2. BRUNNER & SUDDARTHS TEXTBOOK OF Medical-Surgical Nursing(14th ed.). Youll notice signs that your cellulitis infection is healing a few days after starting antibiotics. Procedure Management Guideline. Please go to the home page and simply click on the edition that you wish to read. leading causes of increased morbidity and extended hospital stays. Read theprivacy policyandterms and conditions. The affected skin is usually inflamed and swollen and is warm and painful even to the touch. Cleaning and trimming your fingernails and toenails. https://digital.nhs.uk/catalogue/PUB19124 [Accessed 9 April 2017]. Cellulitis is a frequently encountered condition, but remains a challenging clinical entity. I will assess all lab work. There are many online courses available that offer MHF4U as a part of their curriculum. 1 Between 13.9% and 17% 1-3 of patients seen in the ED with cellulitis are admitted, accounting for 10% of all infectious disease-related US hospitalizations. Thirty day mortality and undertreatment increased with the class of disease severity, from 1% mortality and 14% undertreatment in the class I severity group to 33% mortality and 92% undertreatment in the class IV severity group. 1 Cellulitis presents as a painful, in nursing and other medical fields. MHF4U is a grade 12 mathematics course in Ontario, Canada, and it covers advanced functions. The number needed to treat (NNT) was five (95% CI 49).27. In cases of skin breaks, keep the area clean, use over-the-counter antibiotic creams, and watch out for signs of infection. Approximately 33% of all people who have cellulitis get it again. Nursing Interventions For Risk of infection. Inflammation (0-4 days): neutrophils and macrophages work to remove debris and prevent infection. No, cellulitis doesnt itch. Pat dry the area gently with a piece of clean cloth. WebAnyone can get cellulitis, but the risk is higher if you have a skin wound that allows bacteria to enter your body easily or a weakened immune system. Wound management follow up should be arranged with families prior to discharge (e.g. To assess the efficacy and safety of interventions for non-surgically-acquired cellulitis. As the infection worsens, pus and abscess starts to form, Blood infections as pathogens enter the bloodstream and affect adjacent tissues, Bone infections occur when the infection penetrates the layers of the skin to reach the bone, Gangrene is the worst-case consequence due to lack of oxygen in body tissues. WebThe one-size-fits-all approach of sepsis treatment (cultures, antibiotics, fluid resuscitation and vasopressors) may be replaced by a tailored approach taking into consideration the patients host response, microbiome and the epigenetic changes related to the invasive organism. Bacterial Infections. healing. Use warm water and mild soap, The infected areas must remain clean at all times to promote healing, Encourage patient to stop itching affected skin areas, To avoid worsening the skin inflammation even further, Educate the patient on appropriate hand hygiene and cut their fingernails if they are long, Long fingernails harbor bacteria which are a risk for infections, Use skin indicators to mark the affected skin areas and check for reduction or spread of infection, To determine the effectiveness of interventions particularly the antibiotic energy and if there is need to change, Educate the patient on signs of a deteriorating infection. However, it can occur in any part of your body. Medical-Surgical Nursing Patient-Centered Collaborative Care(8th ed.). Regularly showering and thoroughly drying your skin after. RCP members and fellows (using their login details for the main RCP website) are able toaccess the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:https://cme.rcplondon.ac.uk, Copyright 2021 by the Royal College of Physicians, DOI: https://doi.org/10.7861/clinmedicine.18-2-160, Sign In to Email Alerts with your Email Address, Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic oedema: a randomised controlled trial protocol, NHS Digital. The patient must finish the dose even if the symptoms heal, Educate the patient on appropriate skin sanitation. At NURSING.com, we believe Black Lives Matter , No Human Is Illegal , Love Is Love , Women`s Rights Are Human Rights , Science Is Real , Water Is Life , Injustice Anywhere Is A Threat To Justice Everywhere . Assessing pain before, during, and after the dressing change may provide vital information for further wound management and dressing selection. Assess the patient's skin on the whole body to identify the affected skin areas, To determine the severity of cellulitis and any affected areas that need special consideration during wound care, Administer antibiotics as recommended and ensure the patient completes the course of antibiotics approved by the physician. I present the illustration to differentiate between normal skin and skin affected by cellulitis. I recommend the following nursing interventions in the tables below to reduce the risk of cellulitis. 