Comprehensive Health Assessment – Health System Example

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"Comprehensive Health Assessment" is a wonderful example of a paper on the health systems. Comprehensive health assessment is the examination of a person’ s whole body- a head-to-toe physical exam (Anthony, Papanikolaou P, Parboteeah & Saleh 2010). The purpose of the comprehensive examination is to detect illness or health risks before the occurrence of any symptoms and to monitor and manage already existing illnesses or health problems. comprehensive health assessment includes the following: taking a thorough and comprehensive medical history; physically examining a person from head to toes; assess person heart by means of resting and exercise E. C.G. s; testing lung functions; analyzing the urine; and so forth (Anthony, Papanikolaou, Parboteeah & Saleh 2010).

A health risk assessment is a questionnaire that is used to provide people with an evaluation of their quality of life and health risks (Anthony, Papanikolaou, Parboteeah & Saleh 2010). Health risk assessment has been noted to provide three key elements- a risk score or calculation, an extended questionnaire, and feedback i. e. an automatic online report or face-to-face with a health advisor (Anthony, Papanikolaou P, Parboteeah & Saleh 2010).

The CDCP (Centers for Disease Control and Prevention) defines health risk assessment as a systematic approach that is used to collect data or information from a person that identifies risk factor, and link that person with an intervention that will help him/her to promote his/her health, sustain function and/or prevent illness or diseases (Anthony, Papanikolaou, Parboteeah & Saleh 2010). Question 1a: Reflect on the purpose and intent of this assessment? How this assessment contributes to a person’ s comprehensive health assessment? Provide an example to demonstrate your knowledge. Identifying which patient is at risk of developing pressure injury (also known as pressure ulcers) early is an important part of the prevention care method (Bates-Jensen 2001).

Risk assessment to prevent pressure injury helps doctors and nurses to focus on the risks that have the potential to cause harm to patients. These risks need to be identified and processes started to prevent or reduce the likelihood of harm occurring to patients (Bates-Jensen 2001). In most hospitals, risk assessment has become part of the process of maintaining safety and supporting patients. Documentation of risk for a patient with a pressure injury is key in reviewing and improving a patient's care and in the future, it can act as the basis of investigations.

Pressure injury or ulcer assessment contributes to a person’ s comprehensive health assessment in the following ways (Bates-Jensen 2001): it reduces short-term mortality; increases the chances of living and improves physical and cognitive functions of a patient with pressure sores (Bates-Jensen 2001). In addition, a comprehensive assessment will improve diagnostic accuracy, optimize patient medical treatment, and improve the quality of life of the patient (Bates-Jensen 2001).

For example, carrying out pressure sores risk assessment will help to identify people who are at risk and early intervention with strategies for preventions would be started. Question 1b: Identify and discuss three (3) abnormal findings you might expect when performing this specific assessment. Pressure sores or ulcers are areas of injured tissue and skin (Pancorbo-Hidalgo et el 2006). These injuries or sores are usually caused by lying or sitting in one position for a long time thus putting pressure on certain areas of a person’ s body (Pancorbo-Hidalgo et el 2006).

When there is no enough movement in a person, the blood supply in the body gets too low leading to the formation of a sore (Pancorbo-Hidalgo et el 2006). Pressure ulcers or sores are classified according to the extent of tissue damage. Universally, pressure shore or ulcer symptoms or abnormal findings are classified so that doctors or nurses can know what to give in order to reduce or/and prevent worsening conditions for this illness. Pressure ulcers or sores are grouped by their severity. Stage I is the earliest stage, while stage IV is the worst stage (Lindgren, Unosson, Fredrikson and Ek 2004).

• Stage 1 – Reddened skin. • Stage 2 – Blisters are present. • Stage 3 – Crater can be observed, the skin eventually opens losing its ability to heal. • Stage 4 – The damage now reaches the bones and tendons. The patient skin appears as open craters, often round, with layers of skin that appear to be eroded (Lindgren, Unosson, Fredrikson and Ek 2004). The patient skin around the sore or ulcer may be swollen, tender and red.

The patient will feel pain on the skin around the sore, and fluid may come from the sore. In some cases, the patient will experience bleeding. In Stage One, the patient skin appears to be red with soft underlying tissue. In Stage Two, the skin swells and the redness of the patient’ s skin become more pronounced, and there may be some loss of outer skin layers and blisters appearing (Lindgren, Unosson, Fredrikson and Ek 2004). In Stage Two, the skin becomes necrotic and fats beneath the patient’ s skin may be visible and exposed.

