need insight

[hppygr8ful]

Hi I am a nurse who cares for high functioning Developmentally disabled adults and I Have a problem hope you all can shed some light on.

I have a 20 year old wheelchair bound with spastic CP who developed a pressure ulcer (Stage 2) on her buttock. MY background is primarily L&D and psych so when It was brought to my attention I first sent her to a wound clinic, They cleaned the wound and sent orders for calcium alginate dressing with Syntal ointment to be changed daily. I have been doing this for 10 days and while I do see some improvement a nice ring of pink on the outside edges it's been slow going. I also am having trouble with my house staff (unlicensed) who insist that the wound needs to dry out in spite of the physician's orders that the wound be covered at all times. I have been doing daily education and dressing changes but was wondering about how long this thing might take to heal? And if you have any suggestions on how to deal with staff that think they know better than the Doctor.


Thank You all

Hppy

[suebird3]

Gaaaah! The wound bed should be kept moist, due to the healing process/migration of cells. If you want, I can find literature for you to back this up. If I may ask, is it the aides, or your 'higher ups' who are giving you grief?

The wound will take a while to heal. Please make sure the person gets extra protein in their diet to help with the healing process, also, ie: egg with breakfast.

[hppygr8ful]

Originally Posted by suebird

Gaaaah! The wound bed should be kept moist, due to the healing process/migration of cells. If you want, I can find literature for you to back this up. If I may ask, is it the aides, or your 'higher ups' who are giving you grief?

The wound will take a while to heal. Please make sure the person gets extra protein in their diet to help with the healing process, also, ie: egg with breakfast.

My higher -ups are very good and supportive of anything our patients (consumers need) but I have a lot of staff in this particular house who have their own ideas about things and to be honest many are trying to use traditional (Ethnic practices) for things like nausea, wound healing etc.... While I have great respect for the practices of different cultures I have just been trying to convey that we must follow Dr.s orders on this.

With regard to pressure relief - This client is small only about 4'5" and 74 lbs. She has a very small wheelchair and I need to have a cushion specialy made for it. In your opinion what is the best material - eggcrate is cheapest but I know my company would pay more if say memory foam is better.
We almost never see pressure ulcers in our facilities so they are relying on me to do what's right for this client. I appreciate any advice you can give.

hppy