New England Sinai Hospital (NESH) is a Long Term Acute Care facility that serves a unique population of chronically critically ill patients. Patients are admitted from acute care hospitals for continued medical management of multiple illnesses. Patients have often had an extended and complicated stay in the acute care hospital. A large number of our patients are admitted directly from the ICU and require ventilators to assist them to breath. Due to the nature and length of their illness, they are in a severely deconditioned state with depleted protein stores (necessary for wound prevention and healing) and in most instances are at very high risk for pressure ulcer development. Sinai employs 3 full time wound care certified nurses to provide expert assessment, consultation and care for this fragile population.
Upon admission each patient is assessed by a Registered Nurse using an evidenced based tool called the Braden Pressure Ulcer Risk Assessment Scale to determine their risk of developing a pressure ulcer. Based on the assessment score, various preventative strategies are implemented:
• Pressure reducing surfaces for bed and chair
• Positioning wedges
• Heel protectors
• Frequent turning schedules
• Nutrition consult
• Protein supplementation for improved wound healing
• Wound consult with certified wound care nurse if indicated
Every new patient is examined by a wound care nurse within 48 hours to ensure that appropriate pressure ulcer prevention is implemented. Nursing staff visually assesses the patient’s skin each day as they provide care, and the Braden scale is repeated on a weekly basis.
A registered dietician evaluates every patient admitted to NESH to assure optimal nutrition and wound healing.
As part of our pressure ulcer prevention program, we utilize pressure redistributing mattress for all patients and have standardized our skin care products.
We continue to review best practices/new research on an ongoing basis to drive further improvements in our care.
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| 25 October 2018 |
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