Leading the way in prevention
Despite the existence of prevention protocols, pressure ulcers are still one of the most common hospital-acquired conditions
Hospital-acquired pressure ulcers
Pressure ulcer prevalence ranges between 7.3% and 23% in hospitals throughout Europe and North America
The causes of pressure ulcers
Pressure ulcers are caused by a complex interplay of factors – with pressure on a patient’s skin and subcutaneous tissues playing a major role. Extrinsic factors such as shear and friction, and increased skin temperature and humidity may also be involved
The burden of pressure ulcers
Pressure ulcers cause needless suffering, discomfort and pain for patients. And they lead to longer hospital stays, and increased demand on staff time and resources
Preventing pressure ulcers
The cost of treating pressure ulcers is 3.6 times the cost of preventing them
Key aspects of pressure ulcer prevention
Standard practices aimed at preventing pressure ulcers include:
- Risk assessment to identify ‘at risk’ patients (this normally involves the use of a risk assessment tool (e.g. Braden Scale) in combination with a skin assessment)
- Skin and tissue assessment to look for signs of early pressure damage
- Preventive skin care to promote skin integrity and protect the skin from damage (keeping the skin clean and dry will help to control microclimate)
- Use of support surfaces to reduce the magnitude of pressure
- Keeping the head of the bed at or below 30 degrees elevation in order to reduce the risk of shear
- Use of prophylactic dressings to areas frequently exposed to friction and shear (e.g. sacrum, heel)
- Turning and repositioning patients to reduce the duration of pressure
- Providing nutrition and hydration to maintain tissue tolerance for pressure
Prophylactic dressings
Prophylactic dressings worn on high-risk areas are a key aspect of prevention protocols. An international clinical practice guideline
The results of several studies, including randomised controlled trials, show that these dressings are effective in preventing sacrum and heel pressure ulcers
Turning and positioning systems
Patient repositioning is an important aspect of prevention protocols
- turning and positioning systems that make it easy for hospital staff to move their patients, reduce the physical effort required and reduce the risk of staff injuries
- fluidised positioners that are easily moulded to any shape and will hold the patient in the required position until the next scheduled repositioning
- heel boots designed specifically for positioning the high-risk heel area
'References'
