Full-Time Wound care nurse for two years. Here is the way to justify "Skin prep to bilateral heels q.s." (Yes, my nurses hate it.)
F-314 states, " Based on the comprehensive assessment of a resident, the facility must ensure that a resident who enters the facility without pressure sores does not develop pressure sores unless the individual's clinical condition demonstrates that they were unavoidable; and a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing."
According to Smith-Klein as seen here,
, Skin preps reduce friction.
When utilizing the all-too-familiar Braden Scalen
, most nurses believe their job is complete. In LTC however, this is only the beginning. Dr. Barbara Braden also has protocols
that go along with your outcomes on the Braden Scale that MUST be implemented in a partial effort to avoid an F-314 tag. If you fail to initiate these protocols, you WILL get F-314 and probably at "widespread" level.
As we can see, even at the lowest level of risk, "At Risk - 15-18", the protocol clearly states to "manage friction and sheer". As seen above in the visible link, Skin Preps reduce friction.
Skin preps to bilateral heels Q.S. with supporting documentation of the same being done accomplishes all of the above. Two years, five surveys, and ZERO
You still must manage the other co-morbidities for residents; however, this has proven to demonstrate an effort being made on the part of your facility to AVOID heel wounds, DTIs, etc.
As a side note, we utilize skin prep on DTI (without open areas), blisters (not open), and yes scabbed areas (eschar) in addition to stable eschar, and they all do exceedingly well on preps.
Again, NO F-314 TAGS
or any tag with regard to wounds in five surveys.