Underwater Seal Drainage Tube Management

Underwater Seal drain thermionic valve-shaped structure circumspectionUnderwater seal drainpipe pipe hits ( office tubes) ar inserted to drain the pleural enclosed space (the potential space around the lung) which so-and-soful contain blood, oxygenate or lymph (Rajaraman, Happy Tony W., 2010). The chest tube is connected to a water-seal elastic container and there is only iodine-way movement of air and gas from the pleural cavity. In general, the water-seal container should not be assoil or sortd unless it is full. The chest tube should not be clamped only if ordered by doctors. For the long-suffering inserted with a chest tube, a trained nurse is responsible for managing the down the stairs-water seal waste pipe system (Rajaraman, Happy Tony W., 2010). Management is consist of observeing the position and fond regard of chest tube, adjusting the evacuation of the still and deciding when to intensify or empty the containers, and look after tolerant with the tube and drain system when run (Rajaraman, Happy Tony W., 2010). Nursing pupils atomic number 18 not supposed to manage the drainage system without supervision of a trained nurse.In surgical cases, heterogeneous drains systems bum be used, the management of these drains are different from each others. transgress drainage is a closed in(p)-suction drain with a vacuum container and fluid can be drawed from wound. When the vacuum containers are full or loss its vacuum, they are required to be replaced (Deborah, 2010). While the under-water seal drainage is a closed drainage system and the approach of managing it is different. The water-seal chamber allow the air and fluid to escape from the pleural cavity tho cannot flow back from double back direction (Deborah, 2010).In patients with hemothorax (blood in the pleural cavity), pneumothorax (air in the pleural cavity), chylothorax (lymph in the pleural cavity), the negative pressure is lost and lung expansion can be restricted ( Deborah, 2010). The most important element of ensuring the expansion and compact inspiration of the lung is to take note the negative pressure in the pleural cavity (Deborah, 2010). Consequently, because of the negative pressure in the pleural cavity, the air might place down to pleural cavity specially when the size of the chest tube is big than the size of the trachea which can lead to pneumothorax (Deborah, 2010).The water-seal drainage container is usually collapse full with about 375 ml of sterile water, chest tube is placed under the level of the water, so the air cannot be sucked into the chest, however the water-seal drainage container should forever keep below the level of patients chest to go along back flow of the water to the pleural cavity (Rajaraman, Happy Tony W., 2010).When the chest tubes are inserted for treating pneumothorax, no clamp is excepting and when change the volume of the water in the water-seal container, close monitor is needed as re-expansion p ulmonary can run (Deborah, 2010). If the collapsed lung expands rapidly it can cause damage in the capillary and gird to unilateral pulmonary edema which is called re-expansion pulmonary edema. A specific apportion pathway for chest-tube insertion and management may be useful (Deborah, 2010). wound drainageFor the post operative patient who has a wound drainage tube, the main nurse goals will be healing promotion and transmitting control. To successfully achieve these goals, treasurement of wound and intervention guidelines will be helpful (Bonnie S., 1992).First maintain the tube in proper position. downslope still can happen accidentally even the tube is sutured to the genuflect properly. Apply tape on the tube to stabilize it down to the back of peel can put up to reduction of the risk of extraction. If the tube has overflowing length, nurse can make a partial loop beforehand taping (for slack) (Bonnie S., 1992).Secondly, the skin around the wound should be assessed regularly (Bonnie S., 1992). Drainage tube usually inserted at the invest of surgical incision. If the wound didnt heal well, infection can be a riddle. Assess sites for signs and symptoms of infection which can be redness, swelling, pain and change in vital signs. To assess the drainage every 4 to 8 hours to see sanguineous fluid up to 36 postoperative. Purulent fluid usually indicates infection (Bonnie S., 1992).Thirdly, change the dressing of the site frequently,Depend on the type and amount of the drainage, routinely or frequently change the dressing (using sterile technique) can reduce the risk of infection and maintain a close monitor of skin condition of the drain site and incision site (Bonnie S., 1992).After the tube is saturated and dressing applied, the dressing is suppose to be changed at least(prenominal) every 24 hours. If the doctors ordered to not change the dressing accordingly reinforcement interventions are required to maintain the wound drainage system. co nstantly use separate dressing on the incision and drain site to pr gist cross-infection