Maintaining skin integrity: setting the standard in a rehabilitation facility.

Impaired skin integrity and a high risk for developing it are two of the more common nursing diagnoses made in the rehabilitation setting. Pressure sores and their consequences are directly related to increased length of stay for patients and can create higher costs for the institution. Most of the sequelae of pressure sores can be avoided, as the identification, prevention, and treatment of pressure sores have become more standardized. The rehabilitation facility discussed in this article developed a standard of care for the maintenance of skin integrity, a pressure sore protocol, and nursing care plans to provide a standardized format for nursing care. The standard was designed to ensure consistency among the nursing staff when they assess, plan, evaluate, and document care of patients who have pressure sores or are at risk of developing them. The standard also created a mechanism for evaluating the knowledge and skill of the nursing staff in preventing and treating pressure sores. This article describes the components of the standard of care and its supporting policies as well as its implementation and use.