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Skin Assessment and Pressure Injuries

May 10, 2021

Overview

Comprehensive patient care involves the assessment of the skin & risk of pressure injuries on arrival to the Emergency Department.

Alignment to Western Health Best Care Framework

Right Care & Person-Centred Care

Why is this important:

Pressure injuries take a long time to heal, which has consequences for patients’ quality of life, as such injuries can cause severe pain, and can involve sleep and mood disturbance as well as susceptibility to infection. They also adversely affect rehabilitation, mobility and long-term quality of life.

What does this look like in practice?

  • Daily skin & risk assessment on nursing chart and EMR.
  • Regular pressure area care.
  • Monitor nutrition and hydration.
  • ACE review.
  • Promote independence.
  • Air mattress.
  • Wound charts & Riskman.

Performance

Riskmans on pressure injuries.

QRGs

Skin assessment & Pressure Injuries Quick Reference Guide.

Clinical Practice Links

https://www.safetyandquality.gov.au/sites/default/files/migrated/Pressure-injury-short-clinician-fact-sheet.pdf

Appendix:

EMR Skin and Pressure Injury Assessment

ED Adult Observation Chart – Skin Assessment Section:

Stage of Pressure Injury Picture