Practice development: Assessing the use of simulated wounds in nurse education ?????????????????????????????????????
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Figure 1. Debridement of a simulated pressure ulcer wound. References
regular discussions with Stephens about how the wounds would look and feel. The chronic wound models produced included: n Buttocks with multiple pressure ulcers of varying depth, category and healing
n A fungating breast wound n A dehisced abdominal wound with stoma
n A necrotic heel ulcer n A dehisced cardiac wound n A leg ulcer. The 12 smaller models included incision wounds, ulcers, healing wounds and small burns.
All the models were based on factual patient case studies. This was so the students could experience the wounds as they were observed in practice and also learn about real ‘back-stories’ and patient outcomes. The simulated wounds were used
to augment the theoretical content of a tissue viability module. The introduction of the models provoked debate around the assessment and management of each case.
Project examples Simulation of a fungating breast wound The simulation of a fungating breast wound was based on a patient referred to the tissue viability services by a local group of pharmacists who had noticed her regularly buying large rolls of gamgee. This type of wound was chosen so that
students could learn that healing is not always the objective of wound management — the goals for this particular patient included the absorption of exudate and the reduction of odour and bulk as the patient preferred to wear T-shirts in the summer instead of polo neck jumpers and a coat. The simulation needed to replicate the
visual appearance of a fungating wound, but also have both breasts present. Therefore, when constructing the wound, Jones needed to sculpt on a real woman and then build up the fungating area to replicate the original wound [Fig 2].
Simulation of a pressure ulcer A necrotic pressure ulcer on the heel of a foot was based upon a patient who had undergone a hemiarthroplasty. This enabled students to explore pressure ulcer
12. Guy H. Now is the time for tissue viability. 2011; Br J Nurs 20(11): 30
13. Rennie I. Exploring approaches to clinical skills development in nursing education. 2009; Nurs Times 105(3): 20–22
14. NHS Education for Scotland (2007) Partnerships for Care. Taking Forward the Scottish Clinical Skills Strategy. NES, Edinburgh
15. Gallagher AG, Ritter ME, Champion H, Higgins G, Moses G, Smith DC, Satava RM. Virtual reality simulation for the operating room: proficiency based training as a paradigm shift in surgical skills training. 2005; Ann Surg 241(2): 364–72
16. Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. 1984; Addison- Wesley, California
17. Forsetlund L, Bjorn dal A, Rashidin A, Jamtvedt G, O’Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxmon AD. Continuing Education Meetings and Workshops: Effects on Professional Practice and Healthcare Outcomes. 2009; Available online at:
http://onlinelibrary.wiley.com/ doi/10.1002/
14651858.CD003030. pub2/abstract;jsessionid=ACBE98E30 D293C1470DB775551050E19.d02t02 (accessed 20 January, 2012)
www.woundsinternational.com
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