6 Tips for Avoiding Pressure Ulcers in Healthcare Facilities

calendar icon Posted on March 26, 2018

iStock-525211556A silent but serious condition is impacting healthcare facilities around the world, taking a serious toll not only on patient safety but hospital revenue and operating costs, too. Although it’s not contagious, this condition afflicts 2.5 million patients each year, resulting in 60,000 deaths annually in the United States alone1. On top of that, it costs the U.S. health system an estimated $9-11 billion each year to treat this condition2. There’s little doubt that pressure ulcers — also known as bed sores, pressure sores, or decubitus ulcers — have become a silent, painful and costly condition, as well as a growing contributor to runaway operating costs.

The U.S. government understands the severity of this condition that stems from hospital staff neglect, and in 2011 instituted new laws promoting pressure ulcer care and treatment.

At first glance, this may not seem like a fatal or even particularly serious condition. Indeed, pressure ulcers may be under the radar of most healthcare leaders, who are no doubt familiar with the concept, but perhaps less readily familiar with the toll it exacts.

But in reality, the risk is all too serious. With its capacity to break down areas of skin and tissue from prolonged periods of un-interrupted pressure on the skin — typical of patients confined to their beds and who experience little movement — pressure ulcers can quickly cause dying tissue that, in turn, can quite easily become infected. And this can lead to patient death if not spotted and treated quickly.

Understanding the severity of the condition is the first step. The next, then, is to look at taking steps to avoiding pressure sores among your patients altogether.

6 Tips for Avoiding Patient Pressure Sores:

1. Keep turning the patient’s body. Pending a patient’s condition, the majority of pressure ulcers can start forming after just one hour of pressure and immobility4. It’s crucial, then, to change the position of the patient to relieve harmful pressure on a regular basis. Usual practice calls for nurses to change patient positions every hour or two (with four being the max). 

2. Cut down on shear and friction. Caregivers should be educated and made aware of what causes pressure ulcers, and then make use of proper padding to help protect vulnerable areas. Draw or lift sheets are also great tools for ensuring safe transfer and positioning of patients. 

3. Continuously monitor patients. For a variety of important reasons — including the fact that a clinical study has shown that continuous monitoring can reduce pressure ulcers by 64%5 — more and more facilities are choosing to continuously monitor patients to help ensure that no unforeseen conditions arise — even among those with no serious or critical health issues. A variety of technologies now exist to accomplish this goal efficiently and cost-effectively. Included in this list is EarlySense’s line of monitors, which automatically monitor patient movement and provide customizable timely alerts for nursing staff. 

4. Practice good skin care and healthy eating habits. Skin inspection and maintenance is a big step towards avoiding pressure ulcers among patients. Individuals dealing with incontinence must take additional steps to limit areas of moisture, as this is another primary cause of the affliction. It’s also important to use mild soap and warm water when washing patients, and to refrain from scrubbing or rubbing the skin. Applying lotion and moisturizer to clean skin is also helpful. Also, proper nutrition plays a fundamental role in the wound healing process. Vitamin rich diets coupled with high-protein supplements are very effective in reducing pressure ulcer incidents in at-risk patients, and can even reduce their occurrence by 25%6

5. Identify and treat early signs of pressure ulcers. These early signs can include non-blanching erythema or a purple or maroon localized area of discolored, intact skin, which may be painful, firm, mushy, boggy, or a different temperature than adjacent tissue. When tending to a pressure ulcer, the typical procedure is to clean the wound and apply multiple bandages daily. Early-stage bed sores can lead to full-on infection, so caregivers must be vigilant in identifying and tending to these wounds as early as possible. 

6. Using special mattresses. Pressure-relieving support surfaces such as special mattresses are very commonly used when actively preventing pressure ulcers from developing. These mattresses help distribute patient pressure over a larger area and some can even alternate the pressure applied to the patient’s body7.

Pressure ulcers are a serious and common medical condition in U.S. hospitals, nursing homes, and other healthcare facilities, and are likely to remain an important public health issue unless action is taken. On the bright side, pressure ulcers are avoidable, and as long as we keep healthcare practitioners educated and aware of the threat posed by this often-unsuspected condition, by offering tools and instituting necessary protocols, we can help elevate patient safety, care and comfort.

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1 Lyder CH, Wang Y, Metersky M, Curry M, Kliman R, Verzier NR, Hunt DR. Hospital-acquired pressure ulcers: results from the national Medicare Patient Safety Monitoring System study. J Am Geriatr Soc 2012 Sep;60(9):1603-8.
2 Padula WV, Mishra MK, Makic MB, Sullivan PW (2011). Improving the Quality of Pressure Ulcer Care with Prevention: a cost-effectiveness analysis. Med Care 49(4): 385-392.
3 https://www.gpo.gov/fdsys/pkg/CFR-2011-title42-vol5/xml/CFR-2011-title42-vol5-sec483-25.xml
4 https://www.ncbi.nlm.nih.gov/pubmed/18927481
5 Brown, HV & Zimlichman, E, Improved Outcomes and Reduced Costs with Contact-free Continuous Patient Monitoring on a Medical-Surgical Hospital Unit. 2010
6 http://www.woundsaustralia.com.au/journal/1702_05.pdf
7 https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079409/


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