Chronic Wound Dressing: A Gap in Nursing Knowledge

This article discusses the gap in nursing knowledge related to chronic wound dressing, specifically venous leg ulcers. It explains the significance of this gap and provides an action plan to address it. The article also includes a self-directed learning plan for nurses to gain knowledge in this area.

Running head: NURSING 1
Nursing
Name
Professor
Institution
Date
Gaps in My Knowledge

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The gap that I have identified in my nursing knowledge relates to the nursing and
midwifery professions. The gap in my nursing knowledge is the chronic wound dressing,
especially for venous leg ulcers. According to Nicol et al., (2012), examples of chronic wounds
are diabetic foot ulcers, pressure ulcers and venous leg ulcers. I need to update my knowledge in
this nursing area. Venous ulcers are a common type of chronic wounds that are very distressing
for patients. They are also costly to health providers. Compression therapy is the most
recommended method of managing venous ulcers, through stockings and bandages. The dressing
should be applied below the stockings or bandages aiming to protect the wound and offer a wet
environment for quick healing of the wound (Lloyd, Hancock & Campbell, 2011).
Dressing for chronic wounds continues to be a significant challenge for me in my nursing
practice. Chronic wounds are difficult to manage and treat. Their treatment and management
require gaining an understanding of the underlying pathophysiology (Nicol et al., 2012). Also,
particular attention toward the management of chronic wounds and their perturbations often
results in successful healing. Upon assessing myself, I found that I lack the skills necessary for
addressing most types of chronic wounds. I need to gain knowledge on how to overcome factors
that can lead to delayed healing of chronic wounds and also present the primary challenge to
their treatment. This is a vital component of a comprehensive approach to chronic wound care
(McSherry, MSherry & Watson, 2012).
The Significance of the Gap
As a registered nurse, it is useful to have sufficient knowledge on the dressing,
management and treatment of chronic wounds. Chronic wounds or ulcers are those that do not
have timely healing progress (Melnyk & Fineout-Overholt, 2011). They are a significant

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challenge to the systems of healthcare internationally. In America, chronic wounds affect
approximately two to four million people. Out of the many types of chronic wounds, venous leg
ulcers are among the most chronic wounds that present on the lower extremities and feet in
humans (Lloyd, Hancock & Campbell, 2011). They have a prevalence of up to three per cent of
individuals aged over 65 years.
Venous leg ulcers exist in the skin over the ankles, either on the outer or inner aspect of
the malleolus. They are often painful and colonized. They also have underlying comorbidities
including rheumatoid arthritis and diabetes. Treatment of venous leg ulcers requires standardized
care that depends on a reliable diagnosis and compression as well as local wound care. The
healing of venous leg ulcers varies with the reliability of the diagnosis and the offered treatment
(Jeffreys, 2010).
The consequences of dysfunctional macro and microcirculation lead to venous leg ulcers.
Venous leg ulcers mainly result from ambulatory or unrelieved hypertension in the calf veins that
often result from Deep Venous Thrombosis (VDT). VDT damages valves of the veins, rendering
them incompetent and therefore causing their inability to prevent backflow of blood in the veins
in the leg (Benjamin & Curtis, 2010).
Venous ulcers are diagnosed mainly through clinical examination. Compression and
wound care are the main ways to manage venous leg wounds and other chronic wounds.
Compression can be administered through the use of garments with multiple layers, with at least
one that is elasticated and can deliver external pressures of 35 – 40 mmHg. Bandaging and
dressing venous leg ulcers is challenging and needs adequate training as well as updated
education to be aware of the significant developments in these nursing areas (Jeffreys, 2010).

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NMIH204 Self-directed Learning Plan
Identified
learning need
Action plan Identified
learning
outcome
Estimated time
to complete
Resources required
for completion
The identified
learning gap is
wound dressing
for Chronic
ulcers/wounds,
such as the
venous leg
ulcers.
There are
various action
plans for
addressing the
identified
learning gap in
nursing
knowledge. For
instance, there
is a need to
follow the basic
tenets of wound
care. Also, a
systematic
evaluation of
patients, as well
as their wounds,
is necessary for
the provision of
the appropriate
care.
Additionally, it
is crucial to
improving the
understanding
of the
underlying
differences
among the
various chronic
wounds.
The described
action plans for
the identified
learning need
would facilitate
improved care
for a chronic
wound such as
venous leg
ulcers. This will
lead to
significant
improvements
in the current
approaches of
treatment,
resulting in
improved
healing rates as
well as the
facilitation of
the
development of
new effective
therapies for
wounds.
The estimated
time to
complete the
described action
plans for the
identified
learning need is
six months.
Gaining an
understanding
of nursing care
for chronic
wounds would
take
approximately
six months
learning from
experienced
older nurses
through on-the-
job training.
The critical
resources necessary
for the completion
of the action plans
are:
 Trainers
 Medical
facilities
 Time
 Presentations
(on-the-job
training)

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References
Benjamin, M., & Curtis, J. (2010). Ethics in Nursing: Cases, Principles, and Reasoning. New
York, NY: Oxford University Press, USA.
Jeffreys, M. R. (2010). Teaching Cultural Competence in Nursing and Health Care, Second
Edition. Springer Publishing Company.
Lloyd, H., Hancock, H., & Campbell, S. (2011). Vital Notes for Nurses: Principles of Care.
Hoboken, NJ: John Wiley & Sons.
McSherry, W., MSherry, R., & Watson, R. (2012). Care in Nursing: Principles, Values, and
Skills. New York, NY: Oxford University Press.
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based Practice in Nursing &
Healthcare: A Guide to Best Practice. Philadelphia, PA: Lippincott Williams & Wilkins.
Nicol, M., Bavin, C., Cronin, P., Rawlings-Anderson, K., Cole, E., & Hunter, J.
(2012). Essential Nursing Skills E-Book. St. Louis, MO: Elsevier Health Sciences.