1. Nursing Assistant Monthly Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012 Wound care What you need to know

2. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Wound healing takes a team  Nurses, wound care specialists and therapists, physicians –for diagnosis, assessments, dressing changes, medications such as antibiotics, pain meds, surgical procedures to clean or close the wound  CNAs –For everything else! –The care a resident gets in between the dressing changes and assessments can make the difference between success and failure of the treatment plan.

3. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Step 1- Observing  As a CNA you can help by: –Taking vital signs: helps identify signs of infection or pain –Noticing the condition of the dressing: is it dry, wet, falling off? Any odor? –Noticing the condition of the surrounding skin: is there redness, swelling? –Watching for any signs of pain or discomfort

4. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Step 2: Reporting Communicate your observations to:  The nurse in charge  Other CNAs who will be caring for the resident

5. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Types of wounds  Surgical  Wounds from poor circulation –Arterial wounds –Venous wounds (sometimes called “stasis” wounds)  Diabetic wounds –Usually from a combination of nerve damage and poor circulation  Pressure ulcers  A combination of the above wound types

6. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Caring for someone with a wound  Remember: wounds can be painful -Alert the nurse if the resident shows signs of pain -Reposition gently, protect the site during caregiving activities -Ask the nurse if the resident can have pain medication before getting up or transfers -Wait 20 minutes after pain medication before getting the resident up

7. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Caring for someone with a wound- cont’d  Positioning –Protect wounds from pressure –Position for comfort according to the care plan  Nutrition –Encourage adequate intake of meals and fluids –Ask the resident and his/her family about food preferences –Let the nurse or dietitian know about food likes/dislikes

8. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Emotional support  Having a chronic wound is stressful –Physically –Emotionally  Wounds can decrease life quality due to –Pain, embarrassment about appearance, odor, immobility in some cases –Watch for signs of depression (crying, sadness, loss of appetite) and anxiety and alert the nurse about any concerns

9. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know The best wound treatment? PREVENTION  Not all wounds can be prevented, especially if due to underlying disease  However, many pressure ulcers are preventable -Frequent repositioning is the #1 care strategy -Most of us automatically shift our weight from time to time, BUT -residents who are bedbound or weak need your help to do this -Follow your facility’s policy about turning and reposition

10. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know More on wound prevention  Good nutrition -Skin health depends on getting enough high quality food -Proper hydration is essential for skin health  Protecting skin -Be gentle when bathing (don’t scrub) and when assisting with ADLs -Use lotions and moisturizers according to the care plan -Excellent incontinent care is VERY important -Urine and feces are damaging to the skin

11. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. March 2012Wound care- what you need to know Even more on wound prevention! Special equipment can help protect the skin  Mattresses –low-air loss mattress –foam –fluid filled  Padding –heel, elbow protectors REMEMBER: report to the nurse at the first sign of skin redness!