August 10, 2015

Save the Skin: Preventing Skin Tears and Pressure Ulcers

by Geri Fantasia, LPN, Nurse Manager at the Chelsea Jewish Nursing Home
As people age, their skin becomes thinner and much more frail. The key to preventing skin tears and pressure ulcers in elders is to assess the individuals by trained professionals on a consistent basis. Here at the Chelsea Jewish Nursing Home, we use the Norton assessment tool to determine which of our residents are at risk. Upon admission, we perform a total body skin assessment on every resident, and perform weekly checks thereafter until discharge. Thorough communication and documentation is essential to this process.
There are several ways to protect the skin from tears and pressure ulcers. Barrier cream is used on the skin for added protection, while non-ambulatory residents wear foot and heel protectors, which provide an extra safeguard for the skin. Those residents in wheelchairs use cushions to relieve pressure points and low air loss mattresses are also ordered for high risk residents. Positioning devices are a great tool to put in place and residents are repositioned every two hours. Frequent in-servicing, thorough documentation and weekly assessments also help prevent ulcers. Our Certified Nursing Assistants are well trained and knowledgeable in the assessment process, and any changes or increased redness and swelling of the skin are immediately reported to the nursing staff.
If a pressure area does occur, it is essential for a nurse to complete a weekly pressure ulcer assessment. This requires weekly measurements and the adoption of a regimented treatment plan that is overseen by a Physician. The resident’s diet will often be adapted according to the recommendations of the Dietician, in order to allow the consumption of additional protein supplements that aid in wound healing. As an added precaution, blood work may also be recommended for the individual.
Saving the skin is an essential part of good nursing care and overall body health. It takes a great team effort to protect our residents. At the Chelsea Jewish Nursing Home, we pride ourselves on our nursing staff’s expertise, knowledge and compassion. Please feel free to speak with us if you or a loved one has questions about skin tears and pressure ulcers. Assessment is the first and most important step in maintaining the skin.