Following the Evidence

The registered nurse is making a home care visit to a patient recovering from a deep partial thickness burn of the left hand, forearm, and left side of the chest. The RN assesses the wound and asks the patient and family member who assists the patient to describe how wound care is performed. The RN learns that honey has been used instead of the topical antibiotic, silver sulfadiazine (Silvadene), because it is hard for them to clean the wound after the Silvadene is used and the process is very painful. When the nurse asks the patient to rate the pain on a 0-10 verbal pain scale the patient responds “It is an 8. I had so much pain when I was in the hospital I keep having nightmares.” Discuss appropriate nursing interventions based on this scenario. Would the RN support the continued use of honey or would the RN emphasize the need to only use the Silvadene, which was ordered by the health care provider, for wound care? What else would the nurse consider? What evidence would support the RN's decision? The following articles may provide information to help you create an evidence-based response to this issue. -Belcher, J. (2012). A review of medical-grade honey in wound care. British Journal of Nursing, 21(15), S4-S9. -Connor-Ballard, P.A. (2009). Understanding and managing burn pain: Part 1. American Journal of Nursing, 109(4), 48-56. -Connor-Ballard, P.A. (2009). Understanding and managing burn pain: Part 2. American Journal of Nursing, 109(5), 48-56.