Write an essay based on learning contract
Waterlow score is the most common pressure ulcer risk assessment tool in uk.lt is developed by Judy Waterlow in 1965. The tool was originally designed for her students, as an outcome of the study
on pressure ulcer prevalence, where she found that the Norton scale (Bell.J,2005) did not classify within the at risk” group many patients who in time developed pressure ulcers. After reviewing the
factors which arise in the etiology and pathogenesis of pressure ulcers, Waterlow presented a scale with six subscales:- height/weight relationship(BMI) ,continence, skin appearance, mobility,
age/sex, appetite and four categories of other risk factors( tissue malnutrition, neurological deficit, surgery and medication. Romanelli and Clark(2006) .
According to National pressure ulcer advisory panel(NPUAP2016),A pressure injury is localized damage to the skin and underlying soft tissueusually over a bony prominence or related to a medical or
other device.The injury can present as intact skin or an open ulcer and may be painful.Sometimes the injury occurs as a result of prolonged pressure or pressure in combination with shear.
What is reflection ?? According to O’Donovan’s(2007 )research describes reflection as process of deliberative thinking, looking back,examining oneself and ones practice in order to improve future
practice. In UK , mainly uses the driscoll model reflection in health care settings. What is risk assessment? Assessing risk for pressure ulcer development is an important tool in pressure ulcer
prevention. Even ambulatory patients may be high risk for pressure ulcer development .Some risk factors include age ,altered sensory perception , altered mental status, impaired circulation, co-
morbid conditions such as diabetes, long length of stay at an acute or long term care facility or complicated surgical procedure. Identifying the patients at risk is an Important first step toward
planning the intensity of and the implementation of appropriate prevention and interventions. According to Dziedzic, M.(2013 )Assessing a patients pressure ulcer risk helps guide implementation of
appropriate nursing care designed to halt pressure ulcers from developing. When used correctly, the information obtained provides a picture of the patients overall health status and the strategies
that need to be implement to prevent skin break down. Some key identifiers include What is the patient’s general health appearance? How mobile is the person? Is movement easy or difficult ? Is the
patient incontinent ? Are there other issues with moistures ? Is friction or shear a problem for the patient ? All these factors are vital not only to preventing the pressure ulcer but in the total
care of the patient. Risk assessment tools are used on a regular basis . They are most effective when used consistently and often .The use of the tool really does a clear picture of the patients
well-being in terms that everyone can understand. WHAT I am working in an Orthopaedic surgical unit(fractured neck of femur special unit). I usually receive the elderly and immobile patients. All
the the nursing staff are aware about the daily skin assessment. One day when I was doing daily skin checking and noticed that post operative patient’s skin breakdown in the cocxygeal region (Grade
-1) with a poorly blanching surrounding skin areas and other pressure area also.lmmediately, I have informed the senior nurse and documented. Later, when I checked the admission notes, I realised
that the patient admitted 10 hours ago and no one completed the skin assessment and patient was not been given the air mattress.