Pressure Injury Prevention Awareness

By Mountain-Pacific

Pressure injuries can be serious wounds, and preventive care is one of the best ways to avoid them. As a care giver, that means knowing the signs and stages of pressure injuries, because like many conditions, the earlier you identify symptoms and treat them, the better the outcome.

Pressure injuries, also called pressure ulcers, bed sores, pressure sores or decubitus ulcers, occur when weight is continually put on a person’s skin. People at risk often have a condition that limits their movement or ability to change positions. Pressure injuries usually appear on bony parts of the body, such as on the back, shoulders, hips, heels or back of the head.

Pressure injuries have four stages. Stages 2, 3 and 4 need special wound treatment from a professional.
Stage 1 – Redness of skin that is persistent
Stage 2 – Loss of partial thickness (top layers) of skin; appears as an abrasion, blister or a shallow crater
Stage 3 – Loss of full thickness (deeper layers) of skin; appears as a deep crater
Stage 4 – Loss of full thickness of skin exposing muscle or bone

Prevention – Skin Care
Monitoring and protecting a person’s skin is important to help prevent pressure injuries. It can also help identify a Stage 1 sore before it gets worse.

• Clean affected skin with soap and warm water then gently pat dry.
• Apply lotion to dry skin and talcum powder to moist skin. Frequently change bedding and clothing. Be aware of buttons or wrinkles in clothing that can irritate skin.
• Inspect skin on a daily basis. If it is hard to see any part of a person’s body, use a mirror.
• If a person struggles with incontinence, promptly cleanse his or her skin to remove moisture and bacteria. Change bedding/clothing often, especially if wet.

Prevention – Repositioning in Wheelchairs

• Consider a specialty wheelchair (some have tilt functions that can relieve pressure).
• Use a cushion that is gel-, air-, water- or foam-filled. Be sure the cushion fits the wheelchair. Poorly fitted cushions can cause pressure injuries.
• If possible, encourage a person in a wheelchair to lift him or herself off the seat and to shift his or her weight frequently by pushing on the arms of the chair.

Prevention – Repositioning in Beds

• Change body positions every two hours, if possible.
• Consider a water-, foam- or air-filled mattress that can relieve pressure on bony areas.
• Consider a bed that mechanically adjusts. Never elevate the head of the bed for more than an hour at a time.
• Support a person’s legs with extra pillows. Place clothes in areas to avoid skin-on-skin contact.

Mountain-Pacific has developed a train-the-trainer CD, guide and PowerPoint presentation about pressure injury awareness and education. Please contact Mountain-Pacific’s Wyoming Director Pat Fritz if interested in these tools at Pat.Fritz@area-H.hcqis.org.