NA: Promoting Skin Care in LTC
Presented by Wanda Goldschmidt
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The long-term care population is at high risk for injury to skin. Most people living in long-term care are older adults. Age-related changes alone make the skin thinner and more fragile, which results in a higher risk for injury. Illness and disability are additional factors that pose risks for skin, even among younger residents. There are federal regulations for nursing homes that require care and services be provided to prevent skin injury. Skin injuries have been associated with complications of care, due to infection, pain, and suffering experienced by the resident. Skin may be the first line of defense against infection, but the nursing assistant is the first line of defense for skin protection. Of all people on the health care team, the nursing assistant has the most opportunity to observe skin, monitor changes, and provide care to prevent injury. This course will review the structure and function of the skin and provide guidance to the nursing assistant for identifying common injuries and risk factors, observing and reporting skin conditions, and providing care to maintain skin in good condition and protect against injury.
Meet your instructor
Wanda Goldschmidt
Wanda Murray-Goldschmidt, a life-long resident of Baltimore, Maryland, found her passion for working with older adults while working as a nursing assistant in a nursing home shortly after completing high school. That passion sparked her pursuit of nursing as a career. She first completed a hospital-based program of study to…
Chapters & learning objectives
1. Introduction: Why Is Skin Care so Important?
This chapter provides an overview of what the nursing assistant will learn in this course about skin care in the long-term care environment. It provides information to motivate the nursing assistant’s concern for skin care and identifies what the nursing assistant will be able to do upon completion of specific learning objectives. A case scenario that presents a resident at high risk for skin injury is provided. This case scenario will be used as a point of reference throughout the course to aid the nursing assistant in applying skin care knowledge to typical resident experiences in daily clinical care.
2. Protecting the Skin: A Nursing Assistant Priority
This chapter lays the foundation for why skin care should be a priority for the nursing assistant working in long-term care. There is a quick review of the functions of the skin, with emphasis on protection. The consequences of skin injury are identified, followed by a discussion of why the long-term care population is at risk. The case scenario is used to help guide the nursing assistant to relate knowledge of skin risks to resident care. Due to the nature of the work and the types of interactions with residents, the nursing assistant is identified as being the first line of defense in the protection of skin. General skin care guidelines for the nursing assistant’s role in promoting healthy skin are provided.
3. Common Skin Injuries, Risks, and Prevention
This chapter highlights bruises and skin tears as the most common types of skin injuries that occur in long-term care, often because of accidents and incidents. The nursing assistant will learn about risk factors related to bruises and skin tears, and how to take preventive action by targeting specific care interventions to reduce identified resident risks. The case scenario from Chapter 1 is revisited to explain how interventions are matched to risks to promote prevention of injury.
4. Observing and Reporting
Of all the members of the health care team, the nursing assistant has the most opportunity to observe a resident’s skin, noting problems and changes. This chapter covers how to inspect the skin, what findings are important to note, and how and when to report skin conditions that have been observed. This is an essential role of the nursing assistant as any delay or failure in reporting skin problems can have serious consequences, not only for the resident, but for the entire facility. A demonstration of how a nursing assistant should interview a resident about an observed injury is featured, and examples of reports will be reviewed to examine completeness and clarity.
