Reference no: EM133632583

Scenario: A home health nurse is caring for a 92-year-old patient what a chronic lower leg ulcer. The wound is shallow, just lightly exuding and periodically had a small amount of necrotic tissue. Compression stockings had been tried but were not tolerated by the patient, so just leg elevation and ACE elastic bandages were used. The dressing was changed daily, and the wound was cleansed with sterile water; a 21-day treatment with an enzymatic debriding agent had removed necrotic tissue.

The nurse went to CINAHL, the Registered Nurses' Association of Ontario, and Cochrane Collaboration websites to search for clinical practice guidelines and systematic reviews. The nurse was aware of several mediations that might promote healing. The nurse searched the databases using the terms leg ulcer or venous leg ulcers. Among the helpful documents were three guidelines and several systematic reviews about the management of open wounds in patients with lower extremity venous disease.

From these, the nurse had several evidence-based ideas for promoting the healing of this patient's leg ulcer, including recommending walking in place and/or calf muscle pumping every 2 hours to increase circulation. The nurse also learned that leg elevation is most effective when the feet are above the level of the heart (e.g., putting the foot of the bed on blocks or placing a wedge under the foot end of the mattress). The strong research support for the effectiveness of compression therapy convinced the nurse that they should consider compression alternatives to see if they could find one that the patient would tolerate and found several alternative products. The nurse collaborated with the other members of the patient's healthcare team to discuss possible changes in the patient's plan of care.

The nurse spent a little over an hour on the online search. During that time, the nurse learned about some interventions they had not tried that have research support and confirmed the strong evidence for compression therapy as the central component of treatment.

1. Identify one or more connections to any topic or key point addressed in class related to evidence-based for practice. Provide a short explanation of the connection to class content.

2. Discuss the relevance and importance of the topic you identified from class to your own future professional nursing practice.