Preventing the development of pressure ulcers
Pressure ulcers have to be considered on time. Most pressure ulcers can be prevented through early identification of persons with a higher pressure ulcer risk and proper professional care procedures.
If a person is considered to belong into the risk group, check at least once a day the spots with the highest exposure to pressure. The situation may change with time, so it is necessary to make regular skin status checks.
The first preventive measure is to check what type of mattress or seat pillow is used by the person exposed to risk of developing pressure ulcers. All persons in the risk group have to be provided with pressure relief pads. The application of pressure relief products is of utmost importance in the prevention of pressure ulcers.
Pressure mattresses and pressure cushions for pressure ulcers prevention consist of temperature sensitive highly elastic foam with open cell structure. The foam adapts to body temperature and shape, enabling an optimum pressure distribution. The body area in contact with the base while lying or sitting is increased, which reduces the pressure on tissue.
The preventive measures do not only involve pressure, but also the duration of an external pressure on the same area. The ability of a person to resist potentially bad effects of external pressure depends on many important factors. The most important factor is friction.
Therefore, it is necessary to provide a soft base in order to reduce the body pressure as much as possible, to take care that bed linen is tightly pulled, clean and dry, because wrinkles and moist irritate the skin.
The base has to be selected with respect to the patient’s individual requirements, so special care should be taken of:
- person’s weight
- pressure ulcers development
- pressure ulcers stage
- time spent lying/sitting
The selection of an appropriate base also has to do with the type of bed. The bed may not be too high for the patients who are able to get up and lie down on their own.
Mattresses and cushions that are used 24 hours a day, 365 days a year are exposed to extreme wear and tear and have to be aerated regularly and replaced if necessary. Both mattresses and cushions are consumable products.
Along with the right choice of lying or sitting base, regular patients hygiene is also necessary – medical cosmetics, careful wiping of the body and skin care with medical balms. You can additionally boost blood circulation with either active or passive exercise, introduce a protein rich diet, increase fluids and vitamin C intake.
Spontaneous movements are the way in which our bodies resist the development of pressure ulcers and other complications caused by long confinement to bed. Persons with reduced sensitivity (paralysis, contractures or syncope), due to reduced reaction, its absence or incapability of feeling pain or discomfort, do not react to warning signs of their bodies. Therefore, they need regular help when changing body positions.
Little and frequent position changes are often sufficient for a good blood circulation. Regardless of the base, working with position changes has to be aligned with the patient’s status, individual requirements and wishes of the patient. The lying and sitting positions have to be adjusted to that the pressure between the skin, the bony prominence and the base are reduced as much as possible. The time that a person spends sitting or lying without position changes should not exceed two hours, but this has to be individually adapted.
The pressure required to develop pressure ulcers depends on the pressure force and the duration of pressure on tissue. It may vary from person to person, but pressure location and the overall health status of the patient play a decisive role.
Whenever possible, use aids for patient removal or position change, as they are helpful both for the personnel and the patient, reducing the risk of damage caused by shearing or friction. Never place the patient directly on the bony prominence or on the already reddened skin. Red coloration of the skin is a signal that the body has not yet recovered from the previous pressure and that this particular skin area needs a bit more time before pressure can be applied on that spot again. To reduce the risk of pressure ulcers development, it is important to reduce the duration and force of the pressure the patient is exposed to.
Incontinence has to be taken care of with the application of quality disposable aids, because moisture is one of the important risk factors in the development of pressure ulcers. It is necessary to use quality medical cosmetics and maintain regular skin hygiene.
Let us repeat once more:
- lay the base for pressure relief
- check regularly the spots most exposed to pressure
- maintain regular patient’s hygiene
- use cushions and other pressure relief aids
- change the patient’s position every 2 hours
- never place a person directly on the bony prominence
- make sure that bed linen is dry and tightly pulled (no wrinkles)
- do active or passive exercises
- use aids for moving or changing of the patient’s position
- monitor closely the status and individual requirements of the patient
- provide quality care for incontinence
- assure quality diet for the patient