Prevention plans are critical for bedridden or immobile patients, especially those with pre-existing issues that could put them at risk for pressure injuries.
Risk Assessment: Those with limited mobility, fragile skin, compromised circulatory health or an existing pressure injury are particularly at risk for developing or worsening pressure injuries. Use a structured risk assessment tool, such as Braden Scale, to identify individuals at risk and repeat the risk assessment at regular intervals and/or with any change in condition.
Positioning/Repositioning: Patients should be carefully positioned on a mattress, chair or wheelchair and regularly repositioned as often as needed. Use air support surfaces or pressure redistributing mattresses for preventive care, pressure redistributing chair cushions for individuals in chairs or wheelchairs, and heel offloading devices or mattresses to relieve heel pressure.
Skin Inspections: Regularly examine the patient’s skin for damage or discoloration, especially in areas of pressure points such as buttocks, elbows and heels. The first signs of an injury may include tissue that is red and does not turn white when pressure is applied with a finger. Additional signs include swelling, heat, tender areas or thickening of the skin.
Skin Care: Keep the patient’s skin clean, dry and hydrated. Cleanse the skin promptly after episodes of incontinence. Use pH balanced cleansers and moisturizers for dry skin. Carefully dry skin after bathing and avoid any friction that may cause damage.
Moisture: Ensure that the patient is not excessively perspiring in areas that are most susceptible to pressure injuries. Use a breathable incontinence pad if needed and Low Air loss support surfaces to help individuals stay cool and dry.
Nutrition: A patient’s diet should be assessed regularly to ensure all nutritional needs are being met. Assist the individual at meal time to increase oral intake and assess weight changes over time. Provide nutritional supplements between meals as approved by the clinician. Hydration and proper nutrition are essential in preventing and treating pressure injuries.