Pressure area check for a frail older woman
RCSI OSCE practice station

The task

You are the nurse on a medical ward. Mrs Bridget Nolan, aged 86, was admitted four days ago with a chest infection and has spent most of her time in bed or in the chair. Introduce yourself, confirm her identity and explain what you plan to do. Assess her risk of pressure damage using a validated risk tool and inspect her pressure areas, describing what you check and why. Review her nutrition and continence. Decide on actions and equipment, including who you need to tell, explain the plan to her and complete the record provided.

What this station tests

• Use a validated risk tool and inspect every pressure area.
• Non-blanching redness with intact skin is category 1; it is reversible if acted on.
• Pressure-relieving surfaces, repositioning, continence care and nutrition work together.
• Report and record hospital-acquired damage in line with policy.
• Explain the plan and ask patients to call for help.

Sources for the clinical content

• HSE: National Wound Management Guidelines 2018
• HSE: pressure ulcers
• BAPEN: Malnutrition Universal Screening Tool
• NMBI: Code of Professional Conduct and Ethics
• RCSI: overseas aptitude test preparation (public topic list)

An original practice scenario with invented patients. Not an exam question.

Practise next

• Found on the floor after a fall on the ward