Optimal care and management of wounds in the post-operative stage are essential to prevent the potential development of complications, including infections of the surgical site and dehiscence of the wound. The goal of wound care following surgery is to support fast healing, avoid the occurrence/development of complications, and achieve the finest aesthetic and functional outcomes. Additionally, incompetent wound care is likely to promote infections of surgical sites, causing complications that may lead to hospital readmissions, extended care, long-term health and wellbeing problems, and even deaths. In this context, nursing and healthcare practitioners have a critical responsibility of care to prevent such problems. Nurses and practitioners in the surgery units need to appreciate and understand the physiology of healing of wounds and the values and principles of care for wounds in the post-operative stage to perform effectively. In relation to the problem of post-operative readmissions with wound infections in the medical-surgical unit, the key argument in this paper is that patient education is essential to empower patients to engage effectively in self-care. Patient education would empower the post-operative wound patients to adopt behaviors that can facilitate rapid healing, prevent complications, and produce the best aesthetic and functional results.
Apart from the care that nurses and medical practitioners provide, patients also have a critical role to play in post-operative wound care because following surgery, patients are unlikely to remain in the formal supervision or monitored care of nurses and physicians. When effective, the education of patients empowers them to assume a proactive role in the management of their health needs and to cope effectively with the demands of their health conditions. Moreover, self-care is an extension of the formal care that patients receive from nursing and healthcare practitioners, featuring the initiation and execution of choices, behaviors, and activities that can preserve patients’ wellbeing, life, and health. In relation to the problem of focus, discharge teaching for post-operative patients that includes information relating to wound assessments, care, and dressing would influence their knowledge of the need to change behaviors, choose actions, and resist influences with a potential adverse effect on efforts to facilitate rapid healing, avoid complications, and produce the best aesthetic and functional results.
Evidence is an important basis for effectiveness, value, and quality in the provision of post-operative wound care. The use of evidence ensures that the practices and methods that nursing and healthcare practitioners apply in care are valid, fit the needs of patients, and take into consideration the best available, relevant, and up-to-date knowledge to deliver the desired outcomes. Moreover, the combination of best scientific evidence, sensitivity to patient values, and clinical expertise ensure that the care that practitioners deliver meets the needs and desires of patients, thereby ensuring efficient achievement of patient outcomes.
The article by Ding et al. (2017) supports the above-mentioned assessments. The researchers’ goal was to assess surgical nurses’ practices in wound care following surgery, and whether these practices aligned with evidence-based guidelines. This objective considered that surgical site infections are grave post-operative complications with the potential to lead to undesired outcomes for patients. Furthermore, the study utilized a sample of 60 nurses from 4 surgical units. One of the aspects that the research investigated concerned patient education as an important element of effective, evidence-based post-operative wound care. Surgical wound care guidelines and recommendations include patient education as an important aspect of effective wound care following surgery, alongside compliance with aseptic techniques and documentation and assessment practices. Nonetheless, the study found that a clear gap existed between guidelines or recommended practices in wound care and actual or observed care practice (Ding et al., 2017). Besides, it observed that clinical practice has failed to reflect evidence-based recommendations.
The element of patient education obligates nurses to offer advice and information to caregivers and patients across all stages of care, focusing on the risks of development of surgical site infections and ways to reduce and manage them effectively. The education and assessment outcomes ought to be appropriate to patients’ ages and cognitive statuses. Ding et al. (2017) observe that patient education has a critical role in risk management to prevent surgical site infections and improvements in the effectiveness of wound care and management. The study indicated that the education of patients was not available for most post-surgical patients (Ding et al., 2017). Consistent, age-appropriate, and effective education of patients can reduce the incidence of surgical site infections, and hence related morbidity, mortality, and hospital costs. Ding et al. (2017) conclude that the results from the study illustrated the need for development and implementation of strategies to enable nursing practitioners to incorporate evidence-based wound care recommendations and guidelines into clinical practice.
The theory is essential as a way of developing knowledge that is relevant to the improvement of patient care. Nursing theory serves to structure ideas and project a purposeful and systematic view of a phenomenon to enable nurses to apply its concepts effectively in care for patients. In relation to the problem of post-operative readmissions with wound infections, the nursing theory would support evidence-based research through the promotion of ideals relating to the phenomenon. Particularly, Dorothea Orem’s Self-care Deficit Theory is applicable in research into this context for its characterization of self-care as the initiation and execution of behaviors, activities, and choices that can preserve the life, wellbeing, and health of patients. In this case, patient care empowers post-operative wound patients to adopt behaviors that can facilitate rapid healing, prevent complications, and produce the best aesthetic and functional results.
Ding, S., Lin, F., Marshall, A., & Gillespie, B. (2017). Nurses’ practice in preventing postoperative wound infections: an observational study. Journal of Wound Care 26(1): 28-37.