Prescribing event?

AbstractThis report provides reading on a prescribing answer, which is conducted for a 70-year-old woman, who is bed flinch as a result of facile irritate on left sheen. The prescribing event is adequately structured to present important dilate related to patient roles condition, as her holistic needs shake been exhaustively con grimacered by the learner territory shelter, who has been come with by her practice teacher during the event. The prescribing conclusion taken by the keep back related to prescribing a master(a) fecundation and Allevyn ennoble inch as a vicarious ski binding. It has been identified that this last is usher-based considering its large benefits, as depict in enquiry.IntroductionThe purpose of the essay is to puff and critic bothy analyse a prescribing event in which I was winding in my nursing practice. The focus is on providing an essay-based rationale of the prescribing event.Confidentiality StatementAs a disciple district defend, Mary Brown is allowed access to the records of the client in this slickness, research subjects and operational business information. Information which is directly related to the client and may include paper records or oral chat is identified as strictly occult. Thus, Mary Brown is limited to the minimum amount of confidential information that is required to accomplish the intended purpose of the prescribing event.Description of the Prescribing caseful and Analysis of the SituationThe scholarly person district nurse received a referral from the G.P. that Mrs D has a wound on the left sheen, is bed bound and needs wound appraisal and treatment. The nature of the prescribing event is anticipated beca rehearse I knew beforehand the reason for visiting the client. Except the student as an spry participant in the event, other participants present were practice teacher, patient, and patients husband. The case is represented by a 70-year-old, bed bound female, with superficial woun d to left sheen. Although the skin around the wound has been identified as extremely dry and flimsy, the student nurse has also recognised it is thoroughly creamed. Upon assessing the client, no other broken areas piss been noniced. Patient is using pads for incontinence, gets carers 4 metres a day, has hospital bed and mattress, cushion and a hoist. check to patients husband, she scratched the wounds area and it broke.In the mental process of examining the holistic needs of the client, the student has considered the history of the present complaint (Marcum et al., 2010). This include conducting OPQRSTU mnemonic by exploring pain history checklist, such(prenominal) as infringement of pain, palliative factors for pain, quality of pain, region of body or area affected, bad of pain, timing of pain, and how it affects U in patients daily life. The student has clearly differentiated that patients complaint is simply a wound rather than a lesion (Tjia et al., 2012).Moreover, the student has thoroughly explored patients past medical history, family history and social history by relying on the cooperation of patients husband. Specific question were asked in order to learn patients susceptibility to chronic pain and injury. Patients exposure to hazards has been determined is minimal considering that the bed bound woman is a non-smoker (Marcum et al., 2010). In this case, the student nurse has decided to prescribe 50-50 Paraffin cream. As part of the medication assessment in the prescribing event, the student asked patient for allergies. However, no allergies were mentioned by client at that point. Other aspects of considering patients holistic needs included clinical investigations and physical examination. The student measured patients temperature and took a swab for microbiological analysis (Bradley et al., 2007). The physical examination concern careful physical assessment of the wound and wounds area. decision Making and Actions Taken P. and Tissue Viabi lity Nurse referral has not been indicated because the student nurse has confirmed that the diagnosis is clear and does not need referral. This means that on that point are no all severe aspects related to patients diagnosis. In the decision devising process of the student district nurse, legitimate considerations throw off been made in an attempt to reach a relevant prescribing decision (Bradley et al., 2007). By concluding that patients wound is bare(a) and lacks either signs of severity, the student concluded that the selection of a primary cover and Allevyn Gentle Border as a secondary fecundation is confirm because it is evidence-based (Junqueira and Carneiro, 2005). Patient expectations for a fast recovery of the wound have been thoroughly considered by the nurse eon making that particular decision for administering specialised types of groomings.It is important to put down that the decision of the nurse to prescribe a primary fecundation and Allevyn Gentle Bord er as a second dressing is reasonable considering the wounds condition which has been determined after nonrecreational assessment and careful physical examination (Guarnera et al., 