ROLE OF NUTRITION IN WOUND HEALING
The relationship between wound healing and nutrition has been documented for many years. Nutrient deficiencies and malnutrition can severely impact the outcome of treating surgical and traumatic wounds (Rabess, 2015). The failure of treating the wound appropriately that may be reflected in wound infection or delayed healing does result into an additional financial burden that has to be planned for in the world’s healthcare systems. Indeed, the crucial role that nutrition plays in the healing process of wounds has been acknowledged since the beginning of medicine as a separate discipline (Gandy, 2014). Without following the recommended nutrition, it is possible that the healing process will be unsuccessful or take longer time than it would normally be required. Improving the nutritional status enables the body to heal wounds more effectively as seen in the accelerated wound healing that comes with nutritional supplementation.

The process of wound reparation is complex because it involves the replacement of injured tissues with the new ones that the body produces and this demands increased energy consumption as well as specific nutrients, especially calories and proteins (Ellen, 2012). Whenever the body is able to sustain wounds, there is the release of stress hormones to prepare the individual to either run away or fight back the metabolism of the body changes so as to ensure the needed nutrients are available at the areas that have suffered injuries. The body will experience the increased rate of metabolism, loss of total body water, as well as increased cellular and collagen turnover (Gandy, 2014). The effects can be significant even when there is a small wound since it can cause various changes in the body that can affect the speed and success of the process of healing. The alterations may include the changes in protein, energy, carbohydrate, vitamin, and fat levels, as well as mineral metabolism shifts.

Protein-energy malnourishment is always the worst form of malnutrition, especially in the case when protein and energy amount is not adequate enough. Protein-energy malnutrition is reported to cause the breakdown of protein energy resulting in the reduction of the quanity of amino-acids being supplied. Importantly, amino acids are crucial in the maintenance of body proteins as well as healing, thus resulting into lean-body-mass loss. In that regard, protein-energy malnutrition may have a direct link to wounds that are not healing. Therefore, protein-energy malnutrition can be defined as a low Body Mass Index or unintentional weight loss that is characterized by the loss of subcutaneous fat or muscle wasting.

Protein is useful in the maintenance and repair of body tissues. As a consequence, depleted protein levels cause a decrease in the development of collagen, slowing the process of wound healing (Rabess, 2015). On the other hand, adequate protein levels are helpful in the activation of optimal wound healing rates. It is important to calculate protein requirements for any given individual and these should be monitored very closely. The monitoring, as well as calculation, has to take place in the process of energy provision because failure to meet energy needs results in the body using protein for energy rather than for healing the wound (Rabess, 2015).

An amino acid such as L-arginine has properties that improve a number of pathways that assist in wound healing. For instance, its role in the synthesis of protein is immense. Because the body requires more protein when a wound is healing, the demand for non-essential amino acids such as L-arginine increases (Rabess, 2015). Dietary supplementation with arginine enhances protein metabolism, decreases muscle loss and collagen synthesis, resulting in the increased strength of wound. Besides, L-arginine remains vital for the stimulation of the nitric acid pathway that is beneficial in collagen deposition in the process of wound reparation. Moreover, L-arginine supplementation is capable of boosting one’s immunity and improving insulin secretion, as well as other growth hormones that facilitate the healing process.

Carbohydrates and fats are the main sources of energy for the human body as well as for healing wounds. Collagen synthesis remains the major demand for energy from the part of a vulnerable area. Nonetheless, caloric needs for healing will decrease based on the increasing size as well as complexity of the wound (Ellen, 2012). Fats, particularly monounsaturated and polyunsaturated ones, often provide fuel for reparatory processes as well. Specifically, fats are considered concentrated and safe sources of energy. They are required to prevent the body from using protein for energy. Fatty acids form a major component of cell membranes and the demands for essential fatty acids often increase after injury. The other nutrients that are vital for wound healing include antioxidants, such as vitamins C, A, and E, and minerals, such as zinc and iron (Molnar, Underdown, & William, 2014).

Significance of the Research

The current study is significant because it will help in highlighting nutritional screening by registered nurses and its importance in the process of wound healing. Notably, the study will examine how nutritional screening ought to have its implementation done in healthcare settings, especially within communities with undernourished patients but whose identification is not easy. This has remained among the greatest challenges to the achievement the goal of sustaining a healthy population in the United States. It is noteworthy that malnourishment often affects both the obese and the underweight groups. Nutrition screening tools are helpful in identifying the people who would not be easy to notice and whose failure to observe nutritional requirements may further lead to complications such as infections, dehydration, mineral and vitamin deficiencies which hinder wound healing.

Problem Statement

Lack of nutritional screening by nurses is a serious problem when it comes to public health in any healthcare setting and which complicates the process of wound reparation among various categories of patients in South Florida.

Malnutrition does impair the healing process of wounds and therefore, it is vital that high-risk patients are singled out early enough using appropriate nutritional screening tools identified through evidence accumulated over time. It is necessary to refer patients to a registered nurse or a dietitian to have his/her nutritional health assessed and appropriate treatment plan developed. It should be noted that life quality, especially among chronically wounded patients whose injuries do not seem to heal, is typically rather low and they cannot afford the appropriate quality nutrition to facilitate the reparatory processes of the organism. Therefore, a patient-centered approach should be followed at all times so as to achieve the required outcome. Improving the status of the nutritional needs of patients as well as providing improved diet to eliminate the risks resulting from malnutrition has the potential of preventing further deterioration.

Research Question

Has nutritional screening by nurses been a helpful strategy in enhancing wound healing among patients visiting South Florida hospitals?

Research Purpose

The study aims at determining if nutritional screening that is conducted by nurses in South Florida hospitals has been contributing to improved wound healing among patients. There has been the problem of nurses in some clinics failing to conduct nutritional screening for patients presenting with wounds. This may have been a major contributor to the emergence of some of the chronic wounds that have been observed in health care settings. By emphasizing the need for nutritional screening in wound management and healing nurses will acknowledge the urgent necessity to incorporate the process into a daily practice.

Research Hypothesis

Nutritional screening accelerates and facilitates the process of wound healing.

Null Hypothesis

There no association between nutritional screening and the rate of wound healing.

Operationalizing Research Variables

The research has independent, dependent, and intervening variables. The independent variable is the adequate nutrition determined by screening for the necessary carbohydrates, vitamins, proteins, fats, and minerals. The dependent variable is the wound healing process itself. The intervening variables are represented by the absence of infections, mineral and vitamin deficiencies, the presence of the required amino acids in nutrition, as well as proper hydration. Both the intervening and independent variable are the essential influential factors for effectiveness and the successful outcome of the dependent variable.
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References

Ellen, P. M. (2012). The role of nutrition in wound care. Advances in Skin & Wound Care, 25(2), 62-63.

Gandy, J. (2014). Manual of dietetic practice (5th Ed.). Oxford: Wiley Blackwell.

Molnar, J. A., Underdown, M.J., & William, A. (2014). Nutrition and chronic wounds. Advances in Wound Care, 3(11), 663-681.

Rabess, C. (2015). Understanding the link between wound care and nutrition. Journal of Community Nursing, 29(4), 60-65.