Pressure Injury Prevention

Janet Wolfson's picture

by Janet Wolfson, PT, CLWT, CWS, CLT-LANA

In March of 2017, regular readers of this blog may recall "Making a Daily Difference in Preventing Pressure Injuries." I imagined a wonderful facility where staff went about their duties with a corner of their brain always attentive to how patients' diagnoses, activities, and comorbidities could affect the tendency to develop a pressure injury (ulcer). Magically, the appropriate prevention occurred.

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Nancy Munoz's picture
Nutrition and Protein

by Nancy Munoz, DCN, MHA, RDN, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury as localized damage to the skin and/or underlying soft tissue, usually over a bony prominence or related to a medical or other device. The injury can manifest as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure, occasionally in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities, and the condition of the soft tissue.

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Holly Hovan's picture
patient mobility and activity

By Holly Hovan MSN, APRN, CWOCN-AP

The Braden category of activity focuses on how much (or how little) the resident can move independently. A resident can score from 1 to 4 in this category, 1 being bedfast and 4 being no real limitations. It is important to keep in mind that residents who are chairfast or bedfast are almost always at risk for skin breakdown.

Holly Hovan's picture
enteral nutrition feeding

By Holly Hovan MSN, APRN, CWOCN-AP

A common misconception by nurses is sometimes predicting nutritional status based on a resident's weight. Weight is not always a good predictor of nutritional status. Nutritional status is determined by many factors and by looking at the big picture.

WoundSource Practice Accelerator's picture
pressure injury risk assessment

by the WoundSource Editors

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.

WoundSource Practice Accelerator's picture
repositioning for pressure injury prevention

by the WoundSource Editors

Pressure ulcers/injuries are extremely prevalent, particularly in long-term and other care facilities, and primarily affect older adults, those with cognitive impairment, mobility issues or individuals who are bedfast. Understanding the best ways to prevent skin damage before it develops into a significant injury is critical to improving patient outcomes and reducing costs.1 This brief guide will introduce nurses and other health care professionals to pressure injury prevention best practices to reduce the risk of patients’ developing these preventable wounds.

WoundSource Practice Accelerator's picture
pressure injury prevention and management

by the WoundSource Editors

Nurses and other health care professionals providing care to patients regularly face challenges that can make it more difficult to perform routine tasks and ensure patient comfort and well-being, especially with regard to pressure ulcer/injury prevention and treatment. From a lack of mobility to chronic diseases, these challenges often coincide and interplay, creating unique risks and complications in managing the care of patients.

Holly Hovan's picture
Moisture on Skin

When nurses hear the term moisture, they usually almost always think of urinary or fecal incontinence, or both. There are actually several other reasons why a patient could be moist. Continued moisture breaks down the skin, especially when the pH of the aggravating agent is lower (urine, stomach contents—think fistula, stool). When there is too much moisture in contact with our skin for too long, we become vulnerable to this moisture, and our skin breaks down. Increased moisture places a patient at risk for a pressure injury as the skin is already in a fragile state.

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Jeffrey M. Levine's picture

by Jeffrey Levine MD

Pressure injury prevention and management are sometimes overlooked in the hospital setting, where the focus is generally on acute illness. Given the immense implications in terms of cost, complications, reputation, and risk management, it is in the interest of all facilities to maximize quality of care with regard to wounds. This post will offer some suggestions on how this can be accomplished in hospitals by tweaking the system for maximum quality.

Cheryl Carver's picture
Stop Pressure Injuries - Pressure Injury Prevention

By Cheryl Carver LPN, WCC, CWCA, CWCP, FACCWS, DAPWCA, CLTC

I consider myself to be beyond blessed. I know that my purpose in life is to be useful, compassionate, and to make a difference in wound care… In any capacity I can. I have no problem sharing my mother's story with my patients. I think it shows that I am genuine and compassionate. I do whatever works to help my patients understand the importance of pressure injury prevention and/or treatment. My point is: do whatever works. It is good to think outside of the box!

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