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Preventing skin problems

LTC Nursing Assistant Trainer, January 29, 2004

"Pressure sores," "bed sores," and "skin breakdown" all refer to decubitus ulcers. If they're not properly cared for, these ulcers can lead to painful and potentially fatal infections for frail elderly residents. That's why it's important for nursing staff to observe, report, and immediately care for skin breakdown in every resident.

In order to protect residents from developing decubitus ulcers, remind CNAs to practice these nursing measures:

• Observe residents daily for early signs of breakdown and report these findings to the charge nurse
• Keep skin clean
• Keep skin dry, especially areas that touch each other. When using powder, be careful not to apply too much. Excess powder can form small lumps and apply pressure to the skin
• Apply lotion or ointment to dry skin
• Pat the skin dry, rather than rubbing it

• Turn or reposition immobile residents at least every two hours. This includes:

  - Moving the resident carefully to prevent friction between the skin and the clothing or sheets

  - Reminding or assisting residents in wheelchairs to shift their position - Properly supporting residents to provide support that will relieve pressure on sensitive areas when repositioning

  - Making certain that the sheet or pad beneath the resident does not have any wrinkles

• Encourage the resident to eat as much as possible to maintain good nutrition
• Pad areas of the bed and chair that the resident is apt to hit or rub up against

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