CNA Shower Sheets Form PDF Details

The CNA Shower Sheets form plays a crucial role in maintaining the well-being and health of residents in care facilities. By facilitating a comprehensive visual assessment of a resident's skin during shower times, this document serves as a vital tool for Certified Nursing Assistants (CNAs) to identify and report any abnormalities, such as bruising, skin tears, rashes, swelling, and various other conditions, to the charge nurse promptly. The form also enables detailed documentation of the condition, including the specific location and description, thus ensuring accurate communication with the Director of Nursing (DON) for further review. Additionally, the form includes sections for signatures from the CNA, charge nurse, and DON, along with a prompt about the resident's need for toenail care, further emphasizing its role in comprehensive resident care. Prepared by Primaris under contract with the Centers for Medicare & Medicaid Services (CMS), this form underscores the importance of vigilant skin monitoring in preventing complications and improving the quality of life for residents, reflecting the broader commitment of healthcare providers to meticulous, person-centered care.

QuestionAnswer
Form Name CNA Shower Sheets Form
Form Length 1 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 15 sec
Other names shower schedule nursing home template, shower sheets for cna, cna shower form, shower sheets for nursing homes

Form Preview Example

Skin Monitoring: Comprehensive CNA Shower Review

Perform a visual assessment of a resident’s skin when giving the resident a shower. Report any abnormal looking skin (as described below) to the charge nurse immediately. Forward any problems to the DON for review. Use this form to show the exact location and description of the abnormality. Using the body chart below, describe and graph all abnormalities by number.

RESIDENT: _______________________________________________ DATE:_______________________

Visual Assessment

1. Bruising

2. Skin tears

3. Rashes

4. Swelling

5. Dryness

6. Soft heels

7. Lesions

8. Decubitus

9. Blisters

10. Scratches

11. Abnormal color

12. Abnormal skin

13. Abnormal skin temp (h-hot/c-cold)

14. Hardened skin (orange peel texture)

15. Other: _________________________

CNA Signature:_________________________________________________________ Date: ____________________

Does the resident need his/her toenails cut?

Yes No

Charge Nurse Signature: ________________________________________________ Date: ____________________

Charge Nurse Assessment:___________________________________________________________________________

_________________________________________________________________________________________________

Intervention: ______________________________________________________________________________________

_________________________________________________________________________________________________

Forwarded to DON:

Yes No

DON Signature: ________________________________________________________ Date: ____________________

Document available at www.primaris.org

MO-06-42-PU June 2008 This material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouri, under contract with the Centers for Medicare

&Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily relect CMS policy. Adapted from Ratlif Care Center.

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