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DAILY SKIN INTEGRITY CHECK AND REPOSITIONING RECORD
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(For Pressure Ulcer Prevention) Patient Name:MRN/ID:
Room/Bed:
Date:Allergies:Diagnosis/Risk Factors:
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Reposition every 2 hours and assess skin integrity.
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TimeRepositioned ToSkin Integrity (All areas intact? Y/N + Details/Location of redness or issues)Comments/InterventionsInitials
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6:00
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8:00
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10:00
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12:00
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14:00
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16:00
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18:00
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20:00
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22:00
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0:00
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2:00
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4:00
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Skin Status Guidance:
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Y = All areas intact (no redness, breakdown, or pain)
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N = Issues noted (describe location, e.g., "redness on sacrum - non-blanchable", "heel tenderness") notifications):
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Additional Comments / Actions Taken (e.g., skin care applied, devices checked,
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Staff Signature:Print Name:Date:
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Print Settings for Excel: Set page orientation to Landscape, Scaling: Fit to 1 page wide by 1-2 pages tall, Margins: Narrow. Use Arial 10pt font for content. Adjust column widths as needed (widen Skin Integrity and Comments columns).
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