of bacteria (Bonnie S., 1992).Critical analysis form different perspectives wishing of cognition of professional competency and turn up-based practice can be the tend out that affect the first year RN and nursing student to make inadequate clinical decision.In the education field of clinical wellness professionals, CPD (continuing professional development include a range of education activities to farm profession competencies and good practice) is one program that has been developed to help clinicians to maintain updated evidence-based practice and theories (Brigitte Jeannette, 2011). CPD has been used for post polish nurse and also undergraduate nursing students.The purpose for these activities are to help health professionals to assess their feelings, connect saucy knowledge with ensure and expose value issues (Brigitte Jeannette, 2011). Incident reflection is one of the techniques, ho wever critical analysis can be painful experience sometimes because it might bring discomfort feeling like anger, frustration, rue and guilty ( Rachel, Joanna, Emma, PaulFehmidah, 2010). And participants of CIR (critical nonessential report) do not always feel verificatory on difficult practice situation. A safer and more supportive purlieu is needed for clinician to discuss about the sequent thus amend the dread of the specific clinical practice and avoid accidents (Rachel etl, 2010). Through out the account experimentation of small group of occupational therapists, it is found that discussing on afoot(predicate) situation and interventions that can still be change will originate less negative feelings and encourage clinicians to transform the advance event into a learning opportunity compare to talk about the past possibility and act that cannot be changed (Rachel etl, 2010).A real issue of concern is the scoop up trigger for clarifies meaning in policy and procedure and change in conceptual perspective. Practitioners can take this reflective action to review their knowledge and have out the assumptions for the cause of their specific intervention then improve in the future practice (Rachel etl, 2010).Different from instrumental education, reflective learning is aiming to order clinicians previous knowledge and form a new understanding and committal to act. Continuously use of reflection on clinical sequent is a lifelong learning cycle which can efficaciously develop a self-evaluation and self-regulation process (Rachel etl, 2010).Another element that can cause the clinical adventure is the workplace form, it can include the inadequate distribution of workload and pitiful working environment which involve the unit coordinator and the co-workers on the ward.For professionals who work in the health care field, stress is a significant issue. Datas shows that particular nurses are at advanced risk for occupational burnout and physical and psychological bore (Jacoba, Anja, Ellen, Hugo J., Arnold B.Bert J., 2011). In the study of THOR psychiatrists in UK, health and social welfare professionals are found to be the group with highest incident of work that related to alloy unhealthy in 2003-2005 (Jacoba etl, 2011).Manage intervention and stress-related incident can contribute to presence or absence of potential hazards in the work environment. (Jacoba etl, 2011) Management involves plan, administrate and evaluate the risk estimations and intervention. Leadership and the model of management yield been constantly reported as the main reason of workplace stress in nursing. There is an association between low management and unworthy psychological health in clinical nurses, found that low animal trainer support was associated with poor psychological well-being in nurses (Jacoba etl, 2011).Managing workload and resources are often referred than other competency (Jacoba etl, 2011). In specific, managers of the unit need t o monitor the workload of the team and individual staff whether the workload is overly high or low. Design probable and achievable goals and deadlines (Jacoba etl, 2011). It is the managers responsibilities to pooh-pooh additional workload for the team members. In one case of a supportive work environment. Staff was interviewed for her feeling about the management.She recognises salutaryly that the work is too much for one person so that was good. Something about her, yes, her caving in and giving me an admin support person when I needed it, made such(prenominal) a difference to my stress levels, it was fantastic (Jacoba etl, 2011).On the other hand, meagre management lead to failure in coping with the assigned workload and increasing pressure level (Jacoba etl, 2011). Cause of that can be respective(a) including the manager is lack of awareness of pressure level of the team or the manager misinterpret the knowledge level and type of work. Nurses who work in this type of enviro nment always feel busy and stressful and find it difficult to cope with (Jacoba etl, 2011).Ive begun to lie about the amount of work I have. What Ive discovered is my boss, she doesnt show it on her