PART TWO | In Part One, we examined why the blame game is often the first step around pressure injuries. Today, we’ll look at some potential solutions that can help address this serious challenge.
All of us are united in our fight against pressure injuries - after all, they’re not just a massive health risk for patients, they’re also a major risk factor for institutions. Here are a few best practices we can all engage with that will help address the issue.
1. Learn some history
A patient’s history can be the most important tool in predicting, preventing, or spotting pressure injuries before they become problematic. If wounds already exist, make sure to ask about:
Chronicity: How long has the patient had the wound?
Current treatment orders: What’s ordered now, and what has been previously ordered or attempted? How successful or unsuccessful was it?
Other healed wounds: Has the patient had any history of other wounds? How and when did they heal?
A good history also covers the entire health history as well as asks explicitly about risk factors for wounds (like advanced age, and diabetes).
2. Keep an eye out for medications that affect wounds
While of course a thorough review of medication history would normally be done as part of a patient’s intake, it’s worth also listing additional medical problems or treatments a patient may be experiencing. Specifically, some medications - like steroids - can inhibit wound healing, and thus may contribute to the formation of wounds. Knowing what medications a patient is taking and how those medications may impact wound formation, healing, or prevention, is key.
3. Check the labs
Your patient may or may not have labs, and often, labs aren’t checked for patients with wounds, but they can tell us a great deal about a patient’s ability to heal. Here are a few key indicators to watch:
Albumin: indicator of whether or not someone is getting enough protein (essential for wound healing) over a period of months
Pre-albumin: indicator of adequacy of protein intake over days to weeks
C Reactive Protein: indicator of inflammation, may cause abnormal nutritional labs for pre-albumin and albumin
Wound tissue cultures: any previous wound cultures that were taken should be verified as actual tissue biopsies and not just swaps, because it is criticial to note pathogen growth in order to determine if appropriate antibiotics with sensitivities are ordered
And remember: healing wounds is a team effort, so make sure that above all else, you are practicing good communication with all members of the team. Only together will we manage and prevent pressure injuries!
Skilled Wound Care is a mobile surgical practice committed to transforming the chronic wound care model in nursing facilities. Wound care experts make weekly bedside visits to patients in long-term care facilities, avoiding transfers to hospitals or clinics. Our expert physicians give patients the most up-to-date and effective wound treatments, and educate facility staff on how to help patients continue to heal quickly and effectively between visits. This model of collaborative care allows SWC’s physicians to improve patients’ lives and health outcomes, to empower nursing staff, and to raise public awareness. Skilled Wound Care, along with its nurse and nursing home partners, is working every day to positively transform traditional nursing home wound care.
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