Pressure Ulcer Prevention A Guide for Patients, their Families and Carers

This leaflet has been written to give you and those caring for you information and advice on pressure ulcer prevention. If there is anything else you would like to know please speak to a member of your care team.

What are pressure ulcers?

Pressure ulcers are areas of skin damage caused by sitting or lying in the same position for to long which reduces blood supply to the tissues. They are also known as pressure sores or bed sores.
Pressure ulcers can be very painful. They may need to have frequent dressing changes, which may mean you have to change your daily routine and lifestyle.
They can affect your health and slow your recovery. They can also lead to a longer hospital stay or admission to hospital from home.
They usually occur over a bony prominence. However they can occur elsewhere, especially where medical devices are used. It is important that you inform staff if you have a poorly fitting or painful medical device e.g. oxygen mask, plaster cast, splint etc.

Who is at risk?

Anyone can get a pressure ulcer but certain people are more at risk. You are at risk if you are spending long periods of time lying in bed or sitting in a chair without changing position.
You may be at risk if one or more of the following situations relate
to you:

You are confined to a bed or a chair and unable to move yourself on your own, or have limited movement.
You have reduced or poor circulation.
You have skin that is either dry or frequently moist through perspiration or loss of bowel or bladder control.
You have a poor diet and don’t drink enough water.
You are unwell

Common areas where pressure ulcers develop

While sitting up:-

back of head
shoulder
base of spine
buttocks
Heel

While lying on side:-

ear
shoulder
elbow
hip
thigh
leg
heel

Lying on back

back of head
shoulder
elbow
buttocks
heel

Important points to prevent or heal pressure ulcers

To assess your risk of developing a pressure ulcer a member of your care team will offer to examine your skin and will also ask you questions about your general health. This is a called a ‘risk assessment’. If you are identified as being ‘at risk’ of developing a pressure ulcer your care team can help develop a plan of care with you to reduce this risk.

SSKIN

This is an abbreviation used to promote pressure ulcer prevention. This is what it means:

S is for Surface

During your stay in hospital or whilst you are at home you may be given pressure relieving equipment e.g. a mattress, chair cushion or heel off-loading boots.
This equipment is designed to help move the pressure away from vulnerable areas such as the buttocks and heels.
As your condition improves and you are able to move around you may no longer need this equipment.

S is for Skin Inspection

Inspecting your skin means that we can spot early signs of pressure damage.
Your care team can help you or your carers to check your skin regularly for early signs of pressure damage.
The most important places to check are areas that are usually bony, like elbows or heels but can also include more padded areas such as buttocks and hips. Also include areas of pain, discomfort or numbness.
Look for skin that doesn’t go back to its normal colour after you have taken weight off it.
Tell your care team immediately if your skin is red or marked, or if your skin feels sore or you develop an area of blistering.

K is for Keep Moving

You can relieve pressure from vulnerable areas by changing your position.
Try to change your position every 2 to 4 hours, more often if possible. Avoid sitting in your chair or lying on your bed for long periods of time without getting up for a walk or changing your position.
If you are unwell it can be difficult to change your position or move yourself. If you have family or carers at home they can assist to help you to change your position.

I is for Incontinence and moisture Management

Moisture from sweating, wounds or incontinence can weaken the skin, making it at risk to damage.
It is important that your skin is kept clean, dry and well moisturised. Creams may be used by your care team to protect your skin from moisture damage.

N is for Nutrition and Hydration

Eating well and drinking enough fluids will keep your skin healthy. Make sure you drink at least 6 to 8 drinks a day. This could be from any combination of water, juice, squash, tea, coffee or milky drinks.
You also need to eat a healthy balanced diet, with plenty of fresh fruit, vegetables and protein-rich foods (e.g. meat, fish, eggs, cheese, and dairy products).

Webpages for extra information

The Eatwell Guide Gov.uk

The Eatwell Guide is a policy tool used to define government recommendations on eating healthily and achieving a balanced diet.

Please click on hyperlink below

The Eatwell Guide - GOV.UK

The Eatwell Guide NHS

The Eatwell Guide shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.

Please click on hyperlink below

The Eatwell Guide - NHS