face, but I think she becomes quite stressed out herself by sense of hearing how much work I have outstanding (Jacoba etl, 2011).When the managers are passing the pressure and deadline to the team, the team members will then pass the pressure to others which can be invitees and other health professionals or students. In the end the gauge of care will declined and the risk of clinical incident can improver (Jacoba etl, 2011).From the customers perspective, hospital consistently emphasized on the feedback and complains of the ( Heejung June, 2012). In fact, education for patient about their treatment is essential for preventing clinical incident and building good therapeutic affinity ( Heejung June, 2012). In this clinical incident, if the client was told how the under-water seal d rainage system work, the nursing student might be able to be stopped from emptying the under-water seal containerThe values of complaints is to meliorate the quality of care and enhancing the process of recovery ( Heejung June, 2012). Customers are given the right of doubting the competence of practice. When it comes to handling complaints, usually there is an adverse event or poor practice, it is not a preventive strategy for clinical incidents ( Heejung June, 2012). overly, customers complaints can be challenge for the contacted nurse and there has poor evidence of how the nurse handle the compliant from clients.An exchange relationship benefit in develop trust with customers over time ( Heejung June, 2012). Customers diagonosis and treatment need to be fully explained and customers should always involved in clinical decision making. The impression concept here is emphasizing the benefit of building emotional adhere between patients and nurses ( Heejung June, 2012). Litera ture has shown the optimistic connection between health relationship and customer satisfaction. Also, well-built relationship with the customers tend to reduce the rate of failure in practice or adverse event ( Heejung June, 2012).Incident reportAs I considered, in this scenario, JC and shift coordinator need to be notified with patients complaint of SOB and further interventions (like refill and connect the water-seal container ) need to be consulted. During that period of time, patients vital signs should be closely monitored. Also the first year RN and the student need to commence incident report.Graduated nurse and student nurse may need to any perform written incident report or telephone incident report. Report incident on telephone, a nurse or student need to be able to identify him/herself, the ward, the client, the presenting issue and patient orbit culture and up-to-date assessment ( Sonja, Regula, Bernd, DanielFranziska, 2013). If there have orders been administrated , nurse moldiness identify the order. Beside that, nurse should also consult for managing order in reasonable time frame. This model is called SBAR and has been used for many facility, situation (S), background signal (B), assessment (A) and recommendation (R) (Sonja etl, 2013).To evaluate the effectiveness of a verbal clinical incident report there are three categories which emphasize on top executive for listener to understand and receiving information.Firstly, at the beginning of the report, patients problem should be clear described which creating a conscious recognition of patients situation (Jacqueline A., 2014). Base on the aware of patient primary issue, the listener can have a better understanding.Secondly, information should be provided in standardize order to enhance efficiency (Jacqueline A., 2014). For example, the patient had deuce sets of obs done, instead of report it separately, compare it and exhibit the decline or change in patients status help listener to proc ess information within minimum time.Thirdly, key factors should be focused in the incident report, thus nursed should avoid descriptive and subjective information (Jacqueline A., 2014). This benefit the health team toward clear diagnosis specially in a emergency situation.For the graduate nurse and student nurse, the ability of effectively communication with the health care team is vital in ensuring patient safety and preventing clinical incidents (Sonja etl, 2013). Expectation for graduate nurse in a clinical incident report is assess critical issue of a patients experience and effectively report to health team, unfortunately, graduate nurses and nursing students are rarely preform this dexterity and receive positive feedback from the health team about the quality of their report (Sonja etl, 2013).Clinical decisions skill is another important expectation of the graduate nurse and nursing student (Sonja etl, 2013). In the dimension of clinical decision-making, clear communication i s one of the bell ringer score. Clinical decision making involve other sills like background assessment of the patient, identify the major concern of patients true situation. Head to toe assessment and ability to provide appropriate recommendations for current situation (Sonja etl, 2013).