Tuesday, January 31, 2023

Pressure Ulcer Prevention And Management

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How We Are Trying To Help

Webinar recording: Pressure ulcer prevention and management in care homes

Here at Airospring, we want to prevent this happening to anyone. Thats why we decided to design and develop our range of pressure relief cushions. Our cushions use our patented 3D fabric technology to stop the formation of pressure ulcers in a number of important ways. The three layers spread the pressure around, so that its not all concentrated in one area – this means that the reduction of blood flow which helps lead to pressure ulcers, is far less likely to happen. On top of that, the material is also designed to be breathable – it allows maximum airflow to keep you cool, and to reduce perspiration. Perspiration is another of the leading causes of pressure ulcers.

Getting The Most Out Of Online Literature Searchestips For Advanced Searches

  • Research articleApplied Nursing Research, Volume 28, Issue 2, 2015, pp. 106-113Show abstract Navigate Down

    Pressure Ulcers are associated with high mortality, morbidity, and health care costs. In addition to being costly, PrUs cause pain, suffering, infection, a lower quality of life, extended hospital stay and even death. Although several nursing interventions have been advocated in the literature, there is a paucity of research on what constitutes the most effective nursing intervention.

    To determine the efficacy of multidisciplinary intervention and to assess which component of the intervention was most predictive of decreasing the prevalence of Hospital acquired pressure ulcers in a tertiary setting in Lebanon.

    An evaluation prospective research design was utilized with data before and after the intervention. The sample consisted of 468 patients admitted to the hospital from January 2012 to April 2013.

    The prevalence of HAPU was significantly reduced from 6.63% in 2012 to 2.47. Sensitivity of the Braden scale in predicting a HAPU was 92.30% and specificity was 60.04%. A logistic multiple regression equation found that two factors significantly predicted the development of a HAPU skin care and Braden scores.

    The multidisciplinary approach was effective in decreasing the prevalence of HAPUs. Skin care management which was a significant predictor of PUs should alert nurses to the cost effectiveness of this intervention. Lower Braden scores also were predictive of HAPUs.

  • Definition Of Pressure Ulcer

    A pressure ulcer is a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.

    Whilst pressure ulcers are more likely to affect older people, it is now accepted that people of all ages may be affected, therefore the principles of these guidelines apply to beneficiaries of all age groups.

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    Causes Of Pressure Sores

    Pressure sores happen if you cant move around and so stay in one position for a long time. We normally move about constantly, even in our sleep. This stops pressure sores developing.

    People who are unable to move around tend to put pressure on the same areas of the body for a long time. If you are ill, bedridden or in a wheelchair, you are at risk of getting pressure sores.

    A number of things can increase your risk of pressure sores, including:

    • being unable to move around easily due to old age or illness
    • weight loss – you may have less padding over bony areas
    • sliding down in a bed or chair – pressure on the skin cuts off blood supply because the skin is being pulled in different directions
    • friction or rubbing of the skin, for example against sheets
    • moist skin – for example, due to sweating or incontinence
    • other medical conditions, such as diabetes
    • having a previous pressure ulcer

    Causes And Prevention Of Pressure Sores

    Pressure Ulcer ... it can be prevented!

    Pressure sores are wounds that develop when constant pressure or friction on one area of the body damages the skin. Constant pressure on an area of skin stops blood flowing normally, so the cells die and the skin breaks down.

    Other names for pressure sores are bedsores, pressure ulcers and decubitus ulcers.

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    What Additional Resources Are Available To Identify Best Practices For Pressure Ulcer Prevention

    A number of guidelines have been published describing best practices for pressure ulcer prevention. These guidelines can be important resources to use in improving pressure ulcer care. In addition, the International Pressure Ulcer Guideline released by the National Pressure Ulcer Advisory Panel and the European Pressure Ulcer Advisory Panel is available. A Quick Reference Guide can be downloaded from their Web site at no charge.

    Resources

    Clinical Practice Guideline 3: Pressure ulcers in adults: prediction and prevention. Rockville, MD: Agency for Healthcare Policy and Research May 1992. AHCPR Pub. No. 92-0047. Archived at: .

