Pressure Ulcer Prevention
::
::
::
::
::
::
::
::
::
::
::
::
|
|
MORE PU RISK RE-ASSESSMENTS NEEDED
Let's start with risk assessment, the first step recommended in the PU prevention practice guidelines not to mention a federal requirement for nearly all nursing homes. Nursing homes are required to conduct a risk assessment for each new resident upon admission to determine whether the person is in danger of developing a PU.
Practice guidelines recommend use of a validated risk assessment tool such as the Norton Scale or the more widely used Braden Scale (5,6). Our research indicates that when nursing homes complete this step, and document the results, at-risk residents are more likely to get the preventive care they need (7). Roughly 60% of nursing homes conduct this entrance risk assessment and document it (7, 8), not a great showing given the importance of this step.
Where they really miss the mark, however, is with the corollary to this initial step. Though not a federal requirement, best practice guidelines call on nursing homes to re-assess at-risk residents, particularly those who are unable to reposition themselves or have limited ability to do so.
"The condition of an individual admitted to a health care facility is not static," notes the guidelines from the Agency for Healthcare Research and Quality (6), "consequently, pressure ulcer risk requires routine re-examination."
PU prevention guidelines from the University of Iowa Gerontological Nursing Interventions Research Center (5) recommend that at-risk nursing home residents be reassessed "every 48 hours for the first week, weekly for one month, then quarterly, or more frequently if (the resident's) condition changes."
(prev | next)
|
|
|
