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Trainer’s tip: Nursing assessment for GCS

LTC Nursing Assistant Trainer, April 19, 2012

Before applying compression hosiery initially, consider these safeguards:

• Review the physician order.
• Clarify hosiery length, if necessary.
• GCS are available in light compression, moderate compression, and firm compression. Clarify the compression strength, or follow facility policies. Common strengths are:

                  --Mild compression (8–15 mmHg)

                  --Medium compression (23–32 mmHg)

                  --Firm compression (20–30 mmHg)

                 --Strong compression (25–35 mmHg)

• Systematically assess the resident and each lower extremity for appropriate use of compression.
• Review contraindications to hosiery and be sure they do not apply to the resident.
• Assess the peripheral circulation, popliteal, posterior tibial, and dorsalis pedis pulses.
• Consider the person’s age, dexterity, and ability to apply the hosiery independently, as appropriate. Determine whether a caregiver is needed to assist with application.
• Assess the need for an adaptive device or specially modified hosiery (an occupational therapist can assist in obtaining an adaptive application device, or hosiery that fasten with Velcro).
• Check the skin condition for potential pressure points, fragile skin, open areas, rashes, signs of infection, healed ulcerations, and areas of possible vulnerability.
• Check the patient’s allergies. Although the incidence of allergic reaction is low, some brands contain latex, nylon, Lycra, and other potential allergens.
• Review facility policies and procedures for fitting, application, and circulation checks, and follow them.
• Initiate a plan of care for the use of GCS.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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