Pressure Ulcer Prevention
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QI 3: REPOSITION RESIDENTS WHO NEED IT
We noted it in Step 1, but it bears repeating here: First impressions can be deceptive. And nurse aide reports can be inaccurate. Before you assume that a PU risk resident requires help with two-hour repositioning, check it out.
Conduct a performance assessment to determine whether residents with mobility limitations are in fact incapable of repositioning themselves independently. Our performance assessment, presented on the next page and in our forms section, takes about five minutes per resident to complete.
Sound like extra work? In the long run this assessment will likely save staff time. The reason is that, in the absence of an objective assessment, nursing home staff tend to overestimate the number of residents who are unable to reposition themselves, thus creating more work for themselves. In a recent study, for example, we found that, of 144 residents whom nursing home staff had identified as in need of repositioning, 46 residents--about 32%--could in fact independently reposition themselves (4). And we found similar overestimates in a pair of related studies (6).
Our performance assessment can be used to both target PU risk assessments (see Step 1) and determine who needs routine repositioning. Residents who are capable of independently repositioning themselves are at lower risk of developing PUs.
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