Management and Prevention of Pressure Ulcers Policy

Management and Prevention of Pressure Ulcers Policy

Aim of the Policy

It is this home aim to prevent pressure ulcers, also known as pressure sores and maintain healthy, intact skin in all our residents wherever possible and to treat pressure ulcers effectively and in a timely manner, if they do occur. Pressure ulcers are detrimental to our residents in terms of their physical, psychological and social well-being, resulting in reduced quality of life. The development of pressure ulcers is recognised as a key indicator of the quality of care delivered and a fundamental aspect of patient care.

Procedures 

Procedure for Pressure Sore Prevention

Staff in this home adopts the following procedure.

1. Assess every resident for pressure ulcer risk on admission using the Waterlow Assessment.
2. Re-assess monthly, or more often if condition deteriorates or changes.
3. Never rub any area identified at risk.
4. Wash areas at risk only if resident is incontinent or sweating profusely.
5. Use only mild soaps and ensure all soap residue is rinsed off afterwards and patted dry.
6. Encourage resident to shift position regularly or to keep as mobile as possible. Use advice from physiotherapist where appropriate.
7. Encourage and facilitate the resident to maintain a good nutritional status and to take adequate fluids.
8. Where necessary utilise appropriate pressure relief aids (such as cushions, mattresses etc) and inform the resident and their carers, if any, of the rationale for this.
9. If necessary reposition the resident two to three hourly in bed to ensure pressure relief on high risk areas. Record pressure care in notes.
10. Reduce amount of time a resident spends sitting in a chair if risk of sacral or pelvic sores is identified, ensuring position changes every 2 to 3 hours.

Procedure for Pressure Sore Treatment/Management

In the event of a pressure sore developing, staff in this home should maintain the procedure above and, in addition, follow the procedure below.

1. Resident to be assessed by a qualified nurse, or other appropriate health care professional for detailed assessment and grading of sore/ulcer, identification of wound management and drawing up of wound care plan. Medication and treatment will be discussed with the resident and their next of kin and recorded in their care plan.

Nursing Staff and Home Manager Responsibility:

1. Nursing staff are responsible for documenting the condition of a pressure ulcer to include; size (measurements), description, presence or absence of sings of infection (and whether a wound swab has been taken) and photographic record.
2. Nursing staff are responsible for coordinating and liaising with other agencies in the plans for pressure ulcer prevention and management, including seeking advice from NHS Tissue Viability Specialist Nurses for the management of complicated or non-healing wounds.
3. Nursing staff are responsible for the reporting of pressure ulcers stage II-IV (EPUAP).

1. Adopt and implement the prescribed plan of care or a suitable treatment plan. The choice of treatment for pressure sores depends on the stage of the ulcer, the presence or absence of infection and/or necrosis, and the location of the ulcer. For ulcer dressings staff should refer to the home’s policy on wound management.Responsibility of all staff is to:
2. Reposition by turning the resident two hourly if cared for in bed, or reposition providing pressure relief two hourly if able to be cared for sitting, and utilize preventative pressure relief aids to ensure pressure relief on high risk areas, recording turns and positions in the residents’ pressure care notes.
3. Provide appropriate and sensitive night-time care which is designed to maintain the requirements of the president’s plan of care and to ensure that they are able to get adequate rest and sleep.

Staff should utilise the following preventative aids available as indicated below.

1. For very high risk skin areas — specialised bed systems alternating air filled pressure mattresses; alternating pressure cushions for wheelchairs/chairs.
2. For high risk skin areas — alternating pressure overlays, mattresses or bed systems; specialist cushions for wheelchairs/chairs.
3. For at risk skin areas — overlays or specialist mattresses; specialist cushions for wheelchairs/chairs.
4. General aids — bed cradles for residents to lift themselves up in bed without friction rubbing ; specialist cushions; hoists and transfer devices for lifting.

Training

All care staff are fully trained in the recognition of the above pressure sore risks and prevention and in the use of the above aids. Nursing Staff should ensure that they receive appropriate education and training in order to maintain their competence in pressure ulcer prevention, update their knowledge of current best practice in wound care, management and the use of equipment. All staff involved in turning or moving a resident in bed or in a chair to relieve pressure areas will have received appropriate moving and handling training.