Pressure Injury Prevention

Heidi Cross's picture

By Heidi Cross, MSN, RN, FNP-BC, CWON

Given the potential consequences of FTT, recognition and diagnosis of this phenomenon are important components of care in older adults. Regardless of status, health care providers should implement and document all appropriate measures within patient goals of care. One of the key factors in lawsuits is a lack of communication with family members, who maintain that they were not informed in a timely manner about their loved one’s health status and prognosis.

Holly Hovan's picture

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Moisture-associated skin damage (MASD) is becoming increasingly prevalent in today’s health care system. Often associated with discomfort and pain, MASD ultimately negatively impacts quality of life. MASD is usually broken down into 3 or 4 categories, most commonly incontinence-associated dermatitis (IAD), intertriginous dermatitis, periwound dermatitis, and peristomal dermatitis. In this blog, I focus on the prevention and treatment of IAD and subsequent pressure injuries in critical care through a nurse-led approach.

Robin Lenz and Fahad Hussain's picture

By Dr. Lenz and Dr. Hussain

For the patient, the prevention of sores and injuries is better than treating them. Pressure-relieving mattresses may be essential for preventing pressure injuries (bed sores). These mattresses aid in relieving and redistributing pressure and can thereby cause a reduction of friction and shearing. Pressure-relieving mattresses provide support for the body and reduce the amount of force applied to a given area. Thus, for bedbound patients and patients who are unable to reposition themselves, these types of beds can be especially beneficial.

Robin Lenz and Fahad Hussain's picture

By Dr. Lenz and Dr. Hussain

Heel pressure injuries and various forms of ulcers are easy to identify, but are you overlooking sleeping position as a cause for wounds in other locations? Do you have a wound you are sure is venous but has normal venous insufficiency testing results and fails to respond to compression? Can pressure while sleeping slow or stop healing in your patients with venous and arterial wounds? Do you ask patients about their sleeping position in your history taking and physical examination? After reading this article, you will be able to ask patients about their sleeping habits and heal more wounds with that knowledge

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

Medical device–related pressure injuries (MDRPIs) are recognized as a significant problem, evidenced by the inclusion in the National Pressure Injury Advisory Panel pressure injury definitions and described by Pitman and Gillespie in 2020.1 Prevention of medical device-related pressure injuries is a goal that may be achieved through meticulous patient care.

Holly Hovan's picture

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Pressure injuries (PIs) typically are the result of unrelieved pressure, shear, or force. In an inpatient or hospital setting, interventions are put into place to prevent pressure injuries based on evidence and patient risk. However, PIs still develop in some patients despite interventions. Experts agree that most PIs are in fact avoidable; however, some patients may experience unavoidable skin breakdown at end of life (EoL).¹ Kennedy terminal ulcers (KTUs), skin changes at life’s end (SCALE), and Trombley-Brennan terminal tissue injuries (TB-TTIs) are some of the common terms used to describe unavoidable skin changes at EoL.¹

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By WoundSource Editors

Pressure injuries are common among patients who experience extended exposure to pressure on a bony prominence or shear to areas of poor turgor, two factors that lead to constriction of a patient’s blood supply to the exposed area. A patient who is bedridden or has certain chronic conditions, such as diabetes, is more likely to develop a pressure injury. When mechanical force is imposed on the skin, it can result in poor blood flow and damage to the bone-muscle interface, thus making tissue sensitive and painful. For patients with limited mobility, this can be especially frustrating because they may not be able to adjust positions or medical equipment. If pressure injuries are left untreated or unnoticed, they can also become infected and even enter muscle and bone. Risk assessment tools are available to assess pressure injury risk and can work in tandem with practice standardization, thereby leading to effective treatment plans for practitioners and patients.

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Ivy Razmus's picture

by Ivy Razmus, RN, PhD, CWOCN

Neonatal patients have unique skin properties compared with older patient populations. However, there is little evidence reported for neonates who receive pressure injury (PI) prevention interventions and the related occurrence of PIs compared with adults. The use of a pressure redistribution surface is intended to decrease pressure and thereby reduce PIs. The Institute for Healthcare Improvement guidelines recommend a support surface that meets the patient’s need for pressure redistribution based on the level of immobility and inactivity to reduce shear and change microclimate; additional factors for type of surface include size and weight of the patient and whether there are existing PIs. Consequently, knowledge about selection and use of pressure redistribution surfaces for neonatal patients is needed.

Ivy Razmus's picture

Neonates are widely known as a vulnerable patient population—especially critically ill and premature infants.1 This vulnerability has limited clinicians’ knowledge of moisture management products in the neonatal population that prevent pressure injuries. Recently, a survey of neonatal nurses from across the United States was conducted to find out what is being used for moisture management.2

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Pressure injuries impact quality of life. Tissue destruction in pressure injuries occurs when capillaries supplying the skin structure are compressed for a prolonged time, usually occurring between a bony prominence and a surface. Education and prevention are essential in reducing the prevalence of pressure injuries.

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