Pressure , pressure ,pressure.........

The Homeless Adult Shelter (HAS) in Hoi An is home to about 100 residents , some of whom are profoundly disabled and bedridden. One of the nursing challenges that presents here is pressure area treatment. I have been volunteering as a nurse with VNHIP for the last couple of months and was asked to assess a few of the pressure areas and provide any treatment suggestions I thought may be helpful.

A pressure sore is any redness or skin break caused by prolonged pressure on the skin. The pressure causes blood flow restriction and eventually the skin breaks down. For the residents here who are unable to move about freely or even turn over in their beds , pressure areas can become a serious problem. 

There are no pressure -relieving mattresses here- beds are the standard Vietnamese slatted variety made of stainless steel and the “mattress” is a thin cypress mat with no pillow.

There is no regime in place for regular turning of those residents confined to their beds. 

There are no fancy wound dressings here- gauze , a solution resembling Betadine and Vaseline covering every wound are common place.

Pain relief is available but not necessarily dispensed readily. 

Simplicity is the key with regard to wound care here. A barrier cream for the incontinent residents was suggested and supplied and a simple homemade recipe for Saline solution to clean wounds  was discussed. The nurses on staff here have recently had a successful inservice on dressing technique .

 A trip to the pharmacy to buy the necessary creams and ointments was in order ,followed by Quynh explaining to the nurses the instructions regarding their applications and our visit was complete. I suggested we take photographs of some wounds before we left and reassess them weekly. This will enable all staff to keep abreast of the healing process.

Capacity building is the basis of the volunteer work here in Hoi An and up skilling in wound care is paramount in facilities such as HAS. The nursing staff are open to further education and VNHIP are happy to provide this where possible.