebauer, 2014). Further, they also include the role to dressing the wounds and this requires professional skills so that the roles that has to be played by them are performed effectively and efficiently. Moreover, they also need to monitor the patient in context of improvement and issues that are faced by them. Strong relationship should be developed so that they share the issues that are faced by patients. Accordingly, steps are taken to overcome them.

Patients: They are the one who make use of the services. It is important they will be able to understand the way and issues that they face. They have to right to make suggestion and to avoid the treatment if they are not comfortable (Satteson, Crantford and David, 2015). However, patient should deliver with information by nurses so that in case of emergency situation they overcome them.

Change theory

There are different type of theories that can be implemented by the organization in order to make sure that changes can be enacted. In this context, one of the effective theory for change includes PDSA cycle.

This is a type of model in which it includes four steps and these are helpful to make sure that proper services are delivered to patients (Slaughter, Pagani and Adamson, 2010). This model is also known as rapid cycle improvement. This highly beneficial for healthcare providers to understand the issues that are faced by patients to provide them services accordingly. In order words, it is a systematic series of steps that are helpful for raising knowledge and learning. Below given are the four different steps that are included in this model:

Before starting with the steps, it important to understand the issues that are faced. Then according to the problem this model is implemented.

Plan: As per the issue, people involved in it will have proper discussion and set out different ways and will also provide their suggestions so that they will be able to overcome the issue (Johnson, Jefferies and Nicholls, 2012). Plan will include all type of steps that can be taken by the people or professional with the help of which the problem can be resolved.

Do: In this step all the plan develop or the steps is developed are implemented. In this context, it includes documentation and listing out the information that are included (Harris and Holloway, 2012). The plan will be enacted and the issues that are faced will be identified.

Study: This is to make observation in which all the plan that are enacted is evaluated and result is identified. In order words, this can also be determined as the result that one gets from the plan that was developed. In addition to this, it also includes different type of experiences each one had and the problems that they faced.

Act: As per the implemented plan, there will be some kind of drawback and that should be improved (Wukich, Armstrong and Pinzur, 2013). To solve the main problems, issues that are faced in the steps to resolve them are considered and changes are made so that main problem can be solved.

This model can be applied for the given case for solving the problem of the issues that are faced by patient who are provided with vacuum assisted dressing. Below given are the implementation of PDSA cycle model:

Plan: In order to solve this type of problem, there should be proper meeting that has to be considered (Albert, Rock and Landis-Erdman, 2012). In this context, it should include patient, professional and the nurses involved. Suggestions should be taken and patient needs to be conveyed about the issues that they face in NPWT. Further, the type of services that are available that should be determined and patient should be given with the opportunity to make decision over the type of service and treatment that they want.

Do: As per plan made it should be enacted and all the steps and improvement that are taken place should be listed down so changes can be made accordingly (Kaufman-Rivi, Hazlett and Seid, 2013).

Study: After the plan is implemented and with proper documentation, professionals should make proper evaluation of the result. They should determined whether the plan developed is working within same direction or not.

Act: In case, the plan does not work as it was planned, then steps are taken so that the issue many nor get worse (Smith and Franzwa, 2015).

Leadership style

There are different type of leadership styles that can be implemented within the organization. However, these styles have their own different type of advantages and disadvantages (Beckmann, Doebler and Graf, 2011). In health and social care there are leadership styles are implemented as per the type of situation that they are in. With this respect, below given are two different styles that are mainly adopted in health and social care and they are as follows:

Autocratic leadership style: This is type of leadership styles in which all the decisions are made by professionals themselves other stakeholder like patients are not involved in decision making. This type of styles is implemented when the patient is not in a state or decision making. In this context, professionals with relatives of patient will make decision for the treatment that they have to be provided with (Cohen, Lagoo‐Deenadayalan and Whitson, 2012). This is helpful as it reduces time and the plan that is developed can be implemented effectively. There are conditions in which patient may not be in favour of this leadership style as they are not involved in decision making.

Democratic leadership style: As per this leadership style, all decision with respect to type of services are taken with proper suggestion and interest is shown by patient. In this context, decision of relatives are also considered and this has positive impact over all the stakeholders (Moghazy, Ellabban and Ahmed, 2015). In order words, all the stakeholder like nurses, professional, patient and relatives are involved in decision making and proper steps are taken to overcome the problem.

