How can we make our skin integrity meetings proactive and prevent pressure injuries?

Most skin integrity meetings discuss only those residents who already have wounds. Taking a proactive approach can help minimize the development of pressure injuries for other residents.

At your next skin integrity meeting, start reviewing these other residents. You can make this manageable by reviewing all the residents who have had an MDS completed since your last meeting. This way, all your residents will be reviewed over each quarter. 

When reviewing the residents without wounds, pull their current skin integrity care plan, the nursing assistant assignment sheet, physician orders, and the most recent skin integrity risk assessment (for example, Braden). As a team, review the risk assessment to ensure it has accurately captured the resident’s risk of skin breakdown. If there have been changes in the resident’s risk, the team may want to complete a new risk assessment. Once it is complete, review the care plan to see that all the risk factors identified in the risk assessment are carried forward to the plan of care. 

Based on the risk assessment, discuss the preventive interventions needed to modify, stabilize or eliminate the resident’s identified risk factors. 

At a minimum, ensure the interventions capture the following: pressure-redistribution surfaces for the bed and wheelchair, turning and repositioning schedule, heel-lift devices, incontinence management, nutritional support and strategies for any noncompliance. 

Review the physician’s orders to see if they contain any interventions regarding skin integrity. Ensure they are appropriate and then bring them forward. 

Once the care plan is complete, update the nursing assistant assignment sheet. This approach will help make your skin integrity meetings proactive.