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way, standard aseptic technique or surgical aseptic technique, RCH Procedure Skin and surgical antisepsis, Parkville EMR | Nursing Documenting Wound Assessments (phs.org.au), Clinical Images- Photography Videography Audio Recordings policy, Pain Assessment and Management Nursing Guideline, Procedural Pain Management Nursing Guideline, Infection Control RCH Policies and Procedures, Pressure injury prevention and management, evidence table for this guideline can be viewed here, The goal of wound management: to stop bleeding, The goal of wound management: to clean debris and prevent infection, The goal of wound management: to promote tissue growth and protect the wound, The goal of wound management: to protect new epithelial tissue, Cellulitis: redness, swelling, pain or infection, Macerated: soft, broken skin caused by increased moisture, Wound management practices and moisture balance (e.g. Jones & Bartlett Learning. This plan aims to lower blood pressure levels and reduce the risk of illness or injury from high blood pressure-related events such as stroke or heart attack. WebNursing Interventions for Nausea Provide routine oral care at least every four hours and as needed. Two authors independently assessed trial quality and extracted data. Perform hand hygiene and change gloves if required, 14. top grade for all the nursing papers you entrust us with. We selected randomised controlled trials comparing two or more different interventions for cellulitis. Nursing Interventions for Cellulitis: Rationale: Assess the patients skin on his/her whole body. Updated February 2023. Patients with mild to moderate cellulitis should be treated with an agent active against streptococci. Getting medical attention right away for any deep cuts or puncture wounds. 1 As a result, the affected skin usually has a pinkish hue with a less defined border, Blog Bacterial Diseases. This nursing care plan we are developing will increase the patients knowledge of preventive measures, treatment plans, and nursing interventions that will help alleviate the cellulitis infection and relieve pain. Cellulitis causes swelling and pain. Clean any wounds with water and antibacterial soap and cover them with a clean bandage to reduce your risk of infection. We will also document an accurate record of all aspects of patient monitoring. Skin breaks, lymphedema, venous insufficiency, tinea pedis and obesity have been associated with an increased risk of lower limb cellulitis in case control studies.911, Assessment of baseline liver and renal function may be useful for assessing end-organ dysfunction in patients with sepsis and for dosing of antimicrobials. The PEI Preserve Company is a Canadian specialty food manufacturer based in Prince Edward Island, Canada. This will ensure the healthcare teams have the information to deliver safe and effective patient care for cellulitis infections. We will also document an accurate record of all aspects of patient monitoring. Policy. Poorly managed wounds are one of the We found only small single studies for duration of antibiotic treatment, intramuscular versus intravenous route, the addition of corticosteroid to antibiotic treatment compared with antibiotic alone, and vibration therapy, so there was insufficient evidence to form conclusions. WebWound care: This is an important part of treating cellulitis. There is a need for trials to evaluate the efficacy of oral antibiotics against intravenous antibiotics in the community setting as there are service implications for cost and comfort. In most cases, your healthcare provider wont conduct any tests. Most cases of uncomplicated cellulitis are traditionally treated with 12weeks of antimicrobial therapy.15However, evidence now exists to suggest that such prolonged courses may be unnecessary, and that 5days treatment may be sufficient in cases of uncomplicated cellulitis.26 Provided there are no concerns about absorption and there has been some clinical improvement, most patients with uncomplicated SSTIs can be safely switched to oral antibiotics after 14days of parenteral therapy.15,16 The CREST guidance suggests settling pyrexia, stable comorbidities, less intense erythema and falling inflammatory markers as criteria for an oral switch.16 Any predisposing factors (eg tinea pedis, lymphoedema etc) should be addressed to reduce the risk of recurrent cellulitis. It can cause warmth, inflammation and swelling of the affected area. Samples should be sent for bacterial culture and consideration given to systemic antibiotics in patients with systemic signs of infection.12, Non-purulent skin and soft tissue infections generally require treatment with systemic antimicrobials. Just to let you know, signs and symptoms do not show a risk diagnosis as the problem has not