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Use of an Interdisciplinary Admission Assessment to Guide Pressure Ulcer Prevention and Treatment in an Acute Rehabilitation Facility

Norma J. Clanin, M.S., R.N., C.R.R.N., The Ohio State University Medical Center, Rehabilitation Clinical Nurse Specialist, 480 Medical Center Drive, 1120 B Dodd hall, Columbus, OH 43210-1245

The purpose of this poster presentation is to share the process used at a 60-bed acute rehabilitation facility to address the individual needs of admitted patients regarding their needs for pressure ulcer prevention and/or treatment. Since nearly all patients admitted (spinal cord injury, brain injury, stroke, and general rehabilitation)are identified as being at risk for pressure ulcers upon admission, it is critical that the team quickly identify and implement measures to prevent breakdown and/or promote healing. Because the average length of stay in rehabilitation is only about 16 days, it is vital to focus both on the quality of care and the efficiency of its delivery. The thorough admission assessment process utilizes a rehabilitation interdisciplinary team consisting of the staff nurse and clinical nurse specialist(CNS), physician, physical therapist, occupational therapist, speech therapist, nutritionist, pharmacist, and psychologist. This admission assessment guides the decision making for type of bed, style of wheelchair and cushion, nutritional interventions, turning schedules, activity schedules, type of bowel and bladder programs and therapy interventions. The patient and family members are included in the assessment and decision-making process to facilitate their learning and follow-through. If a patient is admitted with a pressure ulcer, the rehabilitation CNS evaluates the wound and makes further recommendations for care. The chronic wound team, which includes the rehabilitation CNS, the WOC nurses and a plastic surgeon, are consulted for sharp debridement, for a non-healing ulcer evaluation and recommendations, or for a complicated wound that will need follow-up in the outpatient wound clinic after discharge from rehabilitation.

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See more of The WOCN Society 39th Annual Conference (June 9 -- 13, 2007)