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Pressure Ulcer Prevention and Managing Skin Integrity


A. To maintain the integrity of residents’ skin and overall health.

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B. To effectively identify residents who are at risk for skin breakdown.

C. To provide early interventions for residents with skin breakdown and minimize associated risks.

D. To educate staff, residents, and families on measures to prevent skin breakdown.


Nursing is solely responsible for all aspects of the skin risk assessment and will assess and manage skin integrity for all residents. Risk for pressure ulcer development will be evaluated using the Braden Scale. Skin inspections will be completed on admission for all residents. Any resident with a Braden score < 8 shall have skin inspections done every month. Residents with a Braden score > 8 do not need further skin inspections done.


A. Risk assessment: identification of the potential risk that a resident will contribute to the likelihood for developing skin breakdown.

B. Skin Inspection: a head to toe assessment of residents, intended to detect skin breakdown.

C. Interventions: the steps taken by care providers to increase monitoring of the skin and reduce or alleviate pressure on body parts to minimize or eliminate the risk of skin breakdown.


A. All residents will be assessed one time, on admission to the skilled nursing facility. This will include a head to toe assessment, paying close attention to bony prominences and skin folds.

B. Screening, using the Braden Scale, will be completed by an RN, LPN, or CNA. This must be documented in the medical record.

C. Residents with a Braden score < 8 will have assessments done every month until reaching a score of 8 or higher.

D. All interventions must be documented in the medical record.


A. Patient Repositioning and Turning; required once per shift.

B. Cleanse and dry skin at routine intervals and at the time of soiling;

recommend tub bath once per week.

C. Proper Nutrition; provide meals high in carbohydrates to promote healing.

D. Implement a specialty bed if indicated.

E. Staff Education; require annual training of nursing staff.

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