As someone responsible for caring for patients with decreased mobility, it’s essential to be aware of and be conscious of the possibility of pressure injuries.
Being aware of the risks as well as the ways to prevent such injuries can go a long way in making your patients feel comfortable as well as giving them a better quality of life.
Assessment
When we talk about the subject of pressure injuries, prevention of skin damage is of utmost importance. Relieving the pressure exerted by gravity and weight should be a priority especially over what is assessed as “susceptible areas.”
Facilities have pressure injury risk assessment tools that are readily available. Policies and procedures also exist, most of them incorporating the Braden Scale. It’s important to note, however, that it is up to the clinician’s judgment to increase the risk level if he or she feels that the resident or patient is at high enough risk.
Develop a Plan of Care
Given how each patient’s condition is entirely different from one another, it’s essential to develop an individualized plan of care tailored to each patient’s specific needs. Such a plan should include the following measurable goals:
Prevention and healing
Supportive devices and surfaces
Daily skin care
Position changes
Diet
Lifestyle changes
Risk Factors
Pressure injuries are caused by friction combined with shear applied to the skin over a period of time. Since an older person’s skin is relatively thinner and considered a lot more delicate, they are at an increased risk of developing such injuries.
Below are some of the other risk factors you should be aware of:
Reduced sensation or ability to feel and respond to pain or discomfort
Lack of voluntary control over urination and defecation
Obesity
Immobility and paralysis
Malnutrition or dehydration
Circulation issues that results in reduced blood flow to the skin
Best Practices
Constant position changes
Patients who spend most of their time confined to a bed should be assisted in changing position at least once every two hours including at night time. For patients on a wheelchair, repositioning every 15 to 30 minutes is recommended.
Use of positioning aids
Positioning aids like pillows can be used as buffers between the skin and the bed or chair. Heel lifts, heel boots, and wedge pillows are also good alternatives in removing pressure from areas at risk of developing pressure injuries.
Daily skin care
A good skin regimen will also help in reducing the risk of pressure injury. Make sure to check for redness or signs of discoloration as often as possible while also maintaining the moisture level.
Frequently check and cleanse the skin gently using moisturizing products to keep it supple and keep it from getting dry. It’s crucial to take note that massaging over bony prominences isn’t recommended since these areas are delicate and can easily get injured.
Diet and lifestyle changes
A good diet and proper lifestyle changes is also essential in preventing pressure injuries. Go for nutritious and appetizing meals when possible and consume means that are high in protein.
Take vitamin and mineral supplements and make sure to observe proper hygiene not just for patients but even for all the staff as well as family members the patient gets in contact with.
Lasty, encourage healthy lifestyle changes like changes in the patient’s diet as well as smoking cessation. Adequate fluid intake should also be encouraged.
Always keep in mind that pressure injuries can be difficult to resolve because of the different factors involved. As always, prevention is always better than cure.