    Pressure ulcer prevention and treatment following spinal cord injury: a clinical practice guideline for health-care professionals. Consortium for Spinal Cord Medicine Clinical Practice Guidelines. J Spinal Cord Med 2001 Spring 24 Suppl 1:S40-101.

    National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel . Quick Reference Guide version of the NPUAP/EPUAP International Pressure Ulcer Prevention Guidelines: Available at: and .

    The following guidelines are available for a fee:

    American Medical Directors Association: Pressure Ulcers in the Long-Term Care Setting. Available at: http://www.amda.com

    What Are The Stages Of A Pressure Injury

    There are four stages that describe the severity of the wound. These stages include:

    • Stage 1: This stage is discolored skin. The skin appears red in those with lighter skin tones and blue/purple in those with darker skin tones. The skin does not blanch when pressed with a finger.
    • Stage 2: This stage involves superficial damage of the skin. The top layer of skin is lost. It may also look like a blister. At this stage, the top layer of skin can repair itself.
    • Stage 3: This stage is a deeper wound. The wound is open, extending to the fatty layer of the skin, though muscles and bone are not showing.
    • Stage 4: This stage is the most severe. The wound extends down to the bone. The muscles and bone are prone to infection, which can be life-threatening.

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    Avoid Moisture Associated Skin Damage

    Skin protection products are used to minimize risk of trauma related to excessive moisture. It is essential to avoid overexposure of the skin to moisture and implement prevention strategies focused on maintaining skin integrity.Askina® Barrier protects the skin from bodily fluids and provides a long-lasting barrier to the patients skin. It is available in three different formats: Askina® Barrier Cream, Askina® Barrier Film Spray or Askina® Barrier Film Swabs.

    Askina® Barrier Film may be applied on intact or damaged skin and is particularly indicated for protection of peri-wound skin.

    Less Fragile And More Resistant

    Pressure Ulcer Prevention and Management Webinar

    Linovera® Oil is indicated for prevention and treatment of stage 1 pressure ulcers.Linovera® Emulsion is indicated for prevention and treatment of lower limb ulcers, diabetic foot ulcers and stage 1 pressure ulcers. The products formulation is based on hyperoxygenated fatty acids, important linoleic acids which can contribute to a healthy skin structure. Other ingredients are Aloe Vera and Gingko Biloba which act as emollient and humectant. Centella Asiatica is a soothing skin tonic agent. Linovera® lubricates the skin, thus reducing shear and friction and maintaining the moisture barrier function of the skin.

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    Box : Npuap/epuap/ppia Classifications Of Pressure Injury

    Category 1 Pressure Injury: Non-blanchable erythema of intact skin

    Intact skin with a localised area of non-blanchable erythema. This may appear differently in darkly pigmented skin. Presence of blanchable erythema or changes in sensation, temperature or firmness may precede visual changes. Colour changes do not include purple or maroon discoloration these may indicate deep tissue injury.

    Category 2 Pressure Injury: Partial-thickness loss of skin with exposed dermis

    The wound bed is viable, pink or red and moist and may also present as an intact or ruptured serum-filled blister. Adipose is not visible and deeper tissues are not visible. Granulation tissue, slough and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture-associated skin damage including incontinence-associated dermatitis , intertriginous dermatitis , medical adhesive-related skin injury or traumatic wounds .

    Category 3 Pressure Injury: Full-thickness skin loss

    Category 4 Pressure Injury: Full-thickness skin and tissue loss

    What Is A Pressure Injury

    A pressure injury is an area of injured skin. A pressure injury happens when force is applied on the surface of the skin. This force can be a constant pressure on an area of skin or a dragging force between the skin and another surface. These injuries usually happen over bony parts of the body . A pressure injury can become life-threatening if it advances to a deep wound or becomes infected.

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    Who Is At Risk For Developing Pressure Injuries

    • People with a limited amount of mobility or a total inability to move. Those in wheelchairs or bedridden are at particular risk and need to be moved or turned regularly.
    • Those with prosthetic limbs. If the device does not fit properly, the skin can be irritated and a pressure injury can develop.
    • People with a loss of sensation. They are at risk because they may not feel the pressure being applied to the skin. As a result, they may not move, which could worsen the damage.
    • Those with malnutrition. Wound healing is slowed when nutritional needs are not met.
    • The elderly. As people age, the skin naturally becomes thinner and more easily damaged.