2007). The primary dressing that was prescribe for patient has been indicated as a paraffin gauze dressing. It has important features, such as flossy paraffin base, comprehensive size range, and sterile leno swan presentation. The major benefit of the positivistic primary dressing is that it faecal matter calm and protect the wound as head as open up the passage of viscous exudates, which female genital organ take place into the visit secondary dressing (Chaby et al., 2007). The fact that the prescribed primary dressing is not medicated shows that it wad be ideally used with a topical antiseptic of choice.It can be indicated that the mnemonic EASE has been applied in the decision making process of the prescribing event. The product has been identified as rather trenchant, as all products from the Allevyn Gentle Border range have been especially designed for individuals with fragile and extremely sensitive skin (Chaby et al., 2007). This type of dressing has a soft silicone gel adhesive, which makes it a convenient option for patients condition considering the capacity of the dressing to minimise trauma to the wound when the dressing should be changed. Moreover, this contributes to avoiding patient pain and ensuring adequate care (Guarnera et al., 2007). The effectiveness of the prescribed dressing is evident at its triple-action technology, which contributes to economiseing optimal balance in unsound while the wound is being ameliorate.The choice of Allevyn Gentle Border as a secondary dressing is an appropriate decision made by the district nurse because the dressing provides optimal comfort to patient and it is unclouded to be applied and removed. The product is suitable for this patient, as no allergies have been reported during the initial assessment conducted by the student (Chaby et al., 2007). In addition, the use of the prescribed secondary dressing is completely safe, as patient can even take shower without any problem given that the dressing is shower-proof. The prescription is cost-effective, as a street corner of 10 Allevyn Gentle Border dressings (7.5 cm x 7.5 cm size) costs more or less ?22.44, and a box of the same type of dressings (10 cm x 10 cm size) is approximately ?29.99 (Hurd et al., 2009).In a research by Hurd et al. (2009), the focus has been on presenting fit evidence of the effectiveness of Allevyn Gentle Border. The authors of the research based their evaluation on a multi-centre clinical assessment, which was conducted in 2008. One of the most important conclusions provided by researchers was that this type of dressing was suitable for the specific wound type enured in almost 95% of patients who participated in the study (Chaby et al., 2007). It has been emphasised that patients wounds had healed prior to the en d of the specified study period. There was substantial evidence indicating a step-down in wound area and depth upon presenting the terminal assessment of patients. Moreover, there was significant evidence of a reduction in the precise level of exudates in the wound, which applied to the period between service line and final assessment (Hurd et al., 2009). There was also a visible reduction in the median percentage of devitalised tissue upon concluding the final assessment of patients.In order to assess the appropriateness of the prescribed dressing, the student district nurse demonstrated the initial consideration that the process of prescribing wound products cannot hap generically. The nurse has determined that this type of dressing is appropriate to patients condition. As presented in research, Allevyn Gentle Border dressing is found to maintain moisture, implying the inability of sticking to the wound (Chaby et al., 2007). The prescribed dressing belongs to the group of hydro colloids. The qualities of hydrocolloid dressings have been considered by the student in providing an optimal healing environment, insulation and autolytic debridement. In terms of outlining the advantages of this type of dressing, it is essential to differentiation that hydrocolloid dressings are tight to bacteria and other contaminants (Guarnera et al., 2007). The most important advantage is that they do not adhere to the wound but to the intact skin near the wound. However, a significant consideration should be given to the fact that hydrocolloid dressings are not recommended for wounds with extremely heavy exudates, or in the presence of infection.The frequency of dressing changes depends on the severity of patients wound (Hurd et al., 2009). Yet, it is important to note that the primary dressing should be changed on a daily basis, while the secondary Allevyn Gentle Border dressing should be changed every 3 days (King, 2003). There have not been considerable side personal effe cts associated with the use of the prescribed secondary dressing except slight un goodness in rare cases.In the process of negotiating a contract, it is essential to note the aspects of harmony and adherence. The student demonstrated a high level of negotiated concordance in the sense that sufficient information was provided to client including