Haavasidoksen vaihto kirurgiseen haavaan : Opetusvideo keskivaiheen sairaanhoitajaopiskelijoille

Tuotokseen painottuvan opinnäytetyön tarkoituksena oli tuottaa Tampereen ammattikorkeakoulun kirurgisen hoitotyön keskivaiheen sairaanhoitajaopiskelijoille opetusvideo, aiheesta haavasidoksen vaihto kirurgiseen haavaan. Opinnäytetyön tehtävinä oli selvittää, millainen on kirurginen haava, millaista aseptiikkaa tarvitaan kirurgisen haavan hoidossa, miten haavasidos vaihdetaan kirurgisen haavaan ja millainen on hyvä opetusvideo. Työn tavoitteena oli tukea sairaanhoitajaopiskelijoiden oppimista liittyen alle 24 tuntia vanhan kirurgisen haavan hoitoon. Opetusvideolla havainnollistettiin haavan sidosvaihdon aseptiikkaa sekä valmistamaan opiskelijaa suunnittelemaan tulevaa haavanhoitoa. Opinnäytetyö toteutettiin toiminnallisena opinnäytetyönä, jonka tuotoksena oli opetusvideo ja kirjallinen raportti. Kirurgisella haavalla tarkoitetaan iholle tehtyä leikkaushaavaa. Kirurginen haava kuuluu pitää peiteltynä 24 tuntia leikkauksesta ja sitä käsitellään mahdollisimman vähän. Yleensä puhdas kirurginen haava paranee ongelmitta, mutta komplikaatioihin kuten verenvuotoon on osattava varautua. Haavan vuotaessa ja sidosten kastuessa haavasidos on vaihdettava pohjia myöten, vaikka haavan sulkemisesta olisi alle 24 tuntia. Tällöin haavasidoksen vaihto tulee tehdä steriilisti. Haavan paranemisen kannalta sairaanhoitajan ammattiosaaminen korostuu, jolloin on osattava kirurgisen haavan peittelyn perusteet. Aseptinen työskentely, haavasidoksen valinta ja tietotaito siitä, milloin haavasidoksen vaihto on tarpeellinen ehkäisevät mahdollisia komplikaatioita, kuten haavainfektioita. Opinnäytetyön tuotoksena valmistui opetusvideo kirjallisen raportin teoriatiedon pohjalta. Video toimii sairaanhoitajaopiskelijoille opetuksen tukena ja havainnollistaa konkreettisesti eri työvaiheita alle 24 tuntia vanhan kirurgisen haavan sidoksen vaihdossa. Opinnäytetyön kirjallista tuotosta ja opetusvideota voidaan hyödyntää kirurgisen hoitotyön opetuksessa. Alle 24 tuntia vanhan kirurgisen haavan sidosvaihdosta ei löydy selkeää ohjeistusta siitä, kuinka toimia, joten opinnäytetyö on hyvä lisämateriaali sairaanhoitajaopiskelijoille. Jatkotutkimusehdotuksena esitetään kvantitatiivista tutkimusta siitä, kuinka työelämässä kirurgisen haavan sidoksen vaihto tapahtuu ja kuinka eri työvaiheet toteutuvat.The aim of this study was to define the concept of a surgical wound, the methods of protection against infections in wound care and how to change the wound dressing for a surgical wound. Moreover, the aim was to produce a suitable educational video in addition to the theoretical part of the study.  The study had a functional approach with the written report and an educational video as a tangible output of the process. The aim of the report and the video was to support the education of nursing students in the care of an under 24-hour-old surgical wound. The educational video presents protection against infections during the change of a wound dressing. It also prepares the student to plan the upcoming wound care.  The surgical wound should be covered up and left untouched for 24 hours after the operation. The wound dressing should be changed thoroughly if the wound bleeds and the dressings get wet even though the operation has been performed less than 24 hours ago. In that case, the change of the dressings should be performed in a sterile manner. Written instructions on changing the surgical wound dressings being somewhat limited, this thesis provides important information about surgical wound care in this particular respect. There is a need for a further quantitative study about the various stages in changing the surgical wound dressings in hospital settings

Defect turbulence in inclined layer convection

We report experimental results on the defect turbulent state of undulation chaos in inclined layer convection of a fluid withPrandtl number $\approx 1$. By measuring defect density and undulation wavenumber, we find that the onset of undulation chaos coincides with the theoretically predicted onset for stable, stationary undulations. At stronger driving, we observe a competition between ordered undulations and undulation chaos, suggesting bistability between a fixed-point attractor and spatiotemporal chaos. In the defect turbulent regime, we measured the defect creation, annihilation, entering, leaving, and rates. We show that entering and leaving rates through boundaries must be considered in order to describe the observed statistics. We derive a universal probability distribution function which agrees with the experimental findings.Comment: 4 pages, 5 figure

