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Heeling Suspension Boot Evaluation Form

How to fill out revised heelift evaluation form

How to Fill Out the Revised Heelift Evaluation Form:

1. Start by entering the patient's personal information in the designated fields. This includes their name, date of birth, gender, and contact information.
2. Proceed to the medical history section, where you will be required to provide details of the patient's current health status. This may include information about any existing medical conditions, surgeries, or medication allergies.
3. Next, evaluate the patient's risk factors. Assess their level of mobility, skin integrity, and overall health. This will help determine whether the patient is at high risk for pressure ulcers or not.
4. Move on to the evaluation of the current support surface being used by the patient. This includes assessing the type of mattress or cushion being utilized, as well as any additional aids such as positioning devices or heel protection devices.
5. In the next section, record your observations regarding the patient's heel condition. Assess the skin integrity, presence of any wounds or pressure injuries, and document any signs of redness or swelling.
6. Finally, provide recommendations for the appropriate heel relief interventions based on your evaluation. This may involve the use of heel cushions or specialized support surfaces to alleviate pressure.

Who Needs the Revised Heelift Evaluation Form?

1. Healthcare professionals involved in wound care, podiatry, or rehabilitation may need to use the revised Heelift Evaluation Form. This form helps in assessing and managing heel-related issues, such as pressure ulcers or skin breakdown.
2. Patients who are at risk of developing pressure ulcers, especially in the heel area, may require the use of this evaluation form. It aids healthcare professionals in determining the most suitable interventions to prevent or treat such conditions.
3. Caregivers or family members involved in the care of individuals with limited mobility or compromised skin integrity should be familiar with this form. It helps them understand the importance of heel protection and how to identify potential issues.

Note: The revised Heelift Evaluation Form should be used in conjunction with clinical judgment and other assessment tools to provide comprehensive care for patients at risk of developing heel-related conditions.

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