Chapter 3

Technical and emancipatory service development

There are different set of techniques that can be implemented by professional who are working at orthopaedic ward. In this context, one of the effective technique that can be used to have continues learning attitude and to identify the issues that are faced at patients at this ward (Hosseinrezaei, Rafiei and Amiri, 2012). Professionals at this ward make sure that there is proper elective joint replacement surgery, manage musculoskeletal injury and trauma surgery.

Emancipatory service development: This can be determined as method that is helpful to support the team of healthcare to enhance their skills and knowledge so as to deliver proper care to patients. This is generally supported by facilitators who are committed to rigorous processes or system for change related to emancipatory and this reflects the patient's perspective related to care (Brumley and Jevitt, 2012). As per the findings, it can be determined as services providers do not take proper care and due to this issue there are serious issues faced by patient and in few of serious cases death is possible. There are two different aspects, that has to be considered. With this respect, it includes providing patients with proper information and developing and maintaining proper checklist for discharging. This is done in order to make sure at all the services are properly provided and they are not missed out. Service development is a continuous process and it requires proper support from care providers so that they will be able to contribute effectively towards development and betterment of patients. In order to make sure that proper services are delivered and effective treatment is provided, it is important to make sure that they will be able to develop a check list in which all the steps should be included with the help of which services providers may not miss out any point (Slaughter, Pagani and Adamson, 2010). With this respect, there are cases in which patient do not have proper information or things that they have to do when they are stuck in serious situation. For example, when patient face any type of difficulty when they are in the process of vacuum therapy, they are provided with an emergency alarm that they can press and care providers will run out to them. This is possible when they are provided with proper information to patients (Johnson, Jefferies and Nicholls, 2012). There are situations in which patient fail to call on for help and when care providers reach them, then the situation would have become worse. In order to make proper evaluation of practices, one will make sure that all the information is conveyed at the time when patient agree to make use of this therapy. Further, all the details that has to be considered while providing care should be listed down and day to day analysis should be made. Further, at the time of discharging all the listed out points should considered again and care provider should make sure that patients are discharged when all the list out points are covered (Harris and Holloway, 2012).

Planning change

All the changes that has to be implemented should be listed down and they need to be measured properly. This is because, when changes are implemented, then there are chances that barriers arise but with proper plan the issues can be minimised and high quality services can be provided to patients (Wukich, Armstrong and Pinzur, 2013). So as to make sure that changes are implemented effectively, then proper steps should be listed out that care providers and patient should considered. This is done in order to make sure that proper services are delivered to patients. There are many benefits that stakeholders get in order to implement changes. There are many cases that are identified in which patient face different type of problems when they are given NPWT. Some of the main causes for this issue is because improper information to patients. Further, it includes few things that are missed out by care providers due to patient face serious issues. It enables to chart a course of all the achievements of goals (Albert, Rock and Landis-Erdman, 2012). The process of planning starts when the process that was previously followed are evaluated and many issues were identified. There are many benefits that care providers get through proper planning and few of them are as follows:

Effective use of resources: There are different set of materials that are used to make sure that proper dressing is done and the equipment is properly used at the temperature as per the wound requires (Kaufman-Rivi, Hazlett and Seid, 2013). Proper planning enables to make optimum use of resources and enables to cover the changes that is to be implemented.

Manages risk: In order to achieve the desired targets, managing risk is an essential aspect. Through planning, unseen barriers can be identified. Further, changes are implemented in order to make sure that the process previous implemented is causing serious issues (Smith and Franzwa, 2015). However, through proper planning all the risk involved are identified and this will enable to achieve the desired goals.

What measurements: There are different way with the help of which measurements can be made for the change. In this context, care takers can get feedback from patients. In which the rate of satisfaction that they have received can be evaluated (Beckmann, Doebler and Graf, 2011). This will also help in know the areas in which the services provided were not adequate. Further, to make proper measurement the rate of issue will be monitored. When changes will be implemented, then they will get to know other problems that are faced by them. Measurement can be done with the help of monitoring the proper rate of problems that were faced by the care providers earlier. Before the changes were implemented, the decrease or increase of problems will enable to understand the impact of changes that that has been enforced. Further, professionals will consider that the list that has been developed is properly maintained or not (Cohen, Lagoo‐Deenadayalan and Whitson, 2012). In this context, it is important that management have proper communication so that the areas in which they have missed can be determined ans appropriate steps are taken to overcome them.