    All Ages: Healthcare Professional Training And Education

    How You Can Prevent Pressure Ulcers by Pritchett &  Hull Associates, Inc ...

    Provide training to healthcare professionals on preventing a pressure ulcer, including:

    • who is most likely to be at risk of developing a pressure ulcer
    • how to identify pressure damage
    • what steps to take to prevent new or further pressure damage
    • who to contact for further information and for further action.

    Provide further training to healthcare professionals who have contact with anyone who has been assessed as being at high risk of developing a pressure ulcer. Training should include:

    • how to carry out a risk and skin assessment
    • how to reposition
    • information on pressure redistributing devices
    • discussion of pressure ulcer prevention with patients and their carers
    • details of sources of advice and support.

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    Prone To Sores Every Body Partexpand: More

    Bony protrusions are not the only parts of the body which are exposed to pressure and friction. Other parts are affected, too. For example, when a patient is lying in a supine position, which is the preferred position for critical COVID-19 patients.

    Askina® DresSil® is a foam with a silicone adhesive which ensures gentle, secure adherence and minimal trauma during dressing changes. It can be cut and shaped for application on smaller areas which need protection.

    Askina® DresSil® Border is a foam dressing with silicone adhesive and an additional adhesive border, are made for difficult-to-dress or moving areas as they are able to conform to a variety of anatomical contours.

    Every foam dressing can be repositioned during application or even lifted up during wear time to check the skin or wound. They can also be applied on wounds as they provide a moist environment promoting natural healing.

    Pressure ulcer treatment

    Crafted With Your Health In Mind

    Each 3D Spacer fabric has been engineered to transfer moisture vapour away.

    Microclimates are important in preventing unwanted skin conditions. Its been claimed that wet skin has only 4% of the strength of dry skin, leaving it much more susceptible to breaks, sores and rashes. Dont take any risks when it comes to your health.

    Recent guidance from the European Pressure Ulcer Advisory Panel and the National Pressure Ulcer Advisory Panel states Heat increases the metabolic rate, induces sweating and decreases the tolerance of the tissue for pressure. When body heat cannot dissipate it will increase the risk of skin breakdown and may impede healing.

    Pressure ulcers are a really nasty health problem that are both painful and entirely avoidable. Wheelchair users or those who spend a lot of time sitting down are the most at risk of these and we have designed our cushions and mattress overlays with their prevention in mind.

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    Prevention And Management Of Pressure Ulcers In Primary And Secondary Care: Summary Of Nice Guidance

  • Gerry Stansby, professor of vascular surgery and honorary consultant vascular surgeon1,
  • Liz Avital, associate director2,
  • Grace Marsden, senior health economist2
  • On behalf of the Guideline Development Group
  • 1Department of Vascular Surgery, Freeman Hospital, Newcastle upon Tyne, UK
  • 2National Clinical Guideline Centre, Royal College of Physicians, London NW1 4LE, UK
  • Correspondence to: L Avital liz.avitalrcplondon.ac.uk
  • Pressure ulcers are serious and distressing, and they can affect people of any age. Not only do they increase mortality, result in extended hospital stays, and consume substantial healthcare resources, they are often an example of avoidable harm. Reported prevalence rates range from 4.7% to 32.1% in hospital populations and as much as 22% in nursing home populations.1 Prevention of this devastating condition must be a priority for the NHS. Stage 1 pressure ulcers can be reversible if identified promptly, and most stage 2 and 3 ulcers can be healed with appropriate care, but all require a multidisciplinary approach for effective management. It is hoped that this guideline will help reduce pressure ulcers nationally and improve care when pressure ulcers do occur.

