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Preventing Pressure Injuries in High-Risk LTC Residents

Preventing pressure injuries has always been a challenge for healthcare. Here’s what long-term care providers can do.

Preventing pressure injuries has always been a challenge for the healthcare and long-term care industries. In addition to the high cost of treatment, pressure injuries have an immensely negative impact on patients’ lives. The development of pressure ulcers or injuries can interfere with patients’ functional recovery, is often complicated by pain and infection, and can contribute to longer hospital stays. Furthermore, the presence of pressure injuries is a marker of poor overall prognosis and may contribute to premature mortality.

Pressure injuries are commonly seen in high-risk populations, such as the elderly; those requiring ventilators; and those who are very ill. Critical or intensive care patients are always at heightened risk for pressure injury development because of hemodynamic instability, increased use of devices and the use of vasoactive drugs. Since 2008, the Centers for Medicare and Medicaid Services (CMS) stopped paying for additional costs incurred for hospital-acquired pressure injuries because the development of pressure injuries can be prevented: with a comprehensive pressure injury prevention and treatment plan which includes an off-loading or pressure redistribution bed and seated support surface.

Preventing pressure injuries is incredibly resource and time-intensive. Every patient must be given a comprehensive skin assessment repeatedly throughout their stay. For patients who are at risk for or have a pressure injury, a myriad of interventions is recommended such as regularly off-loading the patient in their bed or chair, applying dressings to body bony prominences, and changing their meals to enhance proper nutrition.

Pressure relieving and redistributing devices are widely accepted methods of trying to prevent and help treat pressure injuries. The devices used include different types of mattresses, overlays, cushions and seating. These devices work by reducing or redistributing pressure, friction, or shearing forces; and helping control the microclimate at the skin/mattress interface.

Proper selection of a support surface depends on factors such as the mobility of the individual, the results of skin assessment, the level of and site at risk, weight, staff availability and skill, plus the general health and condition of the individual. It is also important that any device can be cleaned and decontaminated effectively. It is accepted that these devices should be used in conjunction with other preventative strategies such as repositioning. Help prevent pressure injuries at your facility by issuing a specialized pressure redistribution bed and seated support surface for every patient at risk for or with a pressure injury.

About the Author

Karen Lerner, RN, MSN, ATP, CWS is Regional VP of Pressure Prevention, at Drive DeVilbiss Healthcare.


This article was adapted from content originally posted on