Pressure Ulcers CareResources for Nursing
July 23, 2012 — 1,397 views
According to the U.S. National Library of Medicine, pressure ulcers occur when an area of the skin experiences reduced blood flow. An ulcer forms when the skin breaks down after something continues to run or press on the skin. The reduced blood flow can cause this area of the skin to die and an ulcer to develop.
Patients who are at higher risk for developing pressure ulcers include those who are in a wheelchair who stay in bed for extended periods of time, those who suffer from diseases that cause reduced mobility such as multiple sclerosis, those who suffer from a disease that affects blood flow such as diabetes and those who have fragile skin or who are malnourished. The source states that pressure sores most commonly occur on the heels, hips, elbows, shoulders and back.
Healthcare professionals must be aware of the best practices when handling wound care and pressure ulcers as these can lead to infection if not prevented and treated properly. Johns Hopkins Medicine reports this is significant because pressure ulcers are associated with an increased morbidity and mortality as nearly 70 percent of patients who develop these die within six months. Pressure ulcer incidence has been determined to be a quality of care indicator for healthcare facilities and it is regulated by the Center for Medicare and Medicaid. Furthermore, the resource states that wound allegations are the second leading cause of long term care (LTC) litigation.
A physician or nurse can determine the development of pressure ulcers by using the grading, or staging system, that measures the breakdown of the skin, according to StopPain.org. Stage one begins with red or purple shaded skin and the area may feel painful or warm to the touch. Throughout stages two and three, the area will become progressively worse as skin blisters form. Finally, in stage four, the wound is deep and the muscles, tendon or bone may become visible.
Johns Hopkins states that healthcare professionals should take preventative measures such as providing an appropriate support surface, repositioning patients every two hours in bed and every one hour in a chair and using positioning pillows when caring for patients who are at risk for pressure ulcers. Doughnut-type devices should not be used and patients should not be positioned directly on the trochanter. Finally, encourage use of a trapeze if possible and utilize lift and transfer devices when necessary in order to reduce friction and shear.