Aged care nursing (Wound care and management (Nurses are required to…
Aged care nursing
Wound care and management
Nurses are required to monitor and manage resident wounds such as skin tears and pressure injuries etc.
Documentation: When residents get wounded nurses are required to complete the correct documentation. This includes an incident form, short term wound care plan and contact family.
The wound is to be appropriately dressed. Clinical example: a patient had a skin split 3cm by 0.5cm. The wound was dressed with steristrips to pull wound together, then cuticerin, and leukomeds. The dressing was changed every 3 days when the wound was cleaned and a photo was taken. The photos were uploaded to the residents wound care plan to show healing progress.
Delegation and shift management of care staff
Nurses are required to be approachable and trusted as they are the one care staff and health care assistants report back to regarding resident care. For example if the care staff notice a skin tear or developing pressure injury, or if they notice any kind of deterioration in the residents.
They are also required to ensure the residents are getting appropriate care by working with and ensuring staff are aware of any special cares or tasks to be done for resident during their care rounds and that other special and important care tasks are well delegated and organised.
Illness and disease management
Diabetes management: within aged care nurses are required to actively monitor and manage diabetes. This is accomplished by ensuring to complete BSL checks as often as required for that resident and provide intervention as needed.
Clinical example: A resident with T1DM required pre-meal BSL checks, if his BSL was higher than 12.0 the patient was to have 4 units of novorapid however was charted Lantus to have before breakfast each morning.
Illness management: nurses are required to monitor and advocate for patient's who become unwell. This includes collecting and monitoring information such as their vital signs, sign and symptoms and concerns and report to the doctor via phone or email as their are no doctors on site.
Clinical example: A resident became gradually unwell, including the development of a productive cough. The residents phlegm was monitored as it went from being clear to bright green. the patient's vitals were monitored TDS, PRN nebulisers were given and the doctor was notified. after the doctors visit the patient was placed on Antibiotics for a chest infection and she was continued to be monitored.
Nurses are to ensure accurate documentation for each resident under principle 4 of the Code of Conduct (Nursing council of New Zealand, 2012).
This may include: progress notes, updating care plans, short term care plans, wound care plans, incident forms, medication documentation, observations charts if required, BSL charts if required.
It is the nurses responsibility to ensure residents are receiving the right medications at their right times. this includes both regular and PRN medications.
Aged care services typically have three medication rounds, breakfast, lunch and dinner. There are also occasionally bed time medications rounds as well.
PRN medications are also important for the management of acute and chronic pain. Paracetamol and liquid Panadol are commonly used to maintain resident comfort.
Insulin management is also an important responsibility of the RN. Ensuring resident's diabetes are controlled and the right method of administration and dose is given when needed whether it be long or short acting.
Medication documentation and handover is essential in ensuring residents are receiving the correct medications at the right time. This is important for PRN medications such as paracetamol as it must be given no less than four hourly as it can be extremely toxic to the liver, even more so for an elderly person.