Pressure ulcers/injuries pose a major risk to patients by increasing morbidity and mortality and causing significant discomfort.1 They are also prevalent, particularly in long-term care facilities, where patient populations may be at higher risk of developing pressure injuries as a result of factors of age, immobility, and comorbidities.2 To reduce the incidence of pressure injuries effectively, nurses and other health care professionals should be aware of the risk factors and the means to evaluate patients. This will allow caregivers to take steps to prevent problems before they develop and treat them more effectively if they do.
To measure a patient's risk for pressure injuries effectively and take the appropriate prevention steps, health care professionals should use standardized assessment tools such as the Braden Scale For Prediction Pressure Sore Risk® (Braden Scale) or the Pressure Ulcer Scale for Healing (PUSH Tool). The Braden Scale offers a simple six risk factor assessment that takes into account sensory perception, moisture, physical activity, mobility, nutrition, and exposure to friction and shear. Each of these is rated on a three- or four-point scale (one representing the greatest risk), with a combined score of 12 or less indicating a patient who has a high risk of pressure injuries. The PUSH Tool was developed by the National Pressure Ulcer Advisory Panel (NPUAP) to monitor healing over time. The PUSH Tool monitors three parameters: surface area of the wound, wound exudate, and type of wound tissue. The scores are rated from 0 to 10 according to the size of the wound. Tissue types are noted, scoring from 0 to 4. A comparison of total scores measured over time provides a status of wound healing progress or decline.
The NPUAP recommends that individuals who are at high risk for pressure injuries have their skin assessed as soon as possible on admission to the health care facility and on an ongoing basis after their admission. The assessment should include identification of any erythema, measurement of skin temperature, and note of changes in tissue consistency. Localized pain should also be measured to identify areas where damage may be developing.4 Proactive assessment can help prevent the development of pressure injuries in the care facility, thereby helping to reduce incidence rates. By working to stop damage before it develops into a pressure injury, health care providers can help improve patient outcomes, reduce complications, and control costs in the facility. 1,4
1. Bauer K, Rock K, Nazzal M, Jones O, Qu W. Pressure Ulcers in the United States' Inpatient Population From 2008 to 2012: Results of a Retrospective Nationwide Study. Ostomy Wound Manage. 2016 Nov;62(11):30-38.
2. White-Chu EF, Flock P, Struck B, Aronson L. Pressure ulcers in long-term care. Clin Geriatr Med. 2011 May;27(2):241-58. doi: 10.1016/j.cger.2011.02.001.
3. Primiano M, Friend M, McClure C, et al. Pressure ulcer prevalence and risk factors among prolonged surgical procedures in the OR. AORN J. 2011 Dec;94(6):555-66. doi:10.1016/j.aorn.2011.03.014.
4. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler, ed. Cambridge Media: Osborne Park, Western Australia; 2014.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.