There are multiple risk factors for pressure ulcers including immobility, chronic illness, incontinence, poor nutrition, altered levels of consciousness and sensory perception, and a history of having pressure ulcers. Primaris’ initiative attempts to eliminate any pressure ulcer that can be avoided and to reduce the rate of pressure ulcers by eight percent.
Prevention begins with sound skin care and effective management of risk, especially by home healthcare providers, who have the opportunity to bridge gaps in communication between the patient and other healthcare facilities, whether it is a hospital or nursing home. The tips below can help care providers indentify risks that contribute to pressure ulcers in their care settings.
- Inspect the skin at every home visit and document assessment results. Instruct caregivers to inspect skin daily and report any signs of breakdown.
- Home health aides and chore workers should use a mild cleansing agent, and avoid hot water and excessive friction when bathing patients.
- Assess and treat incontinence. When incontinence cannot be controlled, cleanse skin at time of soiling, use a topical moisture barrier, and select under pads or briefs that are absorbent and provide a quick drying surface to the skin.
- Use moisturizers for dry skin. Minimize environmental factors leading to dry skin such as low humidity and cold air.
- Avoid massage over bony prominences.
- Use proper positioning, transferring, and turning techniques to minimize skin injury due to friction and shear forces.
- Use dry lubricants (cornstarch) or protective coverings to reduce friction injury
- Identify and correct factors compromising protein/calorie intake and consider. nutritional supplementation and support for nutritionally compromised persons.
- Initiate a rehabilitation program to maintain or improve the patients’ mobility/activity status, and/or to train caregivers in correct transfer techniques to minimize shearing and friction injury.
- Evaluate the patient for mechanical loading and support devices that are appropriate.
- Use devices that totally relieve pressure on the heels (e.g., place pillows under the calf to raise the heels off the bed, use pressure displacing boots).