Evaluating practice development

There are both positive and negative impact that stakeholders will be faced with these changes is implemented. In this context, management needs to make sure that they provided their patients with leaflets in which all the information related with vacuum assisted closure therapy is provided (Moghazy, Ellabban and Ahmed, 2015). This leaflet will cover all the steps by step process that has to be followed by patients at the time when the process for therapy is given. Further, care providers need to put on more efforts to make sure that all the information is provided to client that includes the steps that has to be taken by them.

There are basic steps that are skipped by nurses in order to make the work more easy. However, these type of decision made by them creates serious issues (Hosseinrezaei, Rafiei and Amiri, 2012). For example, after forth day, dressing needs to be removed and if there are any issues related to bleeding, then the dressing done should be checked again. In this context, management has to pay more for their training and development so that nurses will be able to develop skills and knowledge with the help of which high quality services can be provided. Further, it requires proper monitoring of wound and all the changes that take place should be listed down so that during the time of discharge proper condition of patient can be evaluated and they can overcome the problem (Brumley and Jevitt, 2012). Further, check list need to be prepared and this should be done by considering the type of wound issues that the patient is facing. Further, there are certain things that has to be considered and it includes monitoring the wound and behaviour of patients. For each of the wound type, it requires different type of check list that has to be developed by management. Moreover, all the things that are included in these checklists should be considered and proper steps needs to be taken so that they will be able to list out all the details that care providers have to consider. Proper efforts needs to be put by patients so that they will be able to understand the steps that they have followed and so the leaflet that is provided by management should have provided so that they follow them and contribute effectively (Kaufman-Rivi, Hazlett and Seid, 2013).

Chapter 4

Conclusion

It is important for healthcare organization to make sure that they will be able to understand the issues that are faced by them and accordingly services should be delivered. There are certain laws that are followed in health care and it also includes policies which has to be considered by care providers. In this context, it includes confidentiality in which information that is provided by client is not disclosed to anyone until patient allows. Further, there needs to have healthy interaction with service users and care providers so that they develop trust and confidence within mind of patient and this is helpful to provide proper care. Moreover, proper information should be provided to client about the treatment that will be provided and it should include the issues or barriers so that patient understand the consequences.

Recommendation for practice

In order to makes sure that all the changes that the health and social wants to implement needs to follow these things with the help of which all the strategies can be enacted effectively and efficiently. In this context, below given are few of the recommendation:

Understanding requirement of customers: There are different type of people who have diverse type of wound visit to health and social care (Kaufman-Rivi, Hazlett and Seid, 2013). All require different type of treatment to be given. In this context, it is important that proper evaluation that is made so that professionals will be able to understand the areas in issues and treatment can be provided. Further, information should be conveyed so that they will be able to list our the steps that they should consider so that issues can be reduced. In addition to this, care providers should take feedback from clients so that all those areas that are not provided with proper care can be identified. Accordingly, proper step can be taken with the help of which high quality services can be provided.

Proper training to care providers: There are different type of steps, dressing and equipments that are used in order to conduct NPWT.

The care providers should know about the steps that has to be taken so that they will be able to make sure that the steps included in the process is followed effectively and efficiently (Slaughter, Pagani and Adamson, 2010). With the help of training they will understand the issues and problems that they are facing. Moreover, the skills and capabilities that are required can be developed. As per the changes it is important that there is proper list of steps and monitoring is made so that the services provided is performed effectively.

Considering all steps to be satisfied by care provider: There are different type of steps that has to be considered and it is the responsibility of care providers to complete them. There are cases in which steps that are neglected by nurses and it creates issues for the patient. With this respect, check list should be followed for each day so that they cover all the steps that are included in process for this therapy (Albert, Rock and Landis-Erdman, 2012). When there is check list, then it enables the care provider to make sure that all the steps are followed. In addition to this, proper documentation can be made for each and every day for the improvement or issues that were faced by client.

Frequent monitoring: There should be proper interaction make by care provider with patient. This is done in order to make sure that they will be able to share all the issues that they face. Further, it also enables to develop trust and confidence within patients mind. There are issues like bleeding, skin rashes, etc. all these should be observed by care provided and for this patient should be trained so that they understand the problems and proper steps can be taken.

References

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