Heel protectors

RNPATL, DNP, RN · Oct 16, 2004

Do any of you feel that heel protector "booties"(foam type) really help PREVENT pressure sores and points on the heel surfaces? I just wonder if this intervention/prevention does any good or just makes us feel like we are doing something. Thanks!

I think heel protectors are good for those patients that do not have contractures and can help keep their feet off the mattress .... but, I have told my staff that we need to float the patient's heels off the mattress. I want NO pressure on the heels at all and find that floating heels, is far more effective.

Raccoon · Oct 16, 2004

We recently applied heel protectors to a gentleman with 3 cm blisters on both heels. In just a few days the blisters disappeared and both heels are fine.But, I agree, floating heels is best when situation allows.

TracyB,RN, RN · Oct 16, 2004

I think that heel protectors are only as good as the staff applying them. They ARE NOT a substitute for turning & repositioning a patient. Skin checks still need to be done. I HATE the waffle boots. I have seen more skin breakdown because they were not properly utilized!!!!!!!

rnmi2004 · Oct 16, 2004

I prefer floating heels--it is easier than trying to order/track down the boots. Besides, some people's feet can get pretty sweaty & smelly in those things.

see2mee · Oct 16, 2004

My hospital won't even let us use the old style heel protectors/egg-crate foam boots anymore. We usually use pillows to "float" the heels, but we can also use what we call a "cheese boot". It's a big rectangular piece of faom with a hole (like swiss cheese) where the heel lands, so it does a pretty good job of suspending the heel. Most patients don't like them, though, so we usually use pillows.

Catherine

Antikigirl, ASN, RN · Oct 16, 2004

I am the odd duck at work...I believe in floating where as I have a nurse that overrides everything I try to do r/t skin care to try out the latest crazes! For many of my walking clients, I find that a combo of using heel protectors is great, but we have to have them recline with floating as much as they will allow us to!

But I have so many confused residents that do not remember that they are to float their heels or wear protection that they wonder off on thier own and damage things further (I am in assisted living...not a nursing home...these people have their own apt. and live as individually as they can...but lately more residents need more care, but the managment is NOT making the distinction due to the ol'mighty buck! It is getting rather scary!!!!! I may have to call state really soon..too many of my clients need more direct nursing care...not one nurse per shift that has to scramble to everyone in 8 hours [160 residents]). These situations are better in using heel protectors, constant cuing, and a prayer or two..LOL!

I had a set of nurses think I was crazy one day when I saw not only did I have quite a heel wound on a patient..but toe nail bed damage from the blankets of their bed! I put two boxes on either side of the bed and floated the sheets...we don't have the devices for this..so what the hay! Now..LOL, they are eating crow because it is now common practice, and we even went so far as to decorate these boxes to match the bedding! LOL!!!!!! So you can see I believe in floating more so than other devices!

Sometimes the classic ideas are really the best! (like letting wounds heal with AIR and careful attention an not 100's of dollars in duoderms like my fellow nurses do way too much I mean they slap a duoderm on ANYTHING!!!! BUT that is another story!!!!!!).

Energizer Bunny · Oct 16, 2004

hmmmmm.....I'm a student and I am assuming that by "floating the heels" you mean that a pillow or blanket is put underneath the calves to allow the feet to be raised from the bed surface?

That is how we are being taught to do it for clinicals in the long-term care facilities.

Antikigirl, ASN, RN · Oct 16, 2004

Yes..that is how we do it at my facility...but there are other alternatives as well...like special air matresses that can be put on a bed and float or even change positioning of air set to different times to keep other areas floated or lessen pressure (talk about expensive!!!!!!).

For me, the toughest thing is the practice of my clients to put quilts or other folded blankets at the foot of the bed and keep them there while they are in bed because "my feet are always too cold"...that causes more pressure on the feet! I always have to use something to go under the blankets to lift these up...so another factor to watch for!

meownsmile, BSN, RN · Oct 17, 2004

We use rolled blankets under the ankles. Only when a patient is in hospital long term or has unusual breakdown problems will we use heel protectors. But they also need watched, because for as much as you are trying to protect the heels if they dont fit right,, the ankle area can be at risk for pressure from the cuffs.

claire_au · Oct 17, 2004

We use air mattresses for the worst at risk patients but I find many nurses think this takes the place of repositioning. The only true way to avoid pressure is to keep the patient moving.Even with air mattresses some died in the wool bootie lovers insist on using both which defeats the purpose of the mattress

Marie_LPN, RN, LPN, RN · Oct 17, 2004

I've seen sores develop from the STRAP that goes over top of the foot on heel protectors.

What i used to do for my bed-ridden pts: Put one heal protector on, leave the other off, and use a pillow(s) to arrage and pad. Then when it was time to reposition, put the other heel protector on, take the one off. I typically put both on if the pt. was going to get visitors or if they were going to the dining room in the Geri-Chair.