occurred. If you are still unable to access the content you require, please let us know through the 'Contact us' page. What is cellulititis?.2, Clinical manifestations/signs of cellulitis 3, Risk factors for cellulitis ..5, Complications of cellulitis.6, Nursing assessment/ Diagnosis .7, Nursing outcomes and goals8, Nursing interventions.8, Nursing care plan for cellulitis 1(Impaired skin integrity)..9, Nursing care plan for cellulitis 2(Risk of infection)11, Nursing care plan for cellulitis 3 (ineffective tissue perfusion, Nursing care plan for cellulitis 4(Acute pain), Nursing care plan for cellulitis 5(Disturbed body image). Untreated cellulitis can lead to life-threatening conditions such as sepsis and gangrene. For complex wounds any new need for debridement must be discussed with the treating medical team. I will assess and monitor closely for signs of deteriorating infection. Cellulitis is an infection that occurs when bacteria enter the skin, causing a dented appearance attributed to fatty deposits. I recommend the following nursing interventions in the table below to reduce the risk of impaired skin integrity linked to infection of the skin ancillary to cellulitis, as shown by erythema, warmness, and swelling of the infected leg. Dressings that have direct contact with the wound and have the ability to change the wound (e.g. Oral care may make the patient feel more comfortable. Intravenous third-class penicillin is also administered for severe cellulitis. In 3 trials involving 419 people, 2 of these studies used oral macrolide against intravenous (iv) penicillin demonstrating that oral therapies can be more effective than iv therapies (RR 0.85, 95% CI 0.73 to 0.98). That Time I Dropped Out of Nursing School, 5 Steps to Writing a (kick ass) Nursing Care Plan, Dear Other Guys, Stop Scamming Nursing Students, The S.O.C.K. The community nurse may be involved in dressing leg ulcers and may refer a patient with The affected skin is usually inflamed and swollen and is warm and painful even to the touch. Carpenito, L. J. It most commonly affects the lower part of your body, including your legs, feet and toes. No single treatment was clearly superior. To prevent cellulitis in the futureTry to prevent cuts, scrapes, or other injuries to your skin. If you get a scrape, cut, mild burn, or bite, wash the wound with clean water as soon as you can to help avoid infection. If you have swelling in your legs (edema), support stockings and good skin care may help prevent leg sores and cellulitis.More items Having the knowledge, skills and resources to assess a wound will result in positive outcomes, regardless of product accessibility. Royal College of Physicians 2018. Many different bacteria can cause cellulitis. This nursing care plan will provide the nursing care team with sufficiently treating impaired skin integrity related to cellulitis, ensuring the patient's well-being. (https://www.ncbi.nlm.nih.gov/books/NBK303987/), Visitation, mask requirements and COVID-19 information, You have a long-lasting (chronic) skin condition such as. Apply the paste on the affected area of the skin to cover the infected site. For example, use odor-eliminating spray, and avoid strong scents such as perfume. It may feel slightly warm to the touch. Herdman, T., Kamitsuru, S. & Lopes, C. (2021). Cellulitis is a bacterial subcutaneous skin infection. Daily review and early switch to oral therapies is optimal, In patients with recurrent episodes of cellulitis, risk factors should be addressed and consideration given to prophylaxis. impaired skin integrity linked to infection of the skin ancillary to cellulitis, as shown by erythema, warmness, and swelling of the infected leg. In addition, it may also affect areas around the eyes. The bacteria could spread to your bloodstream (bacteremia) or heart (endocarditis), which may be fatal. Human or animal bites and wounds on underwater surfaces can also cause cellulitis, . treatment and management plans are documented clearly and comprehensively. They produce a variety of products such as jams, jellies, marmalades, sauces, condiments, teas, and other gourmet foods. Nursing interventions are centered on an antibiotic regimen while practicing proper wound care to prevent complications. For how long and at what times of the day should I take my medication? Diverticulitis Pathophysiology for nursing students and nursing school, 20 NANDA nursing diagnosis for Chronic Kidney Disease (CKD), 5 Stages of Bone Healing Process |Fracture classification |5 Ps, 19 NANDA Nursing Diagnosis for Fracture |Nursing Priorities & Management, 25 NANDA Nursing Diagnosis for Breast Cancer, 9 NANDA nursing diagnosis for Cellulitis |Management |Patho |Pt education, Trauma, surgical incision, thermal injury, insect bites. See RCH Human or animal bites and wounds on underwater surfaces can also cause cellulitis. Dispose of single-use equipment into waste bag and clean work