Localized transverse bursts in inclined layer convection

We investigate a novel bursting state in inclined layer thermal convection in which convection rolls exhibit intermittent, localized, transverse bursts. With increasing temperature difference, the bursts increase in duration and number while exhibiting a characteristic wavenumber, magnitude, and size. We propose a mechanism which describes the duration of the observed bursting intervals and compare our results to bursting processes in other systems.Comment: 4 pages, 8 figure

Fractal Stability Border in Plane Couette Flow

We study the dynamics of localised perturbations in plane Couette flow with periodic lateral boundary conditions. For small Reynolds number and small amplitude of the initial state the perturbation decays on a viscous time scale $t \propto Re$. For Reynolds number larger than about 200, chaotic transients appear with life times longer than the viscous one. Depending on the type of the perturbation isolated initial conditions with infinite life time appear for Reynolds numbers larger than about 270--320. In this third regime, the life time as a function of Reynolds number and amplitude is fractal. These results suggest that in the transition region the turbulent dynamics is characterised by a chaotic repeller rather than an attractor.Comment: 4 pages, Latex, 4 eps-figures, submitted to Phys. Rev. Le

Transition from the Couette-Taylor system to the plane Couette system

We discuss the flow between concentric rotating cylinders in the limit of large radii where the system approaches plane Couette flow. We discuss how in this limit the linear instability that leads to the formation of Taylor vortices is lost and how the character of the transition approaches that of planar shear flows. In particular, a parameter regime is identified where fractal distributions of life times and spatiotemporal intermittency occur. Experiments in this regime should allow to study the characteristics of shear flow turbulence in a closed flow geometry.Comment: 5 pages, 5 figure

Dynamics of a hyperbolic system that applies at the onset of the oscillatory instability

A real hyperbolic system is considered that applies near the onset of the oscillatory instability in large spatial domains. The validity of that system requires that some intermediate scales (large compared with the basic wavelength of the unstable modes but small compared with the size of the system) remain inhibited; that condition is analysed in some detail. The dynamics associated with the hyperbolic system is fully analysed to conclude that it is very simple if the coefficient of the cross-nonlinearity is such that , while the system exhibits increasing complexity (including period-doubling sequences, quasiperiodic transitions, crises) as the bifurcation parameter grows if ; if then the system behaves subcritically. Our results are seen to compare well, both qualitatively and quantitatively, with the experimentally obtained ones for the oscillatory instability of straight rolls in pure Rayleigh - Bénard convection

Resonant enhanced diffusion in time dependent flow

Explicit examples of scalar enhanced diffusion due to resonances between different transport mechanisms are presented. Their signature is provided by the sharp and narrow peaks observed in the effective diffusivity coefficients and, in the absence of molecular diffusion, by anomalous transport. For the time-dependent flow considered here, resonances arise between their oscillations in time and either molecular diffusion or a mean flow. The effective diffusivities are calculated using multiscale techniques.Comment: 18 latex pages, 11 figure

Rotating Convection in an Anisotropic System

We study the stability of patterns arising in rotating convection in weakly anisotropic systems using a modified Swift-Hohenberg equation. The anisotropy, either an endogenous characteristic of the system or induced by external forcing, can stabilize periodic rolls in the K\"uppers-Lortz chaotic regime. For the particular case of rotating convection with time-modulated rotation where recently, in experiment, chiral patterns have been observed in otherwise K\"uppers-Lortz-unstable regimes, we show how the underlying base-flow breaks the isotropy, thereby affecting the linear growth-rate of convection rolls in such a way as to stabilize spirals and targets. Throughout we compare analytical results to numerical simulations of the Swift-Hohenberg equation

Square patterns in Rayleigh-Benard convection with rotation about a vertical axis

We present experimental results for Rayleigh-Benard convection with rotation about a vertical axis at dimensionless rotation rates in the range 0 to 250 and upto 20% above the onset. Critical Rayleigh numbers and wavenumbers agree with predictions of linear stability analysis. For rotation rates greater than 70 and close to onset, the patterns are cellular with local four-fold coordination and differ from the theoretically expected Kuppers-Lortz unstable state. Stable as well as intermittent defect-free square lattices exist over certain parameter ranges. Over other ranges defects dynamically disrupt the lattice but cellular flow and local four-fold coordination is maintained.Comment: ReVTeX, 4 pages, 7 eps figures include