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21 Nov 2018

How To Determine If A Resident Is At A High Risk Of Pressure Ulcers

How To Determine If A Resident Is At A High Risk Of Pressure Ulcers

Pressure ulcers can be extremely detrimental to a person’s health, as once a pressure ulcer develops, it can be a long and timely process healing it and preventing the ulcer from getting worse. Which is why it’s so essential that you and your care team understand how to spot residents who are at risk of developing pressure ulcers so that steps can be taken to prevent them from occurring.

What has been learned in recent years, due to the fact that there are various care environment facilities across the UK that have not had any pressure ulcers occur in them for years, is that pressure ulcers are 100% preventable, it’s just a case of knowing how to spot the signs that a care home resident is at risk, and know what steps to take to prevent a pressure ulcer occurring.

Research from the NHS has shown that pressure ulcers affect around 20% of people who live in care homes in the UK. 20% might seem like a small amount, but the fact is that when you consider the fact that in a care home with 50 residents, 10 would suffer from pressure ulcers, this puts it into perspective, about how many people this condition can affect.

The good news is that pressure ulcers can be prevented, it’s just a case of determining what puts a person at risk of developing them. The question is, of course: how can you go about doing that?

Do a Risk Assessment

The first step to determining whether a resident is at a high risk of developing pressure ulcers is to perform a risk assessment. Whenever a new resident enters your care facility, it’s crucial that a risk assessment of their chance of developing pressure ulcers is undertaken, because you cannot prevent a pressure ulcer if you don’t know that it’s a risk.

There are a varying number of ways in which a person’s risk of developing a pressure ulcer can be determined. One of these is the Braden Scale, which is commonly used in many hospitals and care facilities across the UK.

What factors impact a Risk Assessment?

There are various factors that should be used in risk assessments being performed for pressure ulcers. On a regular basis, patient’s and resident’s skin should be checked for any signs of pressure-related damage. A tell-tale sign of an occurring pressure ulcer is red skin that doesn’t blanch when pressed, like a healthy area of red skin would do. Other signs of skin damage include skin that is hot to the touch, is swollen, and sore.

Skin care is crucial. It’s vital that the skin is kept clean, dry and well hydrated. This can be particularly difficult in patients that are incontinent, as leaked urine can make pressure ulcers more likely to occur. The skin should be washed and dried regularly, and should always be kept clean and well hydrated. When drying skin, a patting motion rather than a rubbing motion is recommended, as this helps to keep the skin healthier and prevents the onset of pressure ulcers.

Often incontinence and pressure ulcers co-exist. This is because if incontinence isn’t properly managed, it can lead to the patient or resident being left with wet bedding or clothing, which can make pressure sores more likely to occur. That’s why utilising incontinence pads that offer the correct level of protection is vital, as is regularly checking for any leaks or wetness.

In addition to preventative skin care, good nutrition is vital for preventing pressure sores and aiding healing. It’s crucial that the diet of the patient or resident is regularly monitored and assessed, to ensure that they are getting all of the nutrients that they need. Adequate hydration is also crucial when it comes to preventing pressure sores.

When it comes to preventing pressure ulcers from occurring, the position in which a patient's body is placed is a vital factor. It’s important that all patients and residents are encouraged to regularly reposition themselves if they are able to do so. For any patients that aren’t able to naturally reposition themselves, it’s crucial that they are repositioned by your team on a regular basis - it used to be recommended that every two hours was how often repositioning is needed, but there is now some debate over whether this time frame is correct as it can differ depending on the pressure ulcer prevention products being used.

For patients who are prone to pressure ulcers - once a patient gets one pressure ulcer, they are then more prone to developing them in the future - pressure re-distributing equipment can be highly effective. This includes mattresses that provide pressure reducing comfort that helps to reduce the risk of bed sores and increases patient comfort. There are various products to choose from for this, which is why consulting an expert in pressure care products is so vital, to ensure that you choose the right one for your needs.

At CLH we offer a wide range of products for helping care facilities to prevent pressure ulcers, these include the use of the OFFLOAD Heel Pressure Relief Bootee. Offload is an inflatable offloading device to help safely remove pressure from the heel area of vulnerable patients. It is suitable for all levels of risk, including high risk and existing ulcers up to grade 4, and it comes with simple-to-operate manual pump. Offloads the heel to effectively reduce the pressure to zero, protects the Achilles tendon, it's supplied with straps to secure in place, and it has large cost savings when compared with similar branded products.

There is also the Repose Standard Foot Protectors. These foot protectors are a unique product designed specifically to minimise the risk of pressure damage to heels. A significant proportion of pressure ulcers occur on the heels due to a combination of pressure and friction/shear. Whilst support surfaces assist in reducing pressure, only a specific device such as the Repose Standard Foot Protectors can ensure that pressure on the foot is relieved totally. Clinical studies have shown the heel protectors to be effective in a wide variety of settings. 

Studies found 'a significant improvement in skin condition and comfort, and also 'a reduction in incidence of heel pressure ulceration from 17% to 0%'. These may be used in bed or with feet elevated, and are easily secured with stocking or light bandage, they can also be used with other dynamic or static support surfaces.

Another option is the PediSafe Inflated Heel Protector that is designed to prevent pressure ulcers from being able to form on the heels and feet. PediSafe is designed for heel ulcer prevention & treatment. It also helps prevent footdrop & provides pressure relief.

These heel protectors have a lightweight design for convenience of heel comfort, they help to prevent footdrop and relieve pressure on the heels. They are also have a soft fabric covering on the interior provides patient comfort and protects extremely fragile skin. There’s an open hole design for air and moisture ventilation, three adjustable straps which allow custom fit, and it’s manufactured from Polymer and Non-Woven Fabric.

Preventing pressure ulcers in care environments is not always an easy task, particuarly when there are various residents at risk of them, which is why taking the measures listed above and utilising some of the pressure ulcer prevention tools we offer can be highly beneficial.  

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