VOL: 98, ISSUE: 08, PAGE NO: 49
Ann ShuttleworthPatients with a number of co-existing health problems represent major challenges to health care professionals, as they may need care from a range of specialisms. Ensuring continuity of care can be difficult, and all too often their needs may not be met.
Patients with a number of co-existing health problems represent major challenges to health care professionals, as they may need care from a range of specialisms. Ensuring continuity of care can be difficult, and all too often their needs may not be met.
As the number of older people grows, so does the number of patients with co-morbidity, and the issue needs to be tackled by cooperation and collaboration between professions and specialisms. In this issue, Anita Kilroy-Findley and Carolyn Wheatley present a case study which demonstrates how such collaboration helped a patient with intractable leg ulcers and mental health problems. The patient received care in five settings, and nurses in each setting were trained in leg ulcer care and compression bandaging to ensure that her leg ulcers were appropriately treated throughout.
Many nurses will be familiar with the sight of patients seated in chairs next to a bed equipped with an expensive high-tech pressure-redistributing mattress. However, the use of pressure-redistributing cushions for these patients is far less common. Reviewing the research into pressure-redistributing cushions, Michael Clarke suggests that this may be due to the lack of randomised control trials assessing their effectiveness in preventing pressure damage. In the absence of information on which, if any, surfaces are effective, patients are often seated for hours without any cushion.
The NHS spends vast amounts of money on special mattresses and other pressure-redistributing beds. At-risk patients cannot be kept in bed simply because there is no information on how best they can be seated. If we accept that pressure redistribution is cost-effective, trials are urgently needed to ascertain which seating surfaces are safest.
Also in this issue, Lillian Bradley discusses the conservative management of pre-tibial lacerations. Although this can prolong healing, it can avoid creating donor sites and the need for hospitalisation. However, thorough assessment and patient consultation are necessary to ensure the correct treatment choice.
Finally, Terry Shipperley and Claire Martin describe an innovative teaching tool developed to help nurses to understand the wound healing process. The tool uses the allegory of how the emergency services and other professions respond to a burning building to illustrate how the body reacts at each stage of healing.