HHC Health & Home Care Clinical Policy And

More documents

Recommendations

Info

HHC HEALTH & HOME CARE Endocrine: References REFERENCES American Diabetes Association. 1994. Self-monitoring of blood glucose (consensus statement) Diabetes Care 17: 81–86. American Diabetes Association. 2003. Clinical practice recommendations. Diabetes Care 26 (Supplement 1) (January). Franz, Marion J. 2003. Diabetes management therapies: A core curriculum for diabetes education. 5 th ed. Chicago: American Association of Diabetes Educators Grajower, M. et al. 2003. How long should insulin be used once a vial is started? Diabetes Care 26(9): 2665–2669. Nettina, Sandra M., and L. S. Brunner. 2000. The Lippincott manual of nursing practice. 7 th ed. Philadelphia: J. B. Lippincott Company. 100
HHC HEALTH & HOME CARE Section: 7-1 Skin Care: Pressure Ulcer - Prevention __RN PURPOSE: To identify patients at risk for the development of pressure ulcers and define early interventions. CONSIDERATIONS: 1. Patients at increased risk for development of pressure ulcers are those who are chairfast or bedfast. 2. The following characteristics further increase the risk for pressure ulcer development: a. Advanced age b. Chronic illness that requires bed rest, poor circulation; c. Dehydration, malnutrition, significant obesity and thinness; d. Diabetes mellitus; e. Incontinence, excessive perspiration, wound drainage; f. Diminished pain awareness; g. Fractures, trauma, paralyses; h. Corticosteroid therapy, immunosuppression; i. Mental impairment, possibly related to coma, altered level of consciousness, sedation, and/or confusion. 3. Rating scales (i.e. Braden Scale) are the most common risk assessment tools used by clinicians to identify the patients at greatest risk for pressure ulcers. 4. Early intervention refers to treatment prescribed for those patients determined to be at high risk for developing pressure ulcers. These include: adequate pressure reduction/relief, frequent repositioning, attention to nutritional status, aggressive and gentle perineal care, protective devices that lift the heels off the bed, and padding for ankles and knees. 5. Recommendations for an effective prevention program include four goals: a. Identifying at-risk individuals who need prevention and the specific factors placing them at risk. b. Maintaining and improving tissue tolerance to pressure in order to prevent injury. c. Protecting against the adverse effects of pressure, friction, and shear. d. Reducing the incidence of pressure ulcers through educational programs. EQUIPMENT: Pressure Reduction Devices: Low air-loss mattress/beds Alternating-pressure mattress Gel-type flotation pads Thick, foam mattress Skin Protectants/Emollients and Sprays: Lotion Ointment Moisture-barrier creams Transparent film Comfort Aids (do not reduce pressure but aid in comfort): Pillows Heel and elbow protectors PROCEDURE: 1. Adhere to Universal Precautions. 2. Explain procedure to patient. Risk Assessment Tools and Risk Factors 1. Assess all patients on admission to home care and periodically reassess for risk factors related to pressure ulcers, using a validated risk assessment tool such as the Braden Scale. 2. Assess bed and chair bound patients for additional risk factors such as, incontinence, altered level of consciousness, and impaired nutritional status. 3. Document assessment of all risk factors. Skin Care and Early Treatment 1. Inspect the skin at each visit and instruct patient/caregiver to do so on a daily basis, paying particular attention to bony prominences. 2. Individualize and teach frequency of skin cleansing according to need and/or patient preference. During the cleansing process, use minimal force and friction on the skin. 3. Avoid hot water and use a mild cleansing agent that minimizes irritation and dryness of the skin, then apply moisturizers and a barrier cream. 4. Minimize environmental factors leading to dry skin, such as low humidity (less than 40%) and exposure to the cold. Treat dry skin with moisturizers. 5. Avoid massaging over bony prominences. 6. Minimize skin exposure to moisture due to incontinence, perspiration, or wound drainage. When sources of moisture cannot be controlled, be sure to use a Moisture Barrier to protect the skin and use linen-saver pads or briefs made of materials that absorb moisture and present a quickdrying surface to the skin. 101
Page 1 and 2:
HHC Health & Home Care Clinical Pol
Page 3 and 4:
Title Procedure Page 4.06 Gastroint
Page 5 and 6:
Title Procedure Page 9.16 Infusion
Page 7 and 8:
Title Procedure Page 14.14 Emergenc
Page 9 and 10:
HHC HEALTH & HOME CARE SECTION: 1-2
Page 11 and 12:
Page 13 and 14:
HHC HEALTH & HOMECARE SECTION: 1-4
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
HHC HEALTH & HOME CARE Respiratory:
Page 43 and 44:
HHC HEALTH & HOME CARE Section: 3-1
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
HHC HEALTH & HOME CARE Cardiac Refe
Page 55 and 56: HHC HEALTH & HOME CARE Section: 4-2
Page 59 and 60: HHC HEALTH HOME CARE Section: 4-5 G
Page 69 and 70: HHC HEALTH & HOME CARE Gastrointest
Page 71 and 72: HHC HEALTH & HOME CARE Section 5-2
Page 73 and 74: HHC HEALTH & HOME CARE Section 5-4
Page 95 and 96: HHC HEALTH & HOME CARE GenitoUrinar
Page 105: HHC HEALTH & HOME CARE Section: 6-1
Page 139 and 140: HHC HEALTH & HOME CARE Skin Care: R
Page 157 and 158:
Page 159 and 160:
HHC HEALTH & HOME CARE Medications:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Infusion Therapy Section: 9-17 Infu
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
HHC HEALTH & HOME CARE Infusion The
Page 231 and 232:
HHC HEALTH & HOME CARE Section: 10-
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
HHC HEALTH & HOME CARE Section 11-1
Page 255 and 256:
HHC HEALTH & HOME CARE Section 11-2
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Name: Vitamin? Yes No Brand: Date P
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
HHC EHALTH & HOME CARE Section: 13-
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
Page 343 and 344:
Page 345 and 346:
Page 347 and 348:
Page 349 and 350:
Page 351:
HHC HEALTH & HOME CARE General Prac
show all

HHC Health & Home Care Clinical Policy And

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?