Why is reducing pressure ulcers important?
A pressure ulcer or bed sore is an injury to the skin caused by constant pressure over a bony area which reduces the blood supply to the area. Patients who cannot easily reposition themselves are often susceptible to this condition and need special care.
Pressure ulcers form surprisingly quickly and can be very dangerous and painful, in part because broken skin can allow infection into the body. If untreated, they can deepen and even expose the bone. Deeper ulcers may be hard to heal or may not heal at all. Sometimes, pressure ulcers can lead to death.
The total cost in the UK estimated to be £1.4 billion to £2.1 billion annually – 4% of total NHS expenditure. (Bennett et al 2004)
• Decrease in ability to move without help
• Decrease in mental capacity
• Increase in pain
• Decrease in bowel and bladder function
• More incontinence
• Increased risk for infection
• Less participation in activities
Proven techniques for nurses can reduce and almost eliminate this uncomfortable and potentially dangerous condition:
• Read care plans to learn who is at risk of developing pressure ulcers.
• Repositioning who are immobilized when in bed or when up in a chair.
• Provide frequent incontinence care. Remove urine and/or faeces from the skin as soon as possible.
• Adults who have been assessed as being at risk of development a pressure ulcer should be encouraged to change their positions frequently – at least every six hours. If at high risk, then every four hours. (NICE 2014)
• Provide water regularly because well-hydrated skin will not break down easily.
• Check the skin each time you provide care. Note and report redness especially over a bony area which does not disappear.
• If the care plan requires a dressing, make sure it is there.
• Make sure meals are nutritious. Always report if patients aren’t eating well.
• Look for opportunities to increase patient mobility through activities and/or socialization.
• Follow protocols for pressure ulcer prevention and treatment.
• Share what you learn and know with other nursing staff.
24 Hour Postural Management
Postural management is the use of any technique to minimise postural abnormality and enhance function (Farley et al. 2003)
It is a multi-disciplinary approach and clients must be assessed individually.
“A postural management programme is a planned approach encompassing all activities and interventions which impact on an individual’s posture and function. Programmes are tailored… and may include special seating, night time support, standing supports, active exercise, orthotics, surgical interventions, and individual therapy sessions.” (Gericke 2006)
Remember 95% of pressure ulcers are preventable.