CNA Duties: The Importance of Skin Care is to Maintain Skin Integrity

One of our biggest issues of concern for any patient admitted to the hospital is the development of bedsores, also known as pressure ulcers. These are not uncommon to occur, but definitely can be prevented by proper skin care, turning and repositioning of our patients. Making sure that your patients are receiving the proper dietary needs.

As I have discussed before the turning and repositioning does help to alleviate pressure to many areas of our bodies. Patients should be on a schedule of at least turning every 2 hours (Q2H) when possible. This is actually the standard of time for turning and repositioning especially when patients are bedridden and unable to move themselves. Other patients may need assistance to get oob and sit up in the chair. Where I worked, we had a designated form
that needed to be filled out after each repositing of patient. It was hung on the wall in the patient station. This was used so any team member would know when the patients needed to be turned throughout the shift. When you are performing this activity, it is very important to make sure that your patient is not incontinent and in need of hygiene care. This in turn helps you to keep the patient’s skin from any breakdowns. We had a supply of products called Triad or Baza ointments that are moisture barriers. As a Nursing assistant it is within the realm of your practice to provide this service of care. These moisture barrier ointments are part of floor stock and can be used without any doctor’s orders. It is a preventive measure to maintain skin integrity. If for any reason you see any form of redness or irritation to a patient’s body you must report it to your RN team leader. Why is this so important because the tiniest stage 1 redness can evolve into major stage IV especially if a patient body immune system is compromised.

There are many different ways to decrease and prevent skin breakdowns. Use a draw sheet or lift pads to move patients from side to side or to the head of the bed. This prevents friction and shearing to the skin from the sheets. If a patient is too heavy to move you may need more than two-person assistance find the staff to help. NEVER put the head of the bed in Trendelenburg position to slide the patient to the top of the bed. You could alter the patients’ blood pressure or even the level of consciousness. It can happen and did to one of our patients and a Rapid Response was needed to stabilize our patient.

Every patient has dietary orders prescribed by their doctors. Whether they are Npo, clear or full liquids to even a regular diet, every person should have the amounts of their meals documented for proper intake and outputs, especially if any one is on a calorie count.  This task helps the nurses, doctors and dieticians to be able to ensure that the patients are receiving the proper nutritional intake with supplements so that you will continue to maintain skin integrity promote healing.