We collect our data from many sources, such as: medical records, comprehensive nursing physical check-up, existing available documentation about the patient's medical history and interviews with the patient and family. It is important to us to listen carefully to the patient, so we can fully understand the perception of his/her issues.
It is important to assess the patient and the wound to help establish the appropriate dressings selection, and then accurate treatment can be planned. We always try to consider a multi-disciplinary approach.
All our patients have their wounds appropriately assessed by our key nurse. Our considerations for assessment are:
- identification of patient’s specific problem(s): This is where our findings should be matched to established nursing diagnosis as best as possible.
We assess each patient and consider systemic factors which may affect wound healing. These factors include: co-morbidities / disease processes such as cardiovascular, diabetes, immunosuppressant conditions, carcinomas, psychosocial conditions, medication, age and nutritional status. Any known allergies are recorded.
The Regional area:
- regional factors to consider include vascular disease, infection and pain.
The Local Wound area:
- the local wound bed is assessed in terms of the type and amount of each respective tissue type present (necrotic, sloughy, granulating), and also the level of pain, infection, exudates and odor.
The Current Dressing Regime:
- assess the current dressing for signs of leakage and strikethrough and assess efficacy in terms of wear time, pain at dressing change and to be in appropriate position.