Care Plans

[LTC LPN 2006]

Looking for suggestions, advice, or help writting care plans. The program I went through to become a LPN barely touched on care plans since technically LPNs are to assist in the process, but RNs are the ones who write them. I'm learning my school is one of the few that don't focus on care plans, so many other LPN graduates have a much greater understanding of them than I do.

Anyhow... I am the wound care nurse for my facility and I'm told part of my job is initiating care plans for residents with wounds. The template care plans I was shown are not quite what I recall being taught and I'm looking for help with ideas. I'm not even really sure who I need to start care plans, but I'm assuming residents with pressure ulcers, venous ulcers, diabetic ulcers, etc. would be a good start. I will then have a RN look them over and sign off on them.

Also, I'm not really responsible for care plans related to risk of skin breakdown but would like to know if it is possible to create one focused on preventing breakdown of heals for residents who have red/pink, spongy heels. Initially I was getting orders for preventive measures such as Elevate heels off bed with pillows at all times while in bed, Apply bunny boots (heel protectors) to protect feet while in bed, Apply skin prep Q HS, etc. Corporate is now telling me I need to D/C the pillow/heel protector orders. They say these are part of general nursing care and should be done by nurses and charted in their chart but do not need doctors orders nor should they be on the treatment records. In my opinion having them initial they are doing these would be a great way to show efforts to prevent breakdown. Since I can't help it if nurses fail to chart these things, my next idea was to care plan for them as a means to show we are focusing on prevention. Does this make sense? Is this something I can do?? I was thinking something like "Risk of impaired skin integrity of heels related to pressure" and then having interventions that primarily focus on relieving pressure on heels.

Sorry this was so long!!! Any imput/suggestions would be GREATLY appreciated!!

[AprilRN]

I know this is an old post..but it sounds like you were on target. The home I worked in care planned everything. You should definately plan interventions for prevention. How is it going? Did you get care plans done for those areas?