Current through Register Vol. 18, September 20, 2024
(1) A resident shall receive skin care that
meets the following standards:
(a) the
facility shall practice preventive measures to identify those at risk and
maintain a resident's skin integrity; and
(b) an area of broken or damaged skin must be
reported within 24 hours to the resident's practitioner. Treatment must be as
ordered by the resident's practitioner.
(2) A person with an open wound or having a
pressure or stasis ulcer requiring treatment by a health care professional may
not be admitted or permitted to remain in the facility unless:
(a) the wound is in the process of healing,
as determined by a licensed health care professional, and is either:
(i) under the care of a licensed health care
professional; or
(ii) can be cared
for by the resident without assistance.
(3) The facility shall ensure records of
observations, treatments and progress notes are entered in the resident record
and that services are in accordance with the resident health care
plan.
(4) No over the counter
products such as creams, lotions, ointments, soaps, iodine or alcohol shall be
put on an open pressure or stasis wound unless ordered by the resident's
practitioner after an appropriate evaluation of the wound.
(5) Evidence the facility is meeting those
resident's identified as a greater risk for skin care needs include the
following outcomes for residents:
(a) the
facility has identified those residents who are at greater risk of developing a
pressure or stasis ulcer. Primary risk factors include but are not limited to:
(i) continuous urinary incontinence or
chronic voiding dysfunction;
(ii)
severe peripheral vascular disease (poor circulation to the legs);
(iii) diabetes;
(iv) chronic bowel incontinence;
(v) sepsis;
(vi) terminal cancer;
(vii) decreased mobility or confined to bed
or chair;
(viii) edema or swelling
of the legs;
(ix) chronic or end
stage renal, liver or heart disease;
(x) CVA (stroke);
(xi) recent surgery or
hospitalization;
(xii) any resident
with skin redness lasting more than 30 minutes after pressure is relieved from
a bony prominence, such as hips, heels, elbows or coccyx, is at extremely high
risk in that area; and
(xiii)
malnutrition/dehydration whether secondary to poor appetite or another disease
process.
(b) direct care
staff have received training related to maintenance of skin integrity and the
prevention and care of pressure sores from a licensed health care professional
who is trained to care for that condition;
(c) the resident's practitioner has diagnosed
the condition and ordered treatment;
(d) the resident is kept clean and
dry;
(e) the resident is provided
clean and dry bed linens;
(f) the
resident is kept hydrated;
(g) the
resident is turned and repositioned;
(h) the wound is getting smaller;
(i) there is no evidence of
infection;
(j) wound bed is moist,
not dried out or scabbed over;
(k)
the resident has less restriction of movement; and
(l) the resident's pain level has
diminished.
Sec.
50-5-103,
50-5-226
and
50-5-227,
MCA; IMP, Sec.
50-5-225,
50-5-226
and
50-5-227,
MCA;
