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Skin Care Fair Instruction Guide

Lesson: Heels are especially vulnerable to the effects of pressure, even on a good support surface. Heel elevation will help prevent pressure ulcers to the heels.

Hint: On daily rounds monitor to ensure heels are off the beds and equipment is being used appropriately.

5. Under Pressure (Continuation)

Objective: To show the importance of individualizing turning and repositioning intervals for both comfort and prevention of pressure ulcers.

Step 1. Once you are done with the skills fair, check who is left sitting in the same position. Ask them how much longer they think they could each stay that way and how they currently feel.

Step 2. Now have them stand up (and/or entire class) and quickly go back to the same position. Ask them if that helped? Now have them stand up and count or time them to 60 seconds and then go back into the same position and ask them if that helped. Go over off-loading and how it can be effective to relieve the pressure and get circulation back, but for some of the participants it may not have helped with comfort at this point.

Step 3. Now go over how important it is to do individualize turning and repositioning as each of us is different as evidenced by how each participant tolerated different intervals without moving.

Step 4. Also, point out if people in the crowd noticed if the participants changed positions or not and if they said anything. Monitoring of repositioning by all staff is the key to ensure it is happening.

Lesson: Pressure is the primary cause of pressure ulcers and an effective turning and repositioning program is an effective way to prevent pressure ulcers. A tissue tolerance assessment is an effective way to individualize the resident’s turning and repositioning interval. Implementation of a turning and repositioning program is the key and effective monitoring of this by ALL staff can ensure its success. Effective off-loading (for at least a minute) if they are going back into the same position is also helpful, but doesn’t always mean it is comfortable.


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