surface, a. Single-use equipment: dispose after contact with the wound, body or bodily fluids (not into aseptic field), b. Multiple-use equipment: requires cleaning, disinfection and or sterilisation after contact with the wound, body or bodily fluids. Exposure of a skin break to salt or fresh water is associated with Vibrio vulnificus and Aeromonas spp respectively.2, Group A streptococci can be associated with the development of necrotising fasciitis, although this can also be due to mixed infection including Gram-negative and anaerobic organisms, particularly in the elderly and immunosuppressed.2. WebCellulitis is a common bacterial skin infection that leads to 2.3 million emergency department (ED) visits annually in the United States. Remove dressings, discard, and perform hand hygiene, 8. Technique. Copyright 2023 The Cochrane Collaboration. There was no significant difference in antimicrobial therapy or treatment outcomes between class I and II severity patients, suggesting that these two groups could be merged, further simplifying the classification. Cellulitis usually affects the arms and legs. Are there any hygiene requirements for the patient to attend pre procedure (eg shower/bath for pilonidal sinus wounds)? Nausea is associated with increased salivation and vomiting. There is currently no login required to access the journals. Assess for pain, noting quality, characteristics, location, swelling, redness, increased body temperature. Institute for Quality and Efficiency in Health Care. Severe cellulitis is a medical emergency, and treatment must be sought promptly. See Macrolides are used for patients with an allergic reaction to penicillin Fluoroquinolones are approved for gram-harmful bacteria to prevent resistance to severe cellulitis. Apply corticosteroids over the affected skin twice a day for two weeks, To prevent further damage to the skin as they reduce inflammation, Do not use occlusive dressing over the affected site, Occlusive dressing absorbs the corticosteroid cream and ointment making treatment ineffective, Prepare the patient for surgery as indicated. Is all the appropriate equipment available or does this need to be sourced from a different area? Effective wound management requires a collaborative approach between the nursing team and treating medical team. However, Streptococcus (strep) and Staphylococcus (staph) cause most cases of cellulitis. Wound or tissue cultures are negative in up to 70% cases,3 with S aureus, group A streptococci and group G streptococci being the most common isolates from wound cultures.4 Serological studies suggest group A streptococcal infection is an important cause of culture negative cellulitis.5 Skin infection with pus is strongly associated with S aureus.6, Animal bites can be associated with cellulitis due to Gram-negatives such as Pasteurella and Capnocytophaga. If the WBC and CRP continue increasing, it indicates a worsening infection. Assess the surrounding skin (peri wound) for the following: Pain is an essential indicator of poor wound healing and should not be underestimated. If you notice symptoms of cellulitis, talk to your healthcare provider right away. It is important to select a dressing that is suitable for the wound, goals of wound management, the patient and the environment. Perform hand hygiene, use gloves where appropriate, 7. Poorly controlled diabetes may also contribute to repeat instances of cellulitis. No two trials examined the same drugs, therefore we grouped similar types of drugs together. 3. A range of antibiotic treatments are suggested in guidelines. Even if healing is apparent. Can the dressings be removed by the patient at home or prior to starting the procedure? is an expectation that all aspects of wound care, including assessment, Which OTC pain relievers do you recommend? A cellulitis infection may cause flu-like symptoms, including a fever higher than 100 degrees Fahrenheit (38 degrees Celsius), chills, sweats, body aches and fatigue. This nursing care plan is grounded on evidence-based practices as it accurately records prevailing subjective and objective data while identifying any possible needs and risks involved. To sum up, you now know 9 NANDA-I nursing diagnosis for Cellulitis that you can use in your nursing care plans.Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-banner-1','ezslot_13',640,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-banner-1-0'); Additionally, you have also learned about nursing management and patient teaching for cellulitis. Patients sensitive to penicillin are prescribed.IV Lincosomides and IV glycopeptides. I will evaluate any ultrasound, CT scans, and MRI results to detect abscesses, The patient should show opportune healing of wounds without any problems, Patient should be able to preserve ideal diet and physical well being, Person should partake in prevention measures and treatment programs, Patient should articulate feelings of increased self-esteem. Unlike many contagious bacterial infections, we must note thatcellulitis is not infectious and cannot be spread from person to person. Monitor pain closely and report promptly increases in severity. Stop using when wound is granulating or epithelising. * Dressings not available on ward imprest/more extensive dressing supplies can be sourced in hours from The program will also give information on managing any complications that may arise. Assess the The SEWS is a standardised form of early warning score, calculated from the patient's routine clinical observations, with a threshold score of 4 selected to indicate the most severely unwell patients (class IV) in whom a clinical review was mandated at the site where the study was undertaken. Cellulitis. Assess the skin. Elsevier. We know the importance of nursing assessment in identifying factors that may increase the risk of infection. Standard or surgical aseptic technique is used as per the RCH Procedure Aseptic Scissors should be cleaned with an alcohol or disinfectant wipe before and after use. Normal skin can be affected by cellulitis after an injury that causes the skin to break, such as shock and surgical procedures. WebPediculosis Capitis (Head Lice) NCLEX Review and Nursing Care Plans Pediculosis capitis, commonly known as head lice, is a common contagious infection due to human head lice. Your health care provider will likely be able to diagnose cellulitis by looking at your skin. Patients with three to four episodes of cellulitis per year despite addressing predisposing factors could be considered for prophylactic antimicrobial therapy so long as those factors persist.12 A randomised controlled trial of phenoxymethylpenicillin prophylaxis in patients with a history of recurrent cellulitis showed a reduced rate of recurrence in the treatment group (hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.350.86, p=0.001). I summarize the clinical manifestations of cellulitis in the following table. -Provides protection for moderate exudate, -Can adhere to the wound bed and cause trauma on removal (consider the use of an atraumatic dressing), -Permeable dressing but can be washed and dried, -Conforms to the body and controls oedema, -Can be used as a primary dressing or secondary dressing as well, Elastic conforming gauze bandage (handiband), -Provides extra padding, protection and securement of dressings. A new approach to the National Outcomes Registry. It is important to note that these bacteria naturally occur on the skin and mucous tissues of the mouth and nose in healthy people. Open wound site, drainage of pus and lesions. Encourage and assist patient to assume a position of comfort. The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. See. Cellulitis is an infection of the skin and connected soft tissues. Surprisingly, oral antibiotics appeared to be more effective than antibiotics given into a vein for moderate and severe cellulitis. Thieme. Method for Mastering Nursing Pharmacology, 39 Things Every Nursing Student Needs Before Starting School. Accurate assessment of pain is essential when selecting dressings to prevent unnecessary pain, fear and anxiety associated with dressing changes. If While the British Society for Antimicrobial Chemotherapy (BSAC) expert panel recommendations and UK Clinical Resource Efficiency Support Team (CREST) guidelines recommend use of the Eron classification of cellulitis in order to grade severity,15,16 the lack of a clear definition of systemic sepsis and ambiguous and potentially overlapping categories have hampered its use in clinical practice. Approved by the Clinical Effectiveness Committee. Other severity and prognostic scoring systems for skin and soft tissue infections have been proposed but have yet to be validated.18 National Institute for Health and Care Excellence (NICE) moderate- and high-risk criteria (Box3 shows the high-risk criteria) may help clinicians rapidly identify patients with sepsis due to cellulitis who require urgent admission and assessment.19, Patients with purulent skin and soft tissue infections such as abscesses, furuncles or carbuncles should have those collections incised and drained. If there is a history of surgical procedures, it is most likely the policies may have resulted in wound infection, I will analyze results from blood and skin tests to confirm the type of bacteria that is present, I will analyze bacteria culture results to know the type of bacteria as this will guide treatment in knowing the most effective antibiotic against the bacteria identified, I will physically assess the patient for open wounds, cuts, or any other injuries and evaluate the skin for redness, swelling, blisters, and other physical signs of cellulitis. Place Your Order to Get Custom-Written Paper. Nursing Interventions for the Risk of Impaired skin integrity linked to cellulitis. Cellulitis is a bacterial