Prevention of Pressure Ulcers in Immobile Patients
Advanced age, malnutrition, sensory perception, impaired circulation all need to be evaluated and assessed with a immobilized patient.
Multidisciplinary responsibility of every high risk patient is needed to prevent breakdown in the cooperation and skill of the entire health care team (nurses, physicians, physical therapists, nurses aides.)
Staff Education
Where is the situation? Hospital setting, long term care facility, rehab facility, or home care. Each setting can affect the immobile patient differently.
The Braden Scale identifies pressure ulcer risk. The scale ranges from 6 (high risk)- 23 (low risk).
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Skin Care- Keep the skin clean & dry. Excessive moisture from sweat or incontinence can increase the risk.
Turn & position every 2 hours. Utilize pillows & wedges to assist the patient into the turned position.
Common pressure injury sites. Heels, sacrum/ buttocks, back, back of the head and elbows.
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Neuropathy, paralyzed patients are at high risk due to the lack of feeling in parts of the body
Pressure, shear and friction, and skin moisture are all factors that can lead to ulcer formation thus need all 3 to prevent a sore from forming.
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Longer hospital stays can increase the risk for pressure ulcers to develop in immobilized patients.
Nutrition is key. High protein and staying hydrated with adequate amount of fluids can help prevent pressure ulcers.
Physical Therapy. Performing ROM on all extremities and joints everyday if the patient is unable.
Hospitals and long term care facilities need to be properly staffed. Under staffed facilities has a high likelihood a patient wont be turned every 2 hours.
Rehab facilities provide in house therapy to patients who require it everyday to keep patients moving.
Home setting can be challenging. Help for the patient may be their spouse, children or paid nurses/ aides 24/7 to help care for the immobile patient who doesn't require hospitalization
The cost of treating a pressure ulcer can be expensive on a facility.
Continuing education via power points to the staff. Have wound nurses talk to staff nurses on how to prevent, assess, treat pressure ulcers
Proper education of pressure ulcers/ prevention of family who cares for the immobilized patient