You are caring for a patient on your inpatient unit who is bedridden and unconscious. When the patient came to you, they already had a bedsore. How do you prevent this from happening again?
For patients who are bedridden, bedsores can be a common, but avoidable, problem. If these sores become infected, the consequences for the patients can be severe, especially if they are in a weakened medical state. To prevent bedsores for their patients who are bedridden, nurses should ensure their patients are repositioned at least once every two hours. This repositioning may be completed by a care partner or nursing assistant, but it is ultimately the responsibility of the nurse to ensure their patients are properly cared for. The interviewer is asking this question to ensure the candidate understands it is their responsibility to protect their patients from hazards such as bedsores. To effectively answer this question, the candidate should indicate that they would ensure the patient was repositioned at least every two hours. A more successful answer to this question could include examples of how the candidate has worked with physicians and the physical therapy department to ensure the patient was properly moved, trained care partners or nursing assistants on proper patient repositioning, or helped their colleagues prevent bedsores in similar situations with their patients.
"To prevent additional bedsores, I would ensure the patient was moved and repositioned every two hours, at a minimum. If I am fortunate enough to have the support of a nursing assistant while caring for this patient, I would as for their help, but I would still ensure my patient was being moved, rather than assuming it was being done. I know how serious bedsores can be, and I do everything I can to prevent them. If the patient is unconscious for a long period, I will usually ask the physician if the patient needs an intervention from physical therapy, not only to prevent bedsores but to also prevent muscle atrophy."
"To prevent the bedridden patient from developing additional bedsores, I would work with my team to make sure the patient is turned every two hours. I will document the patient's turning and what position we moved the patient to. If available, I will try to get the patient a specialized hospital bed that uses air to help prevent further pressure ulcers. I would use either pillows or waffle boots to prevent pressure ulcers from forming on heels. I would use a foam dressing or other appropriate material to pad any bony prominences that are in danger of contributing to skin breakdown."
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Anonymous Answer
Do a daily skin assessment and document your findings. Reposition the patient every 2hrs and provide skincare every shift and after each incontinent episode. Apply barrier cream as needed.
Chad's Feedback
Good. You have identified all of the proper steps needed to prevent the patient from developing bedsores again. Consider adding a statement that demonstrates you know what the potential consequences of bedsores on the patient can be, and that you recognize it is ultimately the nurse's responsibility to ensure their patients are being properly cared for. Also, use full sentences in your response, to guarantee there is no confusion with the interviewer.
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