possible side effects, the costs of dressing and the impact on lifestyle. In an attempt to set up greater adherence of client to the prescribed treatment, the student district nurse clearly informed client almost the two types of dressings that were prescribed, as well as how to use them and their benefits (Bradley et al., 2007). It has been suggested to both client and her husband to record the time of dressing changes, which served as an additional motivating factor to client to admonisher the condition of her wound. The nurse demonstrated her competence in conducting effective communication with client considering that she is from the elder population, which implies a focus on making the prescribed treatment simple (Hurd et al., 2009). Therefore, the contract between the nurse and client was considered effective in terms of concordance and adherence.Implications for Future PracticeThis event is quite an important for my future practice and learning because it has provided me with a relevant chance to apply all essential steps of a prescribing event in practice. Such a practical experience in prescribing has made me more self-confident in the procedures required to indicate a properly conducted prescribing event in the future (Bradley et al., 2007). I would follow the same model of prescribing for any future standardised situation, as I find it effective and bona fide in bringing an optimal treatment option to client. I have extensively focused on clients holistic needs, as this is considered fundamental in delivering adequate care and make an informed decision regarding clients complaint (King, 2003). I am d isposed(p) to hit the roof my prescribing experience in the future by actively participating in similar events and acting in accordance with strict nursing and prescribing principles outlined in the field.ReflectionThe prescribing event provided an opportunity to learn more closely the stages of prescribing and making the best possible decision in a similar situation as the one faced by client. However, I am aware that such a decision may differ upon considering the details of another case, with different aspects of complaints. This means that I should be adequately prepared to encounter different prescribing scenarios (Hurd et al., 2009). I have not experience any major problems during this experience. Yet, I have learned a lot about wound care in relation to this incident. The treatment of this condition may be challenging under particular circumstances especially among the elderly population (King, 2003). Self-monitoring and management of wound may be inappropriately through with(p) and thus such individuals may need the assistance of a family segment or nurse in order to adhere to the schedule outlined in the prescribing event.ConclusionThis report provided significant information about a prescribing event in which a student district nurse participated, accompanied by her practice teacher. The prescribing event was based on an incident with a 70-year-old female, who was identified as bed bound due to superficial wound to left sheen. The nurse critically analysed the situation and demonstrated a prescribing decision that a primary dressing should be used as well as Allevyn Gentle Border as a secondary dressing (Hurd et al., 2009). The prescribing decision was adequately justified given that the nurse provided solid evidence of the benefits of using this type of dressing. However, the only limitation considered in this event is that the nurse may not have invested sufficient time to explore the case in detail (Chaby et al., 2007). Despite this limitatio n, the student expressed an opinion of increase self-confidence that could help her in similar prescribing situations in the future.ReferencesBradley, E., Hynam, B. and Nolan, P. (2007). Nurse Prescribing Reflections on Safety in Practice. Social Science & Medicine, vol. 65(3), pp. 599-609.Chaby, G., Senet, P., Vaneau, M. et al. (2007). Dressings for Acute and continuing wounds A Systematic Review. Archives of Dermatology, vol. 143, pp. 1297-1304.Guarnera, G., Tinelli, G., Abeni, D., Di Pietro, C., Sampogna, F. and Tabolli, S. (2007). smart and Quality of life-time in Patients with Vascular Leg Ulcers An Italian Multicentre Study. ledger of Wound Care, vol. 16, pp. 347-351.Hurd, T., Gregory, L., Jones, A. and Brown, S. (2009). A Multi-Centre In-Market Evaluation of Allevyn Gentle Border. Wounds UK, vol. 5(3), pp. 32-44.Junqueira, L. C. and Carneiro, J. (2005). Basic Histology. Rio de Janeiro, Brazil Lange.King, B. (2003). Pain at First Dressing Change after Toenail Avulsion 2 F indings and Discussion of the Data Analysis. Journal of Wound Care, vol. 12, pp. 69-75.Marcum, Z. A., Handler, S. M., Wright, R. and Hanlon, J. T. (2010). Interventions to Improve Suboptimal Prescribing in Nursing Homes A Narrative Review. The American Journal of gerontological Pharmacotherapy, vol. 8(3), pp. 183-200.Tjia, J., Gurwitz, J. H. and Briesacher, B. A. (2012). Challenge of Changing Nursing Home Prescribing Culture. The American Journal of Geriatric Pharmacotherapy, vol. 10(1), pp. 37-46.