Action 5.22 states
Clinicians providing care to patients at risk of developing or with a pressure injury conduct comprehensive skin inspections in accordance with best-practice time frames and frequency
Intent
The risk of harm from pressure injuries is minimised by routinely conducting skin inspections.
Reflective questions
What assessment tools or processes are used by the workforce to complete a comprehensive skin inspection for at-risk patients?
What processes are in place to ensure that prevention plans (including skin inspections) for patients at risk of a pressure injury are consistent with best-practice guidelines?
Key task
Develop or adapt a process to prompt clinicians to perform and document comprehensive skin inspections as part of routine patient care.
Strategies for improvement
Hospitals
Incorporate comprehensive skin inspections for patients who are screened as being at high risk of pressure injury into routine admission processes, as outlined in Action 5.11. For at-risk patients, conduct skin inspections on admission and on an ongoing basis, depending on the patient’s clinical needs. Best-practice guidelines provide recommendations on how often skin should be inspected.
Document the results of skin inspections in the healthcare record, as outlined in Action 5.12. When pressure injuries are identified, ensure that measurements and images are included in the documented wound assessment.
For patients at risk of developing a pressure injury or who have an existing pressure injury, integrate skin inspections into patients’ daily care plans, in line with Action 5.13.
Prevention and Treatment of Pressure Ulcers: Clinical practice guideline is the relevant best-practice guidelines. These guidelines outline the components of, and techniques for, comprehensive skin and tissue inspections.
Day Procedure Services
This action is not applicable for day procedure services that can demonstrate that they have had no pressure injury incidents in the past 12 months.
For other services, comprehensive skin assessment for patients screened as high risk for pressure injury should generally be incorporated into routine admission and discharge processes.
Refer to the hospitals tab for more detailed implementation strategies, as required.
Examples of evidence
- Data on pressure injuries from the previous 12 months
- Pre-admission screening documents addressing pressure injury risk.
MPS & Small Hospitals
Develop or adapt a process to prompt clinicians to perform and document comprehensive skin inspections as part of routine patient care.
Incorporate comprehensive skin inspections for patients who are screened as being at high risk of pressure injury into routine admission processes, as outlined in Action 5.11. For at-risk patients, conduct skin inspections on admission and on an ongoing basis, depending on the patient’s clinical needs. Best-practice guidelines provide recommendations on how often skin should be inspected.
Document the results of skin inspections in the healthcare record, as outlined in Action 5.12. When pressure injuries are identified, ensure that measurements and images are included in the documented wound assessment.
For patients at risk of developing a pressure injury or who have an existing pressure injury, integrate skin inspections into patients’ daily care plans, in line with Action 5.13.
Prevention and Treatment of Pressure Ulcers: Clinical practice guideline is the relevant best-practice guidelines. These guidelines outline the components of, and techniques for, comprehensive skin and tissue inspections.
Hospitals
Incorporate comprehensive skin inspections for patients who are screened as being at high risk of pressure injury into routine admission processes, as outlined in Action 5.11. For at-risk patients, conduct skin inspections on admission and on an ongoing basis, depending on the patient’s clinical needs. Best-practice guidelines provide recommendations on how often skin should be inspected.
Document the results of skin inspections in the healthcare record, as outlined in Action 5.12. When pressure injuries are identified, ensure that measurements and images are included in the documented wound assessment.
For patients at risk of developing a pressure injury or who have an existing pressure injury, integrate skin inspections into patients’ daily care plans, in line with Action 5.13.
Prevention and Treatment of Pressure Ulcers: Clinical practice guideline is the relevant best-practice guidelines. These guidelines outline the components of, and techniques for, comprehensive skin and tissue inspections.
Day Procedure Services
This action is not applicable for day procedure services that can demonstrate that they have had no pressure injury incidents in the past 12 months.
For other services, comprehensive skin assessment for patients screened as high risk for pressure injury should generally be incorporated into routine admission and discharge processes.
Refer to the hospitals tab for more detailed implementation strategies, as required.
Examples of evidence
- Data on pressure injuries from the previous 12 months
- Pre-admission screening documents addressing pressure injury risk.
MPS & Small Hospitals
Develop or adapt a process to prompt clinicians to perform and document comprehensive skin inspections as part of routine patient care.
Incorporate comprehensive skin inspections for patients who are screened as being at high risk of pressure injury into routine admission processes, as outlined in Action 5.11. For at-risk patients, conduct skin inspections on admission and on an ongoing basis, depending on the patient’s clinical needs. Best-practice guidelines provide recommendations on how often skin should be inspected.
Document the results of skin inspections in the healthcare record, as outlined in Action 5.12. When pressure injuries are identified, ensure that measurements and images are included in the documented wound assessment.
For patients at risk of developing a pressure injury or who have an existing pressure injury, integrate skin inspections into patients’ daily care plans, in line with Action 5.13.
Prevention and Treatment of Pressure Ulcers: Clinical practice guideline is the relevant best-practice guidelines. These guidelines outline the components of, and techniques for, comprehensive skin and tissue inspections.