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Date issued: July 2023

Review date: July 2025

Ref: C-400/PP/tissue viability/Pressure ulcer prevention v4

PDF:   Pressure Ulcer prevention final July 2023 v4.pdf[pdf] 293KB

What is a pressure ulcer?

A pressure ulcer, also known as a pressure sore or bedsore, is an area of damage to the skin and the tissue below caused by a combination of:

Pressure: from body weight pressing against a hard surface, damaging the blood supply to that area.

Shearing: this may occur if you slide down or are dragged up the bed or chair and may damage the deeper layers of skin.

Pressure ulcers may cause pain or lead to an extended hospital stay. They can become infected, leading to blood poisoning or bone infection.

What to look for?

Pressure ulcers usually occur over bony prominences but can also happen around medical devices, such as oxygen masks or tubing or under anti–embolism stockings.

Think ‘ASSKING’

A – Assessment

We will examine you and carry out a risk assessment within 6 hours of admission. We will then agree a prevention plan with you to reduce your risks. It may include:

• Regular Skin Assessment and repositioning

• Use of specialist equipment if needed (e.g., mattress, cushions)

• Assistance to reduce pressure when lying in bed

• Referral to other healthcare professionals if required   (e.g., a physiotherapist, Tissue Viability)

Tell us

Tell us: If you’re not moving as much as you used to If you have a sore bottom, heels, elbows, hips or any other area of skin or if any of the equipment / tubes / masks are rubbing or causing pain If you think there are any problems with your mattress / cushion If you have problems controlling your bladder/bowel If you have reduced sensation anywhere on your body If you have had a pressure ulcer before

S - Skin Inspection

If you are able, please inspect your skin daily and report the following changes to the nurse looking after you:

• Darker or red patches of skin that do not disappear within 1-2 hours

• Areas of skin that are hot or cold 

• Discomfort or pain - inform your nurse

• Blistering

• Numbness, soreness, swelling or hardness of skin

• Purple / black discolouration to the skin (may look like a bruise on bony areas)

S - Surface

• A pressure relieving mattress or cushion may be provided that will help to reduce the amount of pressure on your body.

• Whilst you are in bed we will ask you to “float” your heels using pillows.

• Please tell your nurse if the equipment provided is uncomfortable or not working

 

• Change your position as often as you can.

• Staff will help you with this if needed.

• If you are able to, change your position frequently, please ask staff to assist you if you need help.

• Equipment will be used if required. If you are able to sit out of bed please continue to   

• Make sure shoes and slippers fit well.

I - Incontinence

Wet skin can increase the risk of pressure ulcers. Avoid soap if you are having to wash frequently and ask your nurse for advice about the types of cleanser to use. Pat skin dry gently and use barrier products as advised.

Be aware that barrier products will not prevent pressure ulcers and keeping moving is still important.

N - Nutrition

Adequate nutrition and fluids are essential to keep your skin healthy and strong.

We will keep an eye on how well you are eating and drinking and help you if needed. Staff can offer supplements or a referral to a dietician if needed.  Please ask for advice if you are concerned.

Tell us

Tell us: If you are experiencing difficulties eating or drinking.

G - Giving / Sharing Information

Staff will discuss with you if you are at risk of pressure ulcers and will offer further advice on how to prevent them.