Level 2 Diploma Health

and Social Care

Unit 22 – Undertake agreed pressure area care
Rebecca Prout
2016
Rebecca Prout Unit 22

Unit 22 – Undertake agreed pressure

area care
1.1 Describe the anatomy and physiology of the skin in relation to
skin breakdown and the development of pressure sores
Skin is the largest organ of the body, covering and protecting the entire surface of the body. The
total surface area of skin is around 3000 sq inches or roughly around 19,355 sq cm depending on
age, height, and body size.

The skin, along with its derivatives, nails, hair, sweat glands, and sebaceous glands forms the
integumentary system. Besides providing protection to the body the skin has a host of other
functions to be performed like regulating body temperature, immune protection, sensations of
touch, heat, cold, and pain through the sensory nerve endings, itself divided into epidermis, dermis,
and subcutaneous layer or hypodermis. Each layer has its own function and own importance in
maintaining the integrity of skin and thereby the whole body structure.

Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over
a bony area such as a heel which may have been in contact with a bed or a splint over an extended
period of time.

The surface of the skin can ulcerate which may become infected. Besides the heel, other areas
commonly involved are the skin over the buttocks, sacrum, ankles hips and other bony sites of the
body

1.2 Identify pressure sites of the body

Pressure sites of the body are:

 Ankles
 Sacrum
 Buttocks
 Hips
 Legs
 Knees

1
Rebecca Prout Unit 22

1.3 Identify factors which might put an individual at risk of skin

breakdown and pressure sores
Below, I have listed a few factors that would put an individual at risk of skin breakdown:

 Staