Prevention of Pressure Ulcers – Learn the Best Practices

Pressure UlcersHaving a pressure ulcer can be a painful and unpleasant experience. A large number of pressure ulcers are avoidable. Patients who develop pressure ulcers while in the hospital have a greater risk for developing infections. Wound care consulting helps in management of such conditions. Also known as bed sores or pressure sores, pressure ulcers are usually caused by some sort of constant pressure that damages the skin and underlying tissue. According to the Agency for Health Research and Quality, each year more than 2.5 million people in the United States develop pressure ulcers.

Pressure ulcers can range in severity from mild (minor skin reddening) to severe (deep craters down to the muscle and bone). The condition usually occurs over a bony prominence in highly vulnerable areas such as the elbows, lower back, coccyx and heels. Even slight rubbing or friction on the skin may cause pressure ulcers. Risk factors for developing pressure ulcers include mobility, activity, sensory perception, nutrition, arteriolar pressure, age, friction and moisture.

Risk Assessment Plays a Critical Role

Risk assessment is crucial to recognize a patient’s risk of developing pressure ulcers. It facilitates care planning and clinical decision making. Clearly documented risk assessment is vital in preventing and treating pressure ulcers. Most healthcare centers are now using wound care software programs to document these assessment and treatment details. Clear documentation also assists in differentiating avoidable or unavoidable ulcer, and indicates whether all possible actions were taken to try to prevent the pressure ulcer.

A patient’s risk of developing a pressure ulcer must be assessed:

  • within six hours of admission
  • weekly basis
  • with change in resident’s health and
  • before transfer to other clinic or facility

It is also recommended that the same assessments must be repeated when transfer occurs between beds or when a patient’s condition changes. The patient’s overall physical and psychological health should also be assessed.

Other best practices that can prevent ulcer include:

  • Better skin care – Examine patient’s skin regularly for signs like non-blanching erythema and swelling of pressure damage. Also keep the patient’s skin clean, dry, and hydrated to prevent damage. Avoid any rubbing or friction. Make sure to use pH balanced soaps or skin cleansers to wash skin gently.
  • Prevent malnutrition – Include meals that are rich in nutrition in patient’s diet. Also assess the diet regularly and any nutritional needs should be addressed. Keeping patients hydrated is also important to prevent damage.
  • Avoid excess moisture – Ensure prevention of moisture retention and excessive warmth. Excessive perspiration, oedema and incontinence can result in skin damage from excess moisture. Incontinence is particularly harmful and appropriate measures should be taken to prevent any associated damage. Protect skin by applying barrier creams, gels or pastes.
  • Change positions – Positions should be changed frequently, which reduces the risk of developing pressure sores. If the patient is lying on the back for a while, encourage to reposition one’s self regularly. For those who require assistance, repositioning should be done with consideration for the patient’s comfort, dignity and functional ability.

Accurate documentation of such care planning using wound management software is essential to ensure continuity of care and the best results.