Pressure Injury Prevention

ConvaTec

10/26/2023

Approximately 2.5 million patients in the United States develop a pressure injury every year,¹ and approximately 60,000 patients die directly from a pressure injury annually.¹ Additionally, the cost of individual patient care ranges from $20,900 to $151,700 per pressure injury. However, it is estimated that 95% of pressure injuries are preventable.

Here are some tips to consider for pressure injury prevention.

Performing Skin Assessment

Look at skin to see if intact/without blemishes
Think about what “normal” skin looks like
Identify that which is NOT normal
Report any area of suspicion to provider
Document findings by describing color, size, location, and distribution

Assessing Pressure Points

Inspect all the patient’s skin upon admission as soon as possible
Inspect skin at least daily for signs of pressure injury, especially nonblanchable erythema
Assess pressure points, such as the sacrum, coccyx, buttocks, heels, ischium, trochanters, elbows and beneath medical devices
When inspecting darkly pigmented skin, look for changes in skin tone, skin temperature and tissue consistency compared to adjacent skin
- Moistening the skin assists in identifying changes in color
Avoid positioning an individual on an area of erythema or pressure injury

Most Common Comorbidities of Patients Admitted with Pressure Injuries²

Immobility
Diabetes
Senility
Malnutrition
Spinal Cord Injury
Substance Abuse Disorders
Vascular Compromise

Clinical Practice Guideline: Use of Prophylactic Dressings (2019)³

Preventive Skin Care 3.5: “use a soft silicone multi-layered foam dressing to protect the skin for individuals at risk of pressure injuries”
Device Related Pressure Injuries 8.5: “use a prophylactic dressing beneath a medical device to reduce the risk of medical device related pressure injuries”
Heel Pressure Injuries 6.4: “use a prophylactic dressing as an adjunct to heel offloading and other strategies to prevent heel pressure injuries”

Features to Consider: Choosing Prophylactic Foam Dressings³

Potential benefit of using a dressing
Appropriateness of the size and design of the dressing
Ability of the dressing to manage microclimate
Ease of dressing application and removal
Ability to maintain the dressing in place
Ability to regularly assess the skin under the dressing
The individual’s preferences, comfort, and any allergies
Coefficient of friction at the skin-dressing interface
Cost-effectiveness and accessibility of dressings (including nursing time, education of new users and support of ongoing use)

References

Preventing pressure ulcers in hospitals. Agency for Healthcare Research and Quality Web Site. Published April 2011. Updated October 2014. Accessed February 1, 2012. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html
Ahn H, Cowan L, Garvan C, Lyon D, Stechmiller J. Risk factors for pressure ulcers including suspected deep tissue injury in nursing home facility residents: analysis of national minimum data set 3.0. Adv Skin Wound Care. 2016. 29(4): 178-90.
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Emily Haesler (Ed). EPUAP/NPIAP/PPPIA: 2019.