Nursing Clinics of North America最新文献

Surgical site infections (SSIs) pose a significant challenge in surgical care, leading to increased patient morbidity, mortality, and health care costs. This article examines the risk factors for SSIs, particularly within the operating room environment, and highlights effective prevention strategies. Key pathogens, such as Staphylococcus aureus, are identified, and the role of infection control practices, including hand hygiene, surgical techniques, and environmental controls, is discussed. A multi-faceted approach to prevention, involving both patient-related and procedural factors, is essential for reducing SSI rates and improving patient outcomes.

Arterial ulcers are a clinical symptom of a complex array of underlying comorbid factors, namely peripheral artery disease (PAD). Chronic limb-threatening ischemia is representative of end-stage PAD. Ulcers of other etiologies can carry an arterial component, mandating recognition of risk factors, a comprehensive history and physical examination, and appropriate diagnostic testing in lower extremity ulcers. The primary therapy for arterial ulcers is re-establishment of in-line arterial flow, achieved by endovascular therapy or open revascularization. Medical management is essential to slow disease progression, and topical therapies are crucial to promote rapid ulcer closure and reduce infection risk.

The circulatory and lymphatic systems play vital roles at the capillary level and throughout our bodies. Venous disease can lead to water-rich edema which this fluid is removed by an intact lymphatic system. However, if the lymphatic system is constantly tasked with removing edema, it can becomes damaged over time. Proper management of both systems is essential, as these progressive diseases can result in skin changes and wounds. Timely recognition and appropriate treatment is key in promoting early disease management, prevention of complications, and a healing trajectory.

Chronic wounds are complex conditions categorized into pressure injuries, diabetic foot ulcers, venous leg ulcers, and arterial ulcers. In managing these wounds, the selection of appropriate wound care products is of critical importance. Commonly used dressings include hydrocolloid, hydrogel, alginate, foam, and silver-containing dressings. Effective wound management requires addressing systemic causes, selecting suitable wound care products, and fostering collaboration within a multidisciplinary team. Looking ahead, nanotechnology and biotechnological innovations promise to revolutionize chronic wound care.

Wound care patients often have a variety of chronic medical conditions that result in poor outcomes, such as delayed healing and nontraumatic limb loss. Many of these suboptimal patient outcomes result from healthcare disparities linked to social determinants of health (SDOH). Race and ethnicity influence SDOH by impacting patients' access to consistent quality healthcare. Understanding and addressing why and how ethnic and cultural factors influence SDOH is crucial for making substantial changes.

This article reviews the current state of pediatric wound care and the future of pediatric wound care and provides an overview of pediatric wound care and skin integrity maintenance. The article guides the dressing selection for wounds across the age spectrum in pediatrics and other conditions.

Pressure injury (PI) prevention in the operating room (OR) has unique considerations based on the patient, procedure, position for the surgical procedure, and available positioning devices. Patient-specific factors contribute to their risk of incurring an intraoperative PI from the American Society of Anesthesiologists classification, sex, body mass index, comorbidities, age, and nutritional status. Additionally, there are surgery-specific risk factors such as length of procedure, intraoperative hypotension, lack of normothermia, and intraoperative blood loss. Knowledge of intraoperative PIs and prevention is developing and continues to have room for growth due to the complexity of the OR environment.

There is a significant care burden on wound care patients in the acute care space. During hospitalization, additional risk factors can cause wounds to develop, particularly in the emergency room, operating room, and intensive care units. This article will highlight common wound types, their potential complications in the acute care setting, and implications for practice.

The increasing complexity of health care and the growing demand for safe, high-quality health care have underscored the crucial need for interdisciplinary teams in health care. As people are living longer, a myriad of complex health care needs arise, necessitating specialized care from various health care professionals. Interdisciplinary teams include a group of health care professionals with various areas of expertise who work together to achieve mutual goals on behalf of a patient and their other significant individuals. Consequently, the role of interdisciplinary teams in health care continues to strengthen, providing more effective responses to the evolving needs of both individuals and health care systems.