Implementation : Setting the plan in motion and delegating responsibility for each step. Communication is essential to the process. The health care team are responsible to report back all significant findings or changes.
Evaluation : The process is an ongoing event. Involves not only analyzing the success of the goals and interventions, but examining the need for adjustments as well. Evaluation leads back to assessment and the whole process begins again.
Critical thinking is the active, organized cognitive process of analyzing the data collected.
The interdisciplinary team draws on knowledge of standards of care, aging process, disease process, physical sciences, psychosocial knowledge, experience, and other areas to analyze the information collected.
The summary of information identified with the assessment types are suggestions (triggers) for consideration when completing the assessment – if the suggestion is not an issue, don’t include it in the assessment
The triggers are not required in the assessment unless the IDT determines it pertinent to the resident’s assessment
Competency – ability to make decisions regarding self; if unable, are there legal instruments in place to legally give decision making authority to another, if not, does a process need to be initiated – what decisions is the resident capable of still making
Listen carefully to what the resident is saying during the behaviors
Observe the resident for periods of time over the course of several days – what do they say, what do they do before, during, and after the behaviors – pay particular attention to the antecedents of the behavior
Review the social history including the cultural background
Research has shown that a significant number of PU’s develop within the first four weeks after admission to a LTC facility
Many clinicians recommend using a standardized pressure ulcer risk assessment tool to assess pressure ulcer risk upon admission, weekly for the first four weeks after admission, then quarterly and as needed with change in cognition or functional ability
An overall risk score indicating the resident is not at high risk of developing pressure ulcers does not mean that existing risk factors or causes should be considered less important or addressed less vigorously