Nursing Management Of Venous Leg Ulcers Reflective Critical Analysis

Introduction

A venous leg ulcer is a skin condition that occurs when an area of the skin breaks down to a critical extent whereby the underlying flesh are exposed. These mainly occur above the ankle and are most common in older people. Females are mostly affected. The venous leg ulcer represents the top commonly experienced chronic wound problem noted in general practice. Just as other chronic illnesses and medical conditions, these venous leg ulcers significantly impact the situation of the health system and also the individual. Frequently, these conditions are managed in the community, which makes it imperative for the community based practitioners to possess some specific clinical skills, expertise and professional judgment. These will ensure that these professionals are better placed to make informed decisions regarding the ulcer etiology, the appropriate method for management and hence ensure optimal outcomes for the patients. In the community, it seems somewhat unclear as to whose responsibility it is to manage such a condition. Hence, nurses end up lining the patients to go and consult the general practitioner. This paper champions the thesis that whilst it may be uncertain as to whose role it is to manage venous leg ulcers, any competent community nurse can independently diagnose and manage venous leg ulcers to achieve an optimal outcome for the patient, and also to relieve some of the burden off the healthcare system.

Literature Review

Quite a number of articles are directly relevant to this research topic. Most have been written from the United Kingdom and Canada, while a few have been written from the United States and Germany. The research papers used feature literature that have either been researched or simply based on expert opinion. Five national evidence based guidelines on venous leg ulcer assessment and management were present from various parts of the world.

Regmi and Regmi (2012:56) define leg ulcers as an area of the lower leg skin that experiences a discontinuity of the epidermis and dermis that continues for over four weeks. This definition is quite similar to others that have been offered in literature, although the period given before being diagnosed as venous leg ulcers varied between four to six weeks (Salavastru, Nedelcu & Ţiplica 2012: 306). The underlying etiology is what has been used to distinguish between the different types of leg ulcers available. For this reason, venous ulcers have been found to be the most common type of leg ulcers.

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