Essay title - Orthopedic Nursing Patients
Several studies are conducted worldwide to improve Orthopedic nursing with past and present experiences to cater to future needs. These studies are mainly conducted to avoid infections from surgical wound. Case studies were taken in total hip replacement patients who are vulnerable to infections under poor sterile conditions. A case study was made on patients from pre-admission till the recovery where the patient have to pass through many stages like admission, care in the ward, admission to operation theatre, sterilizing department and finally the recovery stage. A course spotting committee was geared up including all concerned like hospital managers and clinical staff. Each member of the committee was to address his or her part in their department while handling patients with utmost care to maintain health and hygiene. The committee met on a regular basis to discuss each case and reported to the concerned to implement quality improvement methodology to give the desired results and prevent reoccurrence of infections. These interventions in Orthopedic department paved way for better clinical pathways. A sophisticated and more sterile approach in handling patients from pre admission till the recovery stage eliminated post surgery infections completely among patients who underwent total hip replacement surgery. The reason to conduct such a detailed study was the outbreak of deep wound infections at the Armidale hospital. Orthopedic nursing became a service requiring improvement for various reasons. A review was conducted to determine the basic factors that cause infection and the preventive measures to be adopted. Reports from Microbiologist and CNC Infection Control of the hospital assisted in reaching conclusions over Health Infection Prevention and the methods to control them. Intrinsic factors that risked patients of poor health conditions were few discrepancies. For example, nursing documents that were not recorded with treatment procedures, wound ooze, cleansing of wound and inconsistency in recording the dosage of antibiotics. Some other reasons that contributed to the poor health of patients were high risk like age, poor nutrition, obesity and other coexisting conditions. The requirement of a refurbishment in the nursing methodology of Orthopedics is not limited to infections from surgery. It also attributes to external factors like cleanliness of the operation theatre, operating conditions, clean equipment and literacy of the staff. The methods followed in post surgical ward, nursing in a specific area of the unit, the use of exclusive admission room, bathroom, a planned cleaning regime, the implementation of suitable wound dressing, updating the patient on every stage of developments in health were implemented to give positive results among post operative Orthopedic patients. Proactive hygiene measures included the use of alcohol hand gel in all departments of the hospital. The outcome of alert Orthopedic nursing resulted in negative reports of deep wound infection. The cause-rooting committee met on a regular basis to check the implementation of the new methodology of treating total hip replacement and treatment of joints. Only regular and continuous monitoring, evaluation, analysis and checking kept infections minimal. The Armidale hospital could find total solutions to the problem of infection only through thorough check and the willingness and regular coordination of the whole team to work towards the cause. The scope of orthopedic nursing is wide provided working groups contribute maximum efficiency in handling the case all through the surgery.
1 A survey to determine normal nursing procedures to care total hip and total knee patients evolved a well-designed report. The comparative survey was conducted by NAON Total Joint Special Interest Group with a sample of two hundred eight seven valid surveys. The survey concluded that an average of 183 total hip replacements and 226 total knee replacements were performed annually per hospital. The conclusion included treatment procedures like perioperative practices, postoperative activity practices, use of equipment, anticoagulation practices and discharge practices. The incorporation of available knowledge in clinical practice reduces the risk in patients who undergo surgery. Nurses can keep a check on various issues related to preoperational and post operation to improve the standards of treating orthopedic patients.
2 Around six hundred members who belong to the orthopedic fraternity are members to the assembly. They promote a good network of orthopedic perioperative nurses who give a detailed account of current trends and problems associated to orthopedic nursing. Members of the assembly discusses higher education on orthopedic nursing, group efforts to solve geriatric issues, pain assessment and implementation of perfect surgery position.
3 A review on nursing care provided to patients immobilized with Thomas splint gave the following conclusions for betterment of nursing. Thomas split is used to treat patients with fracture in femur. The equipment is introduced in the patient to immobilize them. Skin ulceration is a regular feature that affects a patient in and around the Thomas splint. The review was conducted to identify the factors that lead to ulceration in patients and investigated different pressure care to prevent skin ulceration among patients with skin ulceration. Factors that cause ulceration was found to be the weight of the patients, type of fracture, leg circumference, traction rings size and traction weight that cause changes in the skin. The above study was conducted on 33 children from various hospitals. The aim of the study was to reduce discomfort levels among patients. The study concluded that, besides the above-mentioned reasons, the duration between each pressure care reduced the infections in skin.
