Pressure Ulcers

4249 words 17 pages
Feature

Strategies to improve the prevention of pressure ulcers
Judy Elliott describes a project that sought to improve tissue viability during the patient journey from admission to discharge
Summary
This article outlines the actions taken by one acute trust to implement evidence-based, best practice recommendations for pressure ulcer prevention. Initially, an exploratory study identified specific areas for practice development, particularly improving early risk assessment, intervention and focus on heel ulcers. Further actions included recruiting tissue viability support workers to promote a pressure ulcer campaign. Prevalence audit results demonstrated improved prevention and reduced prevalence of hospital-acquired pressure ulcers
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November 2010 Volume 22 Number 9

A flatter position distributes body weight more evenly. Semi-Fowler (semi-recumbent) and prone positions yield the lowest interface pressures with sitting cind 90-degree side-lying the highest (Sewchuk et al 2006). Repositioning using the 30-degree tüted side-lying position (alternately right side, back, left side) or prone position is advised (EPUAP/NPUAP 2009). The repositioning regimen should be agreed with the patient and will require adaptation to ensure concordance with comfort, symptoms and medical condition. Prolonged chair sitting is impUcated with greater risk of pressure ulcer development (Gebhardt and BUss 1994). Chair sitting should be Umited to less than two hours at ciny one time for the acutely ül at-risk individual (Clark 2009). A correctly fitting chair is important to ensure sufflcient pressure redistribution (Figure 1). Poor sitting posture may cause posterior pelvic tilt (sacral sitting) or pelvic obUquity (side tUting onto one buttock), with the ideal chair allowing feet to sit flat on the floor, with hips and knees at 90 degrees and arm/shoulders supported (Beldon 2007). Support surfaces High specification foam mattresses have demonstrated improved performance in pressure ulcer prevention (Defloor et al 2005), leading assessme Low risk • Use static foam mattress. • Reassess if patient's condition changes. Medium risk • Use static foam

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