In the last stage (Stage 4), deeper necrosis may occur, and the fat underneath the patient’ s skin will be completely exposed, also the patient’ s muscles may also be exposed (Lindgren, Unosson, Fredrikson, and Ek 2004). In severe cases of pressure ulcers or sores, the cut can extend down to bone level, which may lead to the destruction of the patient’ s bone, and there be sepsis of joints (Lindgren, Unosson, Fredrikson and Ek 2004). Question 1c: What actions would you initiate for each one of the 3 abnormal findings if you were the health professional responsible for planning care? Treating a pressure ulcer or sore illness is difficult than reducing or preventing one.

The most important part in the treatment of pressure sore is to relieve pressure on the sores, keep the sores clean and free from being infected, and providing the patient with appropriate nutrition (Magnan and Maklebust 2009). Subscribing a balanced diet for the patient is important in helping the patient’ s sores to heal and preventing new sores from appearing (Magnan and Maklebust 2009). As a professional responsible for planning a cure I would recommend the patient to be given a well-balanced diet that is rich in protein, as well as daily high-potency mineral and vitamin supplements.

Mineral supplemental zinc and vitamin C will help the patient to heal well. Heat therapy, massage therapy, electrical stimulation, and hyperbaric oxygen therapy can also be used to help the sore to heal (Magnan and Maklebust 2009). In the first stage, pressure ulcers or sores may heal by themselves if pressure is removed from the sores. When the patient’ s skin is broken, it best to consider the condition and location of the pressure ulcer or sore when dressing the sores (Bates-Jensen 2001).

As a professional responsible for planning a cure I will recommend film dressing to help protect early-stage pressure ulcers or sore and allow the patient’ s sores to heal fast (Bates-Jensen 2001). Hydrocolloid patches will protect and keep the patient’ s skin appropriately moist, and also this will help in providing a healthy environment for deep wounds to heal. Other types of dressings can be recommended to be used for deeper sores, those sores that emit fluids, and sores that have been infected.

If the patient’ s sores appear to ooze or infected, I will recommend the sores to be rinsed with saline water and then be dabbed gently with a gauze pad (Magnan and Maklebust 2009). Dead tissues (debride) will then be removed with a chemical solution or a scalpel. Deep crevices will be irrigated with a sterile solution that will help in cleaning hidden debris (Magnan and Maklebust 2009). An air-fluidized bed (a bed that circulates air) can also be recommended in nursing homes or healthcare facilities.

This special bed will help to redistribute or reduce pressure on the patient's body (Magnan and Maklebust 2009). When the severity of pressure sore reaches the final two stages is difficult to treat (Pancorbo-Hidalgo et el 2006). In some cases, it requires muscle and skin flaps, in which thicker, healthy tissue that has a good blood supply in the patient body is surgically repositioned to cover the damaged part of the body (Pancorbo-Hidalgo et el 2006). However, this type of surgery may not be successful especially for older people who are malnourished.

Often, when infections develop deep within a sore, an antibiotic is given (Pancorbo-Hidalgo et el 2006).

References

Anthony D, Papanikolaou P, Parboteeah S and Saleh M. Do risk assessment scales for pressure

ulcers work? Journal of Tissue Viability. 2010.

Bates-Jensen B. (2001). Quality indicators for prevention and management of pressure ulcers in

vulnerable elders. Ann Intern Med 135(8): 744–50.

Lindgren M, Unosson M, Fredrikson M and Ek A. Immobility -- a major risk factor for

development of pressure ulcers among adult hospitalized patients: a prospective study.

Scandinavian Journal of Caring Sciences. 2004;18(1):57-64.

Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Lopez-Medina IM and Alvarez-Nieto C. Risk

assessment scales for pressure ulcer prevention: a systematic review. Journal of

Advanced Nursing. 2006; 54(1):94-110.

Magnan MA and Maklebust J. Braden Scale risk assessments and pressure ulcer prevention

planning: what's the connection? Journal of Wound, Ostomy & Continence Nursing.

2009; 36(6):622-634. Magnan MA and Maklebust J. Braden Scale risk assessments and

pressure ulcer

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