Complications after surgical resection

Home Care Pressure Ulcer Prevention

A stage 1 pressure ulcer is as follows: Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area Pressure ulcers in home care population are sometimes staggering. Prevention should always be a goal.
But how do we prevent them when we are in the home for such a short amount of time?

A stage 1 pressure ulcer is as follows: Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area Pressure ulcers in home care population are sometimes staggering. Prevention should always be a goal.
But how do we prevent them when we are in the home for such a short amount of time? One word – EDUCATION – It seems such a simple task. But how do we convey this to the caregivers? “Grandma only likes to be on her back.” Or “Daddy will only sit in the recliner.” We have all heard this mantra from caregivers, but as professionals we need to be on the front line of patient advocacy and we have to help to educate and help to put into practice pressure ulcer prevention action plans for those patients who are at risk.

With home care pressure ulcer prevalence rates as high as 29% of the total population, we have to be addressing this issue. Today, if a patient acquires a pressure ulcer while in the hospital, Medicare will no longer pay for the treatment of that ulcer, the hospital is expected to care for that wound without reimbursement. So we owe it to our patients and their caregivers to help in every way possible to prevent pressure ulcers from even developing.

So how do we do this?

KEEP THEM MOVING -Implement a 2 hour turning/repositioning schedule, if the patient is bed bound or can move themselves easily. Turn patients every 2 hours, make them shift pressure every 30 minutes if sitting.

KEEP THEM LUBRICATED - Don’t underestimate the power of lotion on dry skin, it helps reduce the friction when moving, helps to keep the epidermis moist and also gives caregivers a visual inspection of the critical areas. Sacrum, coccyx, trochanters, heels, ankle, elbows – boney prominences.

KEEP THEM HYDRATED – If not on fluid restrictions, hydration is essential in maintaining a healthy system

KEEP THEM FED – Nutritional compromise can be a huge factor in the breakdown of tissue in the ill or wounded patient population.

KEEP THEM COMFORTABLE – if patients are not on a specialty mattress, make sure the sheets don’t have wrinkles and are smooth. If incontinent, help reduce the amount and duration of stool and urine that come in contact with the skin. If they are on a specialty mattress, make sure to follow the manufactures instructions for each type of mattress.

KEEP CAREGIVERS EDUCATED – Educate caregivers on how to spot a potential pressure ulcer, is there a red spot that doesn’t go away quickly after turning and repositioning. Pressure ulcer prevention is an important step to treating our home care population systemically and being vigilant for the signs/symptoms of a stage I
pressure ulcer can go a long way in preventing a long and costly wound care episode.