Nursing Interventions

[IvyRN2017, ASN, CNA, RN]

Hello everyone. This goes out to all my assisted living nurses because I am kind of at a loss. We have a pt that is declining and has been developing wounds. Yes he is a hospice pt and hospice is treating those wounds. Our facility requires that we do weekly skin assessments on residents with wounds. Anyone that scores a 16 or less, needs to have a nursing intervention in place. This is not a big deal, right? Wrong! Assisted living is very different from nursing homes or hospitals. They have a different set of standards. I did the weekly assessment yesterday and came up with the intervention to have hospice supply a pressure relieving mattress. Okay great. My facility is requiring a different intervention for each week. The thing with assisted living though, the nursing interventions can't be tied to something directly that would require state to look at another list to show the intervention is in place. I was going to use the intervention toilet the resident q 2 hours. Nope. Can't do that according to my boss. Does anyone have any idea on other interventions that would work for assisted living??? Thanks in advance!

[Scottishtape]

Turn pt Q2 hours

Pad bony prominences

Use barrier cream to prevent further breakdown

Have hospice provide heel protectors to reduce pressure on heels

Have hospice provide wedge to prop legs

Those are the ones that pop out at me off the top of my head. They should be fine for assisted living.

[AJJKRN]

Is it just me or does anyone else think that this pt is no longer appropriate for the assisted living environment? I get trying to die in peace in your home (as the assisted living most likely has been for a while) but the resources and support are not set up for a declining and immobile hospice patient correct?