Principles of managing pressure injuries

Pressure injury reporting and management requirements are covered by the National Safety and Quality Health Service Standards¹. Pressure injury is associated with significant morbidity and mortality. Timely intervention prevents adverse effects of pressure injury. Adverse effects from a pressure injury include pain, increased cost to the patient and the health system, increased length of hospital stay, prolonged home or community care, loss of income, loss of functioning and reduced quality of life. Occasionally, pressure injury can lead to sepsis and death.

After undertaking a full assessment, create an individualised management plan. Management is based on:

• the likelihood of healing
• minimising pressure and shear
• managing the wound characteristics
• optimising nutritional status and general health (see Other interventions for pressure injuries).

Refer to an appropriate specialist if:

• the patient is systemically unwell
• there is rapidly spreading or extensive necrosis
• a fistula develops
• specialist intervention is needed (eg pressure seating clinic, wheelchair prescription, equipment, sharp debridement or surgery).

Maintain prevention strategies—see Preventing pressure injuries.