How to Prevent Pressure Injuries

What is a pressure injury?

A pressure injury, previously called a bedsore or a pressure ulcer, is an injury to the skin and underlying tissue caused by pressure. A pressure injury can happen when your skin presses against a surface, such as a mattress or wheelchair seat, for too long. The pressure on the blood vessels causes reduced blood flow to your skin. This can eventually cause the skin tissue to die and break down into a wound.

Pressure injuries usually develop:

• Over bony parts of the body, such as the tailbone, shoulders, elbows, hips, and heels.
• Under medical devices, such as respiratory equipment, stockings, tubes, and splints.

They can cause pain, muscle damage, and infection.

How do pressure injuries happen?

Pressure injuries are caused by a lack of blood supply to an area of skin. These injuries begin as a reddened area on the skin and can become an open sore. They can result from intense pressure over a short period of time or from less pressure over a long period of time. Pressure injuries can vary in severity.

This condition is more likely to develop in people who:

• Are in the hospital or an extended care facility.
• Are bedridden or in a wheelchair.
• Have an injury or disease that keeps them from:
  • Moving normally.
  • Feeling pain or pressure.
  • Communicating if they feel pain or pressure.
• Have a condition that:
  • Makes them sleepy or less alert.
  • Causes poor blood flow.
• Need to wear a medical device.
• Have poor control of their bladder or bowel functions (incontinence).
• Have poor nutrition (malnutrition).
• Have had this condition before.
• Are of certain ethnicities. People of African American and Latino or Hispanic descent are at higher risk compared to other ethnic groups.

What actions can I take to prevent pressure injuries?

Skin Care

• Keep your skin clean and dry. Gently pat your skin dry.
• Do not rub or massage boney areas of your skin.
• Moisturize dry skin.
• Use gentle cleansers and skin protectants routinely if you are incontinent.
• Check your skin every day for any changes in color and for any new blisters or sores. Make sure to check under and around any medical devices and between skin folds. Have a caregiver do this for you if you are not able.

Reducing and Redistributing Pressure

• Do not lie or sit in one position for a long time. Move or change position every two hours, or as told by your health care provider.
• Use pillows or cushions to redistribute pressure. Ask your health care provider to recommend cushions or pads for you.
• Use medical devices that to not rub your skin. Tell your health care provider if one of your medical devices is causing pain or irritation.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it or apply it as told by your health care provider. Do not stop taking or using the antibiotic even if your condition improves.

General Instructions

• Be as active as you can every day. Ask your health care provider to suggest safe exercises or activities.
• Work with your health care provider to manage any chronic health conditions.
• Eat a healthy diet that includes lots of protein. Ask your health care provider for diet advice.
• Drink enough fluid to keep your urine clear or pale yellow.
• Do not abuse drugs or alcohol.
• Do not smoke.
• Keep all follow-up visits as told by your health care provider. This is important.

What steps will be taken to prevent pressure injuries if I am in the hospital?

Your health care providers:

• Will inspect your skin at least daily. Skin under or around medical devices should be checked at least twice a day while you are in the hospital.
• May recommend that you use certain types of bedding to help prevent them. These may include a pad, mattress, or chair cushion that is filled with gel, air, water, or foam.
• Will evaluate your nutrition and consult a diet specialist (dietician), if needed.
• Will inspect and change any wound dressings regularly.
• May help you move into different positions every few hours.
• Will adjust any medical devices and braces as needed to limit pressure on your skin.
• Will keep your skin clean and dry.
• May use gentle cleansers and skin protectants, if you are incontinent.
• Will moisturize any dry skin.

Make sure that you let your health care provider know if you feel or see any changes in your skin.