    Pressure ulcer categories/stages2

    Category/stage 1: Non-blanchable redness of intact skin
    Category/stage 2: Partial thickness skin loss or blister
    Category/stage 3: Full thickness skin loss

    The depth of

    How Are Pressure Injuries Treated

    Wounds & Pressure Ulcers: Prevention, Evaluation, Management, & Health Literacy

    Pressure injuries can be treated in many ways depending on the stage. Once the stage and severity of the wound is determined, it must be cleaned, usually with a saline solution. After the wound is cleaned, it needs to be kept clean, moist, and covered with an appropriate bandage. There are several different types of bandages your doctor may use to dress the wound. These include:

    • Water-based gel with a dry dressing

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    Needed Change In Prevention Of Pressure Ulcers: Lewins Change Theory Essay

    Pressure ulcers are injuries that occur on the skin of an individual and the underlying tissues and are caused by increased and sustained pressure on the affected area. This pressure often interrupts blood flow resulting in decreased supply of oxygen and nutrients to the affected region resulting in ulceration . Lewins Change Theory involves three fundamental steps unfreezing, changing, and refreezing. The theory indicates that for change to occur, there is a need to recognize the need for change and a subsequent move to the new desired level of behavior. The final step of change, according to the theory, is the solidification of the new behaviors and norms . This paper discusses the application of Lewins Change Theory in the prevention of pressure ulcers.

    According to Lewins Change Theory, the primary phase in preventing pressure ulcers is recognizing the existence of the problem and the class of patients facing the problem. Pressure ulcers are quite common among hospitalized patients who sit or lie in one position for long durations. Additionally, pressure ulcers are usually slow to heal and tend to recur thus, preventing them is quite essential. Patients with a high likelihood of getting pressure ulcers include extremely weak patients and paralyzed or unconscious patients.

    Stop Pressure Ulcer Day 2016

    Tomorrow is a big day – the 17th November is Stop Pressure Ulcer Day. Now, this may not be a day that comes pre-written in your calendar, but it concerns a very important issue that thousands of people face every day. Sponsored by EPUAP , this event has been promoting awareness about this serious condition for a number of years now and were proud to be supporting this initiative.

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    Classification Of Pressure Injuries

    Pressure injuries are classified according to the NPUAP/EPUAP/PPIA guidance, updated in 2014 . An understanding of each classification is essential in helping nurses and other staff to recognise the early development of pressure injuries so that deterioration can be prevented. The initial stage of pressure injury is usually redness of the skin, erythema, particularly over bony prominences. In the first instance, this redness indicates an area of skin that has been subjected to pressure and other forces, resulting in an inflammatory reaction that causes local dilation of blood vessels. This is called blanching erythema if all redness disappears when light finger pressure is applied, indicating that the local capillaries are undamaged. The patient may state that there is localised pain over a bony prominence even before erythema begins . Blanching erythema is a sign that the patients position needs to be changed as there is potential for capillary damage if pressure is not relieved. Blanchable erythema is not considered a pressure injury but an important warning sign that preventive measures are needed. If, however, the forces are not removed, blanching erythema can quickly develop into a pressure injury as indicated by category 1 in Box , non-blanchable erythema of intact skin. Each of the further categories of pressure injury indicates further tissue damage and is much more difficult to reverse than non-blanchable erythema.

    When You Are In Bed

    Pressure Ulcer Prevention Campaign

    Use a foam mattress or one that is filled with gel or air. Place pads under your bottom to absorb wetness to help keep your skin dry.

    Use a soft pillow or a piece of soft foam between parts of your body that press against each other or against your mattress.

    When you are lying on your side, put a pillow or foam between your knees and ankles.

    When you are lying on your back, put a pillow or foam:

    • Under your heels. Or, place a pillow under your calves to lift up your heels, another way to relieve pressure on your heels.
    • Under your tailbone area.
    • Under your shoulders and shoulder blades.
    • Under your elbows.

    Other tips are:

    • Do not put pillows under your knees. It puts pressure on your heels.
    • Never drag yourself to change your position or get in or out of bed. Dragging causes skin breakdown. Get help if you need moving in bed or getting in or out of bed.
    • If someone else moves you, they should lift you or use a draw sheet to move you.
    • Change your position every 1 to 2 hours to keep the pressure off any one spot.
    • Sheets and clothing should be dry and smooth, with no wrinkles.
    • Remove any objects such as pins, pencils or pens, or coins from your bed.
    • Do not raise the head of your bed to more than a 30 degree angle. Being flatter keeps your body from sliding down. Sliding may harm your skin.
    • Check your skin often for any areas of skin breakdown.

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