Wound Prevention

MANAGE MOISTURE                                                                                                      
1.   Incontinence-:   initiate bowel and bladder assessment and training program            
2.   Clean and dry skin after each incontinent episode
    a)   Avoid hot water.
    b)   Use a akin cleanser that loosen soil without agressive scrubbing.
3.   Use incontinence skin barriers cream.
4.   Use incontinent products i.e. indwellong catheters(2-4 weeks only)
    external catheters, briefsm rectal bag/puch, flexi-seal fecal management
    system.
5.   Consider"open system" or no closed diapers while patient in bed or at night.

MANAGE FRICTION AND SHEAR
1.   Elevate HOB no more tthan 30 degrees.
    pts on tube feedings must have HOB at 30 degress.
2.   Use trapeze when indicated.
3.   Use lift sheet to move patien. Avoid dragging the pt.
4.   Use positioning devicesi.e.   Pillows or foam wedges to maintain position.
5.   Protect elbows and heels.


MANAGE NUTRITION
1.   Maintain adequate nutrition that is compatible with patients
    wishes or condition to maximize the potential for healing.
2.   For liquid sttools- assessment of bulk in diet, dietary changes, tube feeding
    formulas, c-difficile management.
3.   Increase protein intake,increase calorie intake to sapare protein,
    supplement with multi-vitamins(vit A,C &E)
4.   Consult dietitian if patient is not eating well or albumin is <3.5 gm/dl or unintentional
    weight loss more than 5% in previous month.


OTHER GENERAL ISSUES
1.   No massage to reddened bony prominences.
2.   No do-nut devisces.
3.   Maintain good hydation.
4.   Avoid drying the skin.
5.   Remove sequential compression device at least once per shift.
6.   Change position q 1 hour if patient in chair or if patient can move
    change postion q 15 mins.

 
 


[continues]

Read full essay