Application of Nursing Theories to Wound Care Practices

Introduction

In nurse care, there are numerous theories and models aimed to facilitate or improve the work processes of nurse practitioners. Some of these theories are describing the importance of high-quality interaction with patients. According to the approaches that will be presented below, the level of such interaction may depend on the nurses’ level of education, their communication with other professionals, and the consistent attention to patient care. Moreover, such theories can be applied as a framework to guide evidence-based practices addressing better patient care. In this presentation, three wound care nursing theories will be identified; the causes of low standards in wound care will be described, and the application of theories to guide the nursing practices will be explained.

Three Theoretical Models

There are several highly beneficial theories related to wound care nursing practices, proved scientifically.

The essence of the first wound care theory is the following: the more consistently the wound care is provided, the better are the outcomes. This theory has been tested by Dufour, Duhoux, and Contandriopoulos (2020) through the measurement and validation of primary care nursing indicators based on a wound care tracer condition. In particular, the scientists conducted a longitudinal study in an ambulatory care clinic in Quebec, Canada; the sample included 482 episodes of care (Dufour, Duhoux, & Contandriopoulos, 2020). Scholars studied five indicators related to processes and 3 to outcomes. They found that continuity and nursing follow-up are associated with improved results. Scientists suggested that “increasing these indicators’ performance level can improve both nursing processes and patient outcomes” (Dufour et al., 2020, p. 63).

The authors of the second theory believe that communication between nursing and medical practitioners may improve the outcomes in wound care. In contrast, the lack of interaction between these specialists leads to “prolonged healing times for patients” (Friman, Wiegleb Edström, & Edelbring, 2017, p. 620). Therefore, scientists proposed to introduce the practice of interprofessional education (IPE) in modern educational institutions.

The third theory is based on the assumption that continuing education will increase nurses’ knowledge of chronic wound care management. This conclusion was made by scientists after most nurses participating in the study reported that they were not prepared enough to treat patients with chronic wounds (Goudy-Egger & Dunn, 2018). The study involved 31 nurses who agreed to be tested on how to care for chronic wounds.

Concerns Related to Wound Care Outcomes

According to the studies, nurses from the UK, Tanzania, and Haiti have problems caring for patients with various types of wounds.

UK scientists report gaps in nursing knowledge in providing wound care. According to reports on 3179 patients, the quality of care for patients with various types of wounds is critically low in the UK, as nurses do not follow treatment protocols in almost 40% of cases.

Most nurses in the surgical divisions at the Muhimbili National Hospital, Dar es Salaam, Tanzania do not follow the post-operative care checklist provided by MNH.

Half of the nurses do not wash their hands before and after the procedures; wound assessment and documentation also cause problems;

Contamination of dressings caused by their improper application leads to contamination of wounds.

In the surgical wards of a hospital in Port-au-Prince, Haiti, “areas that may need improvement include aseptic technique, hand hygiene, pain assessment, patient education, and documentation”.

Application of Theories as Frameworks for Evidence-based Practices

Applying the theories described above can make a vital difference. In particular, it would be most beneficial to use the third theory, which is based on the need to provide nurses with continuing education. It will increase their effectiveness in terms of awareness regarding basic wound care requirements. Besides, nurses’ compliance with treatment protocols will significantly improve patients’ outcomes. After having educational training, nurses will better cope with dressing and will follow hygiene requirements. It will also become easier for them to keep in mind all the nuances of working with non-standard wounds, such as leg ulcers or chronic wounds.

The first theory of consistent wound care will also help improve the quality of nursing care, but only if treatment protocols are followed.

In the frameworks of the second theory, joint educational training for nursing and medical practitioners can be held in the mentioned hospitals. It will allow nurses to understand the importance of all the details of their work and see the overall picture of patient care. Nurses will be able to properly evaluate their contribution to patients’ rehabilitation, finding out how important it is to reduce symptoms for final recovery.

Conclusion

Thus, three wound care nursing theories were identified; the causes of low standards in wound care were described, and the way how mentioned theories can guide the nursing practices was presented. To summarize, wound care nursing theories imply that nurses should provide consistent and attentive care following the treatment protocols. Compulsory educational training in hospitals will improve the qualifications of nurses and will lead them to make their job more responsibly. As a result, the indicators of patients’ outcomes will improve significantly. To better understand the importance of adhering to wound care protocols, training should be conducted jointly for nursing and medical practitioners. In the process of communication, caregivers will be able to appreciate the importance of each other’s work and offer new, more effective ways of interprofessional collaboration.

References

Dufour, E., Duhoux, A, & Contandriopoulos, D. (2020). Measurement and validation of primary care nursing indicators based on a wound care tracer condition. Journal of Nursing Care Quality, 35(1), 63-69.

Friman, A., Wiegleb Edstrom, D., & Edelbring, S. (2017). Attitudes and perceptions from nursing and medical students towards the other professionals in relation to wound care. Jowonal of Interprofessional Care, 31(5), 620-627.

Goudy-Egger, L., & Dunn, KS. (2018). Use of continuing education to increase murses’ knowledge of chronic wound care management. The Jounal of Continuing Education in Nursing, 49(10). 454-459.

Gray, T. A, Rhodes, S_ Atkinson, R.A. Rothwell, K, Wilson, P, Dumville, J.C., & Cullum, N.A. (2018). Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population. BM Open, 5(3), €019440.

Mwakanyamale A A, Mukaja A M. A, Ndomondo, M.D., Zenas, J. P., Stephen, A. M., & Mika, E. Z. (2019). Nursing practice on post-operative wound care in surgical wards at Mubimbili National Hospital, Dar-es-Salaam, Tanzania. Qpen Jownal of Newsing, 98), 870-890.

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