CHAPTER ONE
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.
1.4 Specific objective of the study
1. To
determine nurses’ assessment methods of burn injury among inpatient in UCTH,
Calabar.
2.
How do nurses manage patients with burns in
UCTH, Calabar.
1.5 Research questions
This
research will give answers to questions such as:
1. What
are nurses’ assessment methods to burn injury among in-patient in UCTH, Calabar?
2.
How do nurses manage patients with burns in
UCTH?
1.6 Research hypothesis
There is no significant
relationship between nurses’ assessment and management of burns among inpatient
in UCTH.
1.7 Scope of the study
This
study is limited to all registered nurses’ working at accident and emergency
ward permanent site University of Calabar Teaching Hospital (UCTH).
1.8 Significance of the study
The study was to determine
the nurses’ assessment and management of burns among in-patient.
It will also help to
know the method the method utilized by nurses in the management of burns among
in-patients
It
will also help the policy makers to benefit by knowing the proper or the
initial assessment used in carrying out management of burns among inpatient
until they are completely healed
1.9 Limitations of the study
During
the course of the study, certain difficulties faced the researcher which
includes: some nurses not willing to fill the participant questionnaire because
of too much duties allocation given to them. This was taken care of by giving
them enough time to fill the questionnaire and come back for them before the
close of their shift.
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