4. Various standards of Orthopedic nursing practice us developed based on the broad standards of nursing practice. These standards reflect the knowledge base of the staff, which requires understanding of the specialty of Orthopedic nursing. The aim of provided special care to Orthopedic patients is to restore the health of individuals to undergo neuro muscular or skeletal changes. The intervention of orthopedic nurses is necessary to prevent and correct deformities of muscular-skeletal system and to reduce fractures, dislocation of joints and bones, joint injury and related diseases. The service of an Orthopedic nurse should be to rehabilitate the patient to regain and maximize normal health. A detailed process by the orthopedic nurse includes analysis, plan, prioritization, implementation and evaluation care in consultation with the patient and other healthcare team involved. A holistic assessment of the patient is required initially. The plan of the Orthopedic nurse should emphasize on the following areas like pain, limb & joint alignment, mobility, skin integrity, neuro-vascular integrity, nutrition, self-care, the risk management, social systems, learning needs, coping. The nurse should review the patient’s response to the medication and assistance provided in an efficient and effective manner. Evaluation should be sought from every department of medication to optimize support to the patient. The knowledge of orthopedic nurse includes specially qualified personnel with exceptional clinical skills acquired through practice. This experience is gained through clinical and hands on nursing practice by caring patients with neuro muscular and skeletal challenges. Further an orthopedic nurse becomes well equipped with specialty educational program and continuing educational programs along with their work. With changing knowledge, technology, research, and practice an orthopedic nurse can provide innovative methods of consistent care to patients with reflections from past experience. A nurse can also provide solution for changes in lifestyle and self-care once a patient has regained health. The improvement of a nurse’s knowledge from time to time in various assistance methods and application of tools results in betterment of Orthopedic nursing. Some of the basic qualities required by an Orthopedic nurse are leadership quality and managerial skills. Leadership quality is required to influence the activity of the patient to bring out better result. This is also helpful in gearing up the patient to certain tough task involved in regaining health. The vision of a nurse to lead the patient to total recovery can be obtained only with the participation and cooperation of the patient. A high level of patience thought should be borne by the nurse to instill a positive thought in the patient for speedy and health recovery. A high level of coordination ability to chalk out the need of the patient and to discuss the same with other treating departments is an achievement of Orthopedic nurse. Delegation of activities to peers with respect to the patient is also a duty, which comes under the purview of an Orthopedic nurse. The nurse should be able to identify the limitations at workplace and maintain a decorum that it will not affect the efficiency of treating the patient with skill, safety, compassion and takes timely appropriate action. An orthopedic nurse should share knowledge freely with the patient to improve health conditions. The ability to resolve conflicting patients is also an appreciable quality. Research is an integral aspect of every subject that requires quality improvement. Research on Orthopedic nursing is required for overall development in the care and assistance provided to improve health conditions of orthopedic patients. Orthopedic nurses require developing their knowledge on relevant issues regarding neuro-muscular and skeletal challenges of a patient and the response of patient to medication and assistance. Various questions may arise in the course of care provided to orthopedic patients. A nurse who is very closely monitoring a patient is the best person to assess such challenges and bring a platform for research to find better answers. An orthopedic nurse can also work with the patient to find out the quality improvement required in nursing assistance in terms of managing medication, dealing pain and trauma felt by the patient if any. The role of an Orthopedic nurse in research activity may be further widened to reviews in literature and journals regarding nursing assistance. This leads to the invitation of ideas from counterparts from various quarters, which gives better solutions. Their share of view in professional meetings, conference and publications also bring out challenging experience in handling mobility, independence and self care ability of patients. The ideas and views of a nurse can stimulate the participation and cooperation of colleagues and other health care teams within the hospital.
5 Orthopaedic Nursing is an international journal, which gives information on continuing education for orthopedic nurses. This journal gives detailed information related to clinical setting up of hospital unit, physician's office, ambulatory care centers, emergency room, operating room, community service programs, rehabilitation facility, patient’s home, etc. Every issue gives details on current events, organizational activities, research, product and drug information, and literature findings. The journal helps to focus on professional development and clinical, academic, and research areas of the orthopedic specialty. Other features include patient education, professional opportunities, continuing education, Radiology review, ethics to be followed and pharmacology.