infection that causes inflammation of the dermal and subcutaneous layers of the skin. 1. Antibiotics are needed for Cellulitis nursing management and patient teaching are all included. I must conduct nursing assessments with the knowledge of the several risk factors which make the individual more susceptible to other infections, such as chronic illnesses and compromised immune systems. The symptoms include severe pain, swelling, and inflammation, often accompanied by fever, rigours, nausea, and feeling generally unwell. Treatment success rates are almost 90%.25. Infections of the Skin, Muscles, and Soft Tissues. Patients with a history of cellulitis, particularly of the lower limbs, have an estimated recurrence rate of 820%.12 Patients with recurrent cellulitis should be carefully evaluated for any predisposing factors such as lower limb oedema, lymphoedema, dermatitis, tinea pedis, and measures taken to address them. WebNursing Care Plans for Cellulitis Impaired Skin Integrity r/t to compromised defense mechanism of the skin Expected Outcome: The patient will attain intact skin integrity with Treatment includes antibiotics. How it works cavities. Three studies with a total of 88 people comparing a penicillin with a cephalosporin showed no difference in treatment effect (RR 0.99, 95% CI 0.68 to 1.43). This nursing care plan will provide the nursing care team with sufficiently treating impaired skin integrity related to cellulitis, ensuring the patient's well-being. Of the misdiagnosed patients, 85% did not require hospital admission and 92% received unnecessary antibiotics. All rights reserved. Erysipelas and cellulitis: Can antibiotics prevent cellulitis from coming back? In 20145, cellulitis was listed as a primary diagnosis for 114,190 completed consultant episodes in secondary care and 75,838 inpatient admissions with a median length of stay of 3days with a mean patient age of 63. Oral antibiotics may include dicloxacillin or cephalexin. Pain assessment and measurement guideline. The nursing care plan also assists the nursing care team in developing appropriate interventions to mitigatedifficulties of impaired skin integrity linked to cellulitis. Excess exudate leads to maceration and degradation of skin, while too little moisture can result in the wound bed drying out. It is produced by all wounds to: The overall goal of exudate is to effectively donate moisture and contain it within the wound bed. Avail bestphysics assignmenthelp, andphysics homeworkhelp from nursinghelpexperts.com and boost your grades. Sample nursing care plan for hyperthermia. Cellulitis is a bacterial infection of your skin and the tissues beneath your skin. Monitoring and Managing Complications Cellulitis is defined as a localized, bacterial-inflicted inflammation of the skin and subcutaneous tissue that spreads past the site of injury.if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[468,60],'nurseship_com-large-mobile-banner-1','ezslot_4',646,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0'); Initially, the causative organism enters the body through breaks of skin (such as cuts, insect bites, incisions, etc). Transmission based precautions. Some of the online platforms that offer MHF4U Canadore College in Canada offers a program in Supply Chain Management. The following are the patient goals and anticipated outcomes for patients with Cellulitis. Cleveland Clinic is a non-profit academic medical center. Desired Nursing outcomes and goals for risk of infection related to cellulitis. Hinkle, J., & Cheever, K. (2018). Should only be used for 2-3 weeks, -Moisture management for moderate- high exudate, -Absorbs fluid to form a gel (can be mistaken for slough), -To fill irregular shaped wounds e.g. I have listed the following factors that predispose individuals to cellulitis. Cellulitis | Nursing Times. Cellulitis spreads beyond the invasion site, affecting dermal and subcutaneous tissues. Individuals can protect themselves from cellulitis. Clean and assess the wound (wound and peri wound should be cleaned separately if washing the patient), 9. If you have cellulitis on your hands or feet, it may be challenging to close your hands or walk. The inflammatory response then occurs, exhibiting the hallmark characteristics of cellulitis (i.e., redness, pain, hot skin, and swelling). It also commonly appears on your face, arms, hands and fingers. Your cellulitis infection spreads to surrounding areas of your body. In most cases, you should feel better within seven to 10 days after you start taking antibiotics. NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). Nursing Care Plan and Diagnosis for Cellulitis Ineffective Referrals to the Stomal Therapy, Plastic Surgery, Specialist Clinics or Allied Health teams (via an EMR referral order) may also be necessary for appropriate management and dressing selection, to optimise wound
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