MDS Alert

The approach jumpstarts care plan interventions.

Wesley Healthcare Center uses ultrasound scans as part of its skin assessment, reports Cynthia Canzeri- Labish, RN, MS, CWOCN, director of nursing services for the facility in Saratoga Springs, N.Y.

The facility began using the scans as part of a research study in 2007 and has continued with the approach since then. Staff members scan the heels and sacral areas of residents at admission who are at risk of developing pressure ulcers. If a resident's scan shows fluid under an area of intact skin, the team rescans the area in two weeks to see if care plan interventions are helping, says Canzeri-Labish. Staff members document the scans' findings in all cases.

Perks: The scans provide a good way to increase staff members' awareness of residents' risk -- and to give them feedback when their care efforts result in improvements, adds Canzeri-Labish. For example, if a resident has an abnormal heel scan, the next scan will reflect the CNAs' efforts to "offload" pressure, she says.

Longport Inc. has for several years been selling highresolution ultrasound scanners for assessing pressureprone areas. The scans complement the staff's skin assessments, allowing for earlier intervention in some cases, says Paul Wilson, president of the company in Chadds Ford, Pa.

Sometimes clinical staff members doing a skin assessment on a patient don't find anything suspicious, even though the ultrasound picks up an abnormality under the skin, which appears as a dark area on the scan, Wilson relays. In other cases, staff members find they missed subtle signs of a problem when they revisit an area identified by the scan as abnormal, he adds.