Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC

How do nutrition assessment and interventions support pressure injury prevention?

A nutrition assessment is not simply a weight taken weekly, biweekly, or monthly. Much more is involved, especially if the resident is at risk for developing a pressure injury or has a diagnosis of a wound. It is important to recognize that a majority of residents admitted to skilled nursing facilities from the hospital, who possibly have been NPO due to diagnostic tests or procedures,  are either malnourished or undernourished.

Recommendations by the National Pressure Ulcer Advisory Panel (NPUAP) are as follows:

1. Assess weight changes periodically.

2. Assist with meals and snacks to assess not only intake but also the amount of assistance required.

3. Encourage the resident to eat a balanced diet and drink to hydrate.

4. Complete a valid screening tool (Mini Nutritional Assessment) for indications of malnutrition.

5. Refer all residents at risk for pressure injury to a registered dietitian or nutritionist.

6. Provide all nutritional supplementation between meals as ordered, and document.

Oxygen and protein are vital to skin health. For residents with possible pressure injury, caloric intake also is essential. 

Vitamin C and mineral supplements frequently are ordered for both prevention and treatment of pressure injuries, although there is a lack of consensus about the actual contribution of vitamin C, according to revered nutritionist and wound care professional Nancy Collins, Ph.D., RD, LD/N, FAPWCA. 

Periodic laboratory values are necessary and help the clinician, dietitian and physician plan and make appropriate adjustments to the care of the resident in the long-term care setting.