Nursing practice is the actual provision of nursing care. In providing care, nurses are implementing the nursing care plan which is based on the client’s initial assessment. This is based around a specific nursing theory which will be selected as appropriate for the care setting. In providing nursing care the nurses uses both nursing theory and best practice derived from nursing research. Nursing is practice profession which is depends on a variety of skills which are strongly related to ethical and social aspect in healthcare. There are lists of contemporary issue exist, in an effort to fulfill modern health care system in Malaysia. These contemporary issues provide a challenge in this practice discipline and other health care teams.

Contemporary issues defined as present or current issues which is happening, existing, living or coming into being during the same period of time. Contemporary issue in professional practice is closely related to ethical component of practice also competing ideologies and practice realities.

This assignment will explore contemporary issue on infection control. I’m interested to present about increasing rate of wound infection post total knee replacement (TKR) surgery. TKR or knee arthroplasty is surgical procedures in which the worn, damage surfaces of the knee joint are replaced with metal and high-density plastic. TKR may result in general pain relief, deformity correction and resumption of normal activity. As I’m working in orthopedic ward for the 10 years, wound infection especially post TKR complications commonly affect patients. Wound infection can give a big impact in patient recovery and indirectly public can question the quality of care delivered. Therefore I have decided to discuss about the infection control surveillance and ongoing for patient health care programmed also organization action and strategies undertaken.

In this paper I will critically discuss, how it occur and about how to decrease wound infection of post TKR. This paper also will provide critical knowledge and understanding patient’s needs during hospitalization via reflection upon nurse’s responsibility in health care.


Total knee replacement is a common surgical procedure done routinely around the world on patients with severe arthritis. The surgery has a high rate of success and complications are rare. Most post operative complications are anticipated and prophylactic medications or therapies are administered on a preventative basis. It is a major procedure and recovery will not occur overnight. Post operative care following knee replacement begins immediately and involves basic wound care, a step- wise activity regimen and prevention of complications. TKR is the most devastating and challenging complication for both the surgeon and the patient to face. According to Bengston and Fitzgerald (1991) although surgical techniques and treatment operation have improved the overall risk for deep infection after TKR still remains 1-2 %. In case of infection, it is of great importance to quickly identify the problem and treat it adequately to minimize the risk of complications. A straight forward management algorithm is the only way of dealing with infected implants properly.

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