Hi, I hope you are all well. I was wondering if anyone has any experience in care or nursing homes with the prevention and management of pressure ulcers? This seems to be quite a serious problem but it is not discussed as much,
Hello i have about 7 years experience in working with clients in preventing pressure ulcers
Was there something you specifically that you are having a problem with? It is a very serious problem. Risk assessments around skin integrity can help to prevent and manage proactively.
Just to add to that, these are good measures to put into place to prevent /manage pressure sores (particularly If the service user is not mobile):
As part of personal care always check and record any changes/ sores or bruising on skin (using body maps), Documenting everything is key, when there are changes like redness to skin, pressure sores , inform management, the family if applicable and engage professions . Liase with family/ GP to engage district nurse if applicable. If a pressure sore is present, ensure the area is clean (dressed regularly), dryed thoroughly and prescribed cream is applied, all instances of this must be recorded. If the service user is bed ridden, frequent repositioning is key, ensuring creases are minimised on the bedsheet and cushion/ support equipment is used if provided by OT (you may need to engage OT if needed). Ensure Care plans are updated to reflect the new meassures in place. As an add on, if service user is diabetic, as part of your care log, during personal care observe skin and look out for blackness to toes for example, record it and act quickly as it can progress very quickly.
I hope this helps.
I would like to understand the impact the overall prevention and management strategies are having on carers and patients and why they are not very effective. I am a final year medical student and saw this to be a huge problem while on placement. I tried doing research online but there seems to be very little development over the last ten years. I will be really grateful if anyone willing to talk to me to help improve my understanding of the problem. As I have a few questions I was wondering if anyone would be willing to talk to me over the phone?
Any help will be extremely appreciated.
@rene rogers thank you for the response. Did you feel that the strategies were easy to comply to as its quite physically burdensome and time consuming? It also seems that patients really dont like to be maneuvered which further complicates problems
Not so much easy but weighing up the potential risk to everyone involved and the impact of not have rigorous strategies in place, it's good practice to engage staff in taking preventative measures to avoid any negligence or potential safeguarding. Once the service users and staff where aware of the full scale of implications we found they were happy to comply even though it does take time, effort and ongoing monitoring from management / partnership working having a good compliance officer/ lead can really help to support this process.
Pressure ulcers seem to have increased over the years often as a result of poor if not absent good preventative care. Skin integrity as we all know is easily compromised by illness,poor nutrition hydration and lack of mobility. The initial care plan should address areas that show vulnerability,mapped and measured and a full risk assessment completed, there is access to good tissue viability advice and treatment prescribed by a suitable professional. Being proactive and providing a good skin care regime is imperative to overall outcomes. I have lost count of clients coming back to their home from hospital with a pressure ulcer that they did not have when they went in. This includes my own father who was only in 4 days an came home with a sacral sore.
Pressure sores are so easy to avoid if the necessary precautions are in place. Pressure sores can develop between 3-5 hours on a person's skin if simple guidelines are not followed.
Here are the simplest ways to prevent sites from occurring:-
1- bed sheets need to be as flat as possible and ironed before being placed in a bed.
2- a person laying or sitting needs to be repositioned every 1-2 hours in the day or 2-3 hours during the night
3- staff training in awareness and prevention is a big must for any care provided
4- necessary creams must be applied if prescribed and MAR sheets must also be completed as law requires.
5- personal care must be provided and skin must be left as dry as possible after waging a person as this will prevent rubbing or possible scuffing to the skin when mobilising
If all the points above are followed it is simple to avoid sores from happening but it must become a natural part of daily routines to do this for the pair in our care.
It costs between £5000 for a small skin problem to get treatment to cure and anything upto £40,000 to cure so making sure they do not occur in the first place is not only part of a duty of care but also would save an absolute fortune in money and resources that could be better used elsewhere.
Other than the usual strategies that Natalie Snelson has pointed out it really is necessary to use a proper salve or balm that heals the sores, softens the skin and prevents chafing. I was having real issues with my father who was getting terrible sores all over and thankfully have found a salve that has healed every sore and prevented more from appearing. Redness does still occur occasionally but that is easily rectified by using more salve and/or moving him ever so slightly. This salve is actually for babies and toddlers and is called tiny troubles salve (although other salves are available I hasten to add and I'm sure they would work equally as good!). Auntie's joke that it is his miracle cream and even he has got to asking for it. Such a pleasure to now se him more content and in less pain :)