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C.N.A. s .An Important Part of the Team Effect Towards Pressure Ulcer Prevention

Mission of the Team. Maintain skin integrityPrevent breakdownPromote quality of life. Why Does the Team Assess?. Recognize risk factorsCatch skin breakdown earlyPrevent breakdownDevelop Plan of Care. C.N.A. - Frontline Team Member. C.N.A. spends the most time with residentKnows them the bestFirst to observe changes.

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C.N.A. s .An Important Part of the Team Effect Towards Pressure Ulcer Prevention

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    1. C.N.A.’s….An Important Part of the Team Effect Towards Pressure Ulcer Prevention

    2. Mission of the Team Maintain skin integrity Prevent breakdown Promote quality of life

    3. Why Does the Team Assess? Recognize risk factors Catch skin breakdown early Prevent breakdown Develop Plan of Care

    4. C.N.A. - Frontline Team Member C.N.A. spends the most time with resident Knows them the best First to observe changes

    5. Why Observe the Skin? Answer: Wound Care Costs Average Cost of Pressure Ulcer Treatment per Ulcer $5,000 to $60,000

    6. When to Assess the Skin Upon Admission During ADL care During Shower

    7. Who to Report Observations.. Notify Charge Nurse immediately

    8. Can I Wait? Simple skin conditions can turn into severe wounds when left untreated

    9. Lack of Preventative Interventions

    10. Stage 1 to Stage 4

    11. What Causes a Pressure Ulcer? Decreased or shut down of blood flow to tissue Caused by external pressure

    12. Risk Areas

    13. How Can I Prevent or Assist Healing Pressure Ulcers?

    14. Turning / Repositioning

    15. Turning / Repositioning Able to reposition self = should change positions Q 2 hr in bed & Q 15 minutes in chair Unable to reposition self = Q 2hr in bed & Q 1 hour in chair

    16. Helpful Reminders

    17. Use of Pillows for Positioning IMPROPER Not on the hip PROPER Put on the fat pads

    18. Use of Pillows

    19. Special Wedges for Positioning When normal pillows are not working Obese Bariatric

    20. Use Knee Gatch for Positioning Raise knee gatch / foot of bed Prevents resident from sliding down

    21. Does a Mattress Matter? All residents should at least have a pressure reduction mattress No hospital mattresses

    22. Specialty Mattresses Resident with Stage 3 or 4 to trunk of body OR Braden score of 9 or lower needs a pressure relieving mattress Only use one pad on these mattresses

    23. What Does that Static Button Do? Keeps the same cells inflated until the button is turned off Used when giving ADL care When finished, TURN OFF

    24. Pad the Booty When Sitting Any W/C or recliner should have a pressure reduction cushion Utilize wedge cushion or dycem if sliding

    25. The Ears Break Down Too Any person wearing oxygen more than 8 hours is required to have ear pads No padding can lead to breakdown

    26. What about Incontinence? Incontinence increases risk of breakdown

    27. Incontinence Report to the nurse if resident is incontinent Moisture barrier must be used Incontinent briefs Must fit appropriately Must be changed

    28. Foot Assessment    

    29. What to Look For Dry Skin Cracked skin

    30. What to Look For? Thick build up of skin

    31. What to Look For Long toe nails

    32. What to Look For Skin Tears Rashes Etc.

    33. What to look for? Structural changes

    34. What to look for? Structural changes

    35. What to look for? Open areas, small or large

    36. What to Look For Bruising Redness Discolored

    37. What to Do? Lube Them UP! Petroleum ointment Moisturizes

    38. Heels…Biggest Area of Risk Whether in bed or chair, the heel is at risk! OFFLOAD THE HEELS

    39. Stage 1 to Stage 4

    40. What if it is Just Red or Blistered? REPORT IT & OFFLOAD IT Can develop into deeper tissue damage quickly

    41. Can I Wait to Report It? Don’t wait. The smallest can turn into a major wound

    42. Heels must be suspended off the mattress May use pillows Help the Heels!!!!!!!

    43. Improper vs. Proper Improper Way Proper Way

    44. Special Devices for Heels Devices completely offload the heel Must be ON to be effective

    45. Is Nutrition Important?

    46. Ways to Increase Intake Supplements (vitamin, protein, calories) Feeding assistance Adequate fluid intake Dietitian consult In-between meal snacks

    47. What to Report? Mouth pain Poor appetite Not eating the protein or drinking the fluids given Dentures not fitting Clothes fitting lose

    48. Food Consumption Sheets Only as good as the information recorded DO NOT falsify intake Sheets used to determine appropriate intake

    49. What Else Can I Do to Help? Tell nurse immediately ANY of the following: Dressing loose or off Pain observed or reported

    50. Prevention is a Priority ALWAYS BE ALERT TO EVEN THE SMALLEST CHANGE

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