Preventing pressure injuries
Most pressure injuries are preventable. All healthcare professionals and service providers play a role in preventing pressure injuries.
Assess patients for their risk of developing a pressure injury. An example of a validated risk assessment tool is the PURPOSE-T (Pressure Ulcer Risk Primary or Secondary Evaluation Tool), which covers screening and full assessment. Undertake a validated risk assessment within 8 hours of admission to a healthcare setting (or on the first visit for those in residential aged-care facilities or receiving home-based care). Repeat risk assessment is required; frequency depends on the patient's clinical condition. Follow the policies of the health service provider in relation to pressure injury risk assessment and documentation.
Patients confined to bed or who have severely limited mobility are at risk of a pressure injury.
Prevention strategies are developed and implemented based on risks. Strategies include:
- regular patient repositioning (also consider the weight of blankets on toes, feet, heels)
- using slide sheets and materials that decrease friction
- using mechanical aids (eg lifters) as required for patient transfer
- using an appropriate support surface
- regular skin inspection
- using a pH-appropriate skin cleanser and moisturiser
- implementing a continence management plan
- using barrier creams and ointments
- implementing a nutritional support plan
- using prophylactic dressings (eg a multilayer adhesive silicone foam dressing)
- avoiding the use of heating devices (hot water bottles, heating pads) directly on skin.