Policy Manual sample

MDT Home Health Care Agency, Inc. PREVENTION & TREATMENT OF DECUBITUS/WOUNDS Purpose: Pressure sores/Wounds are easy to develop but very difficult to cure. Daily nursing care plays a large part in prevention. Prevention of infection related to wound care. Procedure for Prevention: 1. Bed should be kept dry and free from wrinkles and crumbs. 2. Patient should be turned at least every two hours. 3. Pressure areas should be massaged often to stimulate circulation and toughen the skin. 4. Talcum or body powder may be used to help absorb skin moisture. 5. Devices such as rubber and cotton rings may be used to prevent pressure. 6. Frequent partial bed baths are often helpful in hot weather. 7. On an incontinent patient, the back and buttocks should be washed and massaged frequently. 8. Air mattresses, alternating pressure mattresses pr turning frames are sometimes used to air in the prevention of decubitus. Procedure for Treatment: 1. Assemble equipment as for a bed bath. 2. Explain procedure to patient. 3. Screen patient. 4. Put bath blanket over patient and remove top cover. 5. Wash area with soap and water. 6. Apply special washing solution, if ordered. 7. Massage the surrounding area briskly, away from the pressure sore. 8. Massage reddened area slightly. 9. Apply medication, if ordered. 10. Relieve the source of pressure according to what the doctor ordered (air mattress, etc.). 11. Leave patient comfortable. 12. Clean and return equipment to proper place. 13. Wash hands. NOTE: THE ABOVE STEPS, IF FOLLOWED FULLY, WILL USUALLY PREVENT THE DEVELOPMENT OF PRESSURE SORES Infection control policies related to dressing changes must also address the most effective method of decreasing the chance of spreading infection, which is hand washing before and after wound care. The contact route, touching a contaminated surface and then touching a suitable host, is the way the organisms common to wounds are spread, and must be avoided. Our field staff are trained in the evaluation of clinical infection that can usually be recognized by signs and symptoms including foul odor, pus, surrounding erythema, increased temperature, pain, and swelling. In some immunocompromised persons— such as the elderly, diabetics with hyperglycemia, or chemotherapy or steroid recipients—these classical signs can be reduced or absent. If a wound is not healing in this population, infection should always be considered. Home Health Agency Nursing Care & Procedures K-24