Saturday, 30 November 2013

NURSES’ ASSESSMENT AND MANAGEMENT OF BURNS AMONG IN-PATIENTS IN UNIVERSITY OF CALABAR TEACHING HOSPITAL, (UCTH) CALABAR.


INTRODUCTION

1.1   Background to the study

        A burn is a type of skin injury that may be caused by heat, electrolyte, chemicals, light, radiation or friction. Most burns only affect skin (epidermal tissue and dermis) rarely deeper tissue, such as muscle, bone and blood vessel can be injured. Burns are important because they are common, painful and can result in disfiguring and disabling scarring (John, 2009). Even those with less serious injury may find their quality of life affected due to pain, wound management and fear of disfigurement, albeit for a shorter period. It is therefore essential that treatment of patient with burns was delivered using multidisciplinary team approach.

        Assessment of burn is identified in three major stages of patient care. The first, known as the primary survey is intended to find all the immediate life threatening condition and to initiate resuscitation of the same. The second, called the secondary survey is undertaken immediately after the primary survey and its aim is to identify all the patients’ injuries, no matter how travails. Finally, the third stage is the stage of definitive care. In the ideal situation the burnt patient should initially be assessed in an appropriate environment, such as an accident and emergency department.

        Other type of assessment like the initial assessment help for the treatment of life threatening problems of airway, breathing and circulation followed by recognition of burn severity, depth, size as well as the current treatment approach will be the focus on using manual Stapin Z.A (2010). It is of paramount importance to determine whether a patient with a burnt should be hospitalized for hydration and burn care or for ambulatory management. And in the management of burn, the critical art is assessed by the depth and extent of injury.

        According to Xymas (2010), each year, more than 1 million persons in Nigeria seek medical care for burns. More than 95 percent of these patients can be manager on an ambulatory basis, because it is a devastative injuries result in death or life long scarring, disfigurement and dysfunction if not properly managed (Brighampa, Longhun, 2004). Ambulatory management of burns is divided into acute treatment and follow-up care. Acute management includes measures to minimize further damage to patients presenting with recently sustained burns, identifying patients requiring hospitalization and implementing measures to promote healing, prevent infection and receive pain.

        During follow-up care the focus shifts to limiting disfigurement from scaring and dysfunction from contractures. Although most patients with burns can be managed by family physicians, some required surgical referral for skin grating and scar rehabilitation (Walsh, 2003).

        Inpatient treatment in burn units are considered to have moderate burn based on the grading system developed by the American Burn Association (ABA) should be admitted for intravenous hydration and surgical difficulties in differentiating deep partial family physicians should strongly consider appears to be a deep partial thickness. This study is therefore designed to assess nurse, knowledge of burns among in-patients in UCTH, Calabar.

1.2   Statement of the problem

        Globally, most nurses focus on the pharmacological management of burn with little consideration about efficacy of non pharmacological measures. Poor management of burn by nurses has negative effect on the inpatients. Often, once a patient dressing material brought may be as a result of misused got finished, patient feel relax and would not like to buy another sets on time which eventually contribute to much delay in the process of wound healing. Furthermore, nurses not keeping to time of wound dressing are also an issue, because it brings about the discomfort of the patient. The hospital facilities not being sufficient enough for the health providers to carry out work is also a major problem because it prolongs the patient’s staying. Poor power holding supply for proper sterilization of hospital and the workers are encountering.
 
 
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