We have a resident who prefers to sit in a wheelchair all day long. How do we address the risk of pressure injury development?
According to F552, the resident has the right to be informed in advance of the risks and benefits of proposed care, treatment, and treatment alternatives or options. The resident has the right to choose the option he or she prefers. Thus, the facility needs to have a risk-benefit conversation with the resident and, when appropriate, with the resident’s representative.
The health information must be provided in a way that the resident understands. The resident needs to comprehend what a pressure injury is, how it can develop, what health risks a pressure injury could cause, and how the proposed interventions can minimize the risks.
Ensure the resident understands a pressure injury is caused from prolonged or intense pressure, or pressure in combination with shear forces. Explain that due to pressure the blood supply gets cut off to the tissue and the tissue dies, forming a pressure injury.
Discuss that when a pressure injury occurs, it can put the resident at risk for, but not limited to: loss of function, loss of tissue, isolation due to being bed bound and malnutrition due to protein loss. Explain how the proposed interventions can help minimize the risks. If the resident still does not choose the interventions proposed, offer alternatives.
Clearly document the risk-benefit conversation, including who was involved with the conversation. Document all the risks discussed, interventions offered, alternatives proposed, and the resident’s overall choice.
Key times to have a risk-benefit conversation would be at the initial care planning conference and, if the risk still exists, at subsequent care conferences or upon changes in condition.
From the October 2019 Issue of McKnight's Long-Term Care News
