Evaluation of and Caring for Patients With Pressure Ulcers

Linda Bell
Am J Crit Care 2008;17:348
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EVALUATION OF AND CARING FOR PATIENTS WITH PRESSURE ULCERS

By Linda Bell, RN, MSN Birck Cox, Illustrator

atients in intensive care units are at risk for development of pressure ulcers because of severity of illness, the presence of multiple comorbid diseases, and complications of bed rest or other positioning restrictions. In addition, appliances such as cervical collars put patients at risk. Nurses increasingly have become more vigilant about preventing hospital-related injury and infection among their patients.

Heres what you can do:

Evaluate and understand the risk factors for each patient in your care. Consider the risks of skin breakdown associated with positioning restrictions or appliance use. For example, elevation of the head of the bed to prevent ventilator-associated pneumonia may increase the risk of breakdown in the coccyx area in some patients. Plan for early mobility for each patient when the patients condition is stable. Use the standardized assessment and documentations required by your institution. Consult knowledgeable nursing colleagues such as wound care nurses for collaboration on developing consistent treatment plans and identifying skin care products for your patients. Become a champion for skin care on your unit. Set up a system of weekly or monthly skin assessment rounds. Collect data about the incidence and prevalence specific to your unit.

Share these data routinely in verbal and graphic form with your nursing colleagues on the unit, with the goal of improving outcomes for patients.

Other helpful resources:

Consult the wound and ostomy/skin care team in your hospital or facility. Take advantage of the resources, links, and educational opportunities on the National Pressure Ulcer Advisory Panel Web site, http://www.npuap.org. The Braden Scale for predicting pressure ulcer risk can be accessed at http://www.bradenscale.com /braden.pdf.

Published as a supplement to the articles by Elliott and colleagues, Quality Improvement Program to Reduce the Prevalence of Pressure Ulcers in an Intensive Care Unit, and Tweed and Tweed, Intensive Care Nurses Knowledge of Pressure Ulcers: Development of an Assessment Tool and Effect of an Educational Program (American Journal of Critical Care. 2008;17:328-337, 338-347).

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