Kansas Reynolds Program in Aging Residency Education Project

Kansas Reynolds Program in Aging Residency Education Project Curriculum Design: Shelley Bhattacharya, D. O, M. P. H. Question Design: Shelley Bhattacharya, D. O. , M. P. H. and Jana Zaudke, M. D. Based on the game show Jeopardy!

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Staging of Ulcers ACOVE Indicators $10 $10 $10 $20 $20 $20 $30 $30 $30 $40 $40 $40 $50 $50 $50 Complications Risk Factors For Ulcers Of Ulcers Prevention of Ulcers

Persistent nonblanchable erythema

What is a Stage I ulcer ?

Full-thickness skin loss that may extend down to the fascia

What is a Stage III ulcer ?

Full thickness skin loss with extensive destruction i. e. damage to muscle, bone, tendon

What is a Stage IV ulcer?

Partial thickness skin loss involving epidermis, dermis or both.

What is a Stage II ulcer?

Full thickness tissue loss in which slough or eschar cover the base of the ulcer

What is an Unstageable ulcer?

As of 10/1/07, care for this condition is no longer reimbursed for by Medicare if obtained during hospital setting

What are pressure ulcers?

A set of quality assessment tools for ill older adults

What are the ACOVE Indicators – Assessing Care Of Vulnerable Elders?

Should be instituted if the patient is at risk for a pressure ulcer and malnourished

What is nutritional intervention?

If the patient is at risk for pressure ulcer, then this must occur within 12 hours of admission

What is pressure reduction?

To be performed upon admission if the patient has limited ability to reposition

What is risk assessment ?

Localized infection can lead to this potentially deadly complication of pressure ulcers

What is sepsis?

This is the mortality rate in older persons who develop a pressure ulcer within 1 year of hospital discharge

360 [Pub. Med - indexed for MEDLINE] What is 60%?

The extent with which ulcers interfere with a patient’s ability to perform basic ADL’s depends on this factor

What are comorbid conditions?

Topical preparations are responsible for this complication associated with pressure ulcers

What are contact allergies?

A predictor of delayed healing and also a chronic complication of pressure ulcers

What is the presence of pain in the wound?

Factors that are physiologic or related to disease states that increase the risk for pressure ulcer development

What are intrinsic risk factors?

Risk factors that lead to damaged skin due to external factors

What are extrinsic risk factors?

Both an intrinsic and extrinsic risk factor

What is urinary and fecal incontinence? Or, what is substance abuse?

1 cigarette leads to this percentage decrease in local oxygen within 1 hour

What is a 30% decrease in local oxygen to the tissue ?

A method for assessing risk by evaluating: sensory perception, moisture, activity, mobility and nutrition

What is the Braden Scale ?

The frequency for repositioning to prevent mechanical loading and thus pressure ulcers

What is q 2 hours ?

Heels account for this percentage of all pressure ulcers

What is 20% of all pressure ulcers ? Pay special attention to heels!!

One method for preventing pressure ulcers that has shown a 60% relative risk reduction via a metaanalysis of 5 RCT’s

What are pressure reduction mattresses?

In addition to decreasing mechanical loading, and providing appropriate support surfaces, this is an evidence-based approach to prevention of pressure ulcers

What is skin care?

Friction and shear are prevented by these devices

What are lifting devices?

Five techniques used to prevent heel ulcers

What are: • 1. Moisturize heels • 2. Heel protectors/heel lifts to keep pressure off • 3. Transparent film for those at risk • 4. Colloid dressing for those with pre -Stage 1 hyperemia • 5. Turn every 2 hours for repositioning • 6. Socks to protect heels • 7. Daily inspection for those at risk