What are pressure ulcers and how can they be avoided?

What are pressure ulcers and how can they be avoided?

Do you have a care plan for pressure ulcer prevention?

Pressure ulcers, also known as bed sores, develop because of injury to the skin and tissues caused by pressure, friction or shear.

Pressure ulcers, also known as bed sores, develop because of injury to the skin and tissues caused by pressure, friction or shear.

Pressure ulcer prevention is therefore very important because once bed sores occur, they can be really hard to heal and can be very painful for the person in your care. 

If you’re taking care of someone who is bedridden, the following information will help you to understand why he or she may be at risk of developing pressure ulcers, and what you, as their caregiver, can do to help reduce that risk.

What is pressure, friction and shear?

Here is a brief overview of how pressure, friction, and shear can cause skin breakdown.

  • Pressure is created when the skin and soft body tissues become compressed or squished between bone inside the body and an outer surface, like a chair or even what we might consider a soft bed. If the pressure is not removed, over time, the tissue and skin die causing a wound or bed sore. This wound can be caused by a person sitting or lying for too long in the same position, or from the pressure of tubes such as oxygen tubes or catheters.
  • Friction is caused when two surfaces rub across one another, for example skin rubbing across rough bed linen causing the skin to become damaged.
  • Shear is caused when the bone moves one way but the skin does not, pulling the underlying tissues and damaging them. Shear can happen, for example, if a person is dragged up the bed, or if the person slides down when the head of the bed is raised. The skin may stay in position as the body moves downwards, dragging the underlying tissues in opposite directions.

As skin ages, it becomes dry and fragile, with less collagen and fat layers. All of these skin changes help to contribute to an increased risk of developing a pressure ulcer.

Risk factors for developing pressure ulcers

  • Reduced mobility or inability to move from bed and/or chair
  • Difficulty changing position easily and/or sliding down in a chair/bed
  • Poor fluid and food intake
  • Decreased ability to feel sensation
  • Prolonged contact with moisture (sweating, incontinence of urine and/or stool)
  • Fragile skin

11 caregiver guidelines for pressure ulcer prevention

  • Encourage the person in your care to drink enough fluids; around 1.5-2 litres per day unless the doctor has instructed differently.
  • Make sure that the person in your care has a balanced diet of protein, vitamins, and minerals to ward off skin damage and speed up the healing process.
  • Ultilize special cushions and mattresses that reduce pressure for people who have mobility issues. An occupational therapist (OT) can help to determine which one is best suited to the person in your care.
  • Encourage and help the person to reposition or move every 1-2 hours.
  • Ask an OT or physiotherapist (PT) about equipment that may help you transfer the person from one surface to another (such as a bed to chair and vice versa) to avoid dragging the person across surfaces that may result in friction or shear.
  • Avoid positioning the person completely on their side, which can put pressure on the hips and shoulders. If needed, use a pillow to prop them over on a 30 degree angle instead. Also, avoid elevating the head of the bed above 30 degrees.
  • Check tubing every couple of hours to ensure it is not digging into the skin or trapped under the person’s body. For instance, check that the oxygen tubing isn’t putting pressure on the person’s ear or that the catheter tube isn’t under the person’s leg.
  • Use pads and incontinence products if urine/stool leakage is a concern. The products should be changed as soon as possible when soiled to avoid skin rash. Take a look at When Nature Won’t Stop Calling, an article about incontinence and how to manage it.
  • Avoid scrubbing the person’s skin during bathing or washing. Water should be lukewarm or room temperature, and don’t forget to apply moisturizer to hydrate their skin.
  • Avoid massaging areas of redness over bony body parts (like hips, elbows, shoulders, heels, ankles), which can increase problems of friction and shear.
  • If you DO see redness in an area that does not go away when the pressure is removed, let the doctor or nurse know so that a referral can be made to assess the problem area.

OT’s and PT’s can help assess seating and surfaces to ensure they are the most appropriate for those at risk. A registered dietician may be able to help if there is a concern related to fluid or food intake.

This caregiver care plan for pressure ulcer prevention and management is a great place to start but for the health and safety of the person in your care be sure to discuss any concerns with the doctor or nurse so that the most appropriate course of action or treatment can be made swiftly.

 

Comments

Close

Order a Service

()-
(UTC - 05:00)
Close

Want to order service?

 

Or drop us your email address, and we'll get back to you:


 

Have a question?
Chat live with a member of our care solutions team Monday to Friday, 9am to 5pm!

Live Chat
Close

Share Your Caregiver Story

We review and post new submissions weekly and we are always looking for new “Faces of Caregiving”.

Yes, you may post my submission and contact me.
Close

Have a Caregiving Question?

Submit your caregiving question to our experts. Our experts review the questions we receive regularly, and we share our responses to the questions that we think are most relevant to the whole community.

Yes, you may post my submission and contact me.
Close

Contact us to discuss your results

 

Have a question?
Chat live with a member of our care solutions team Monday to Friday, 9am to 5pm!

Live Chat
 
 

Or drop us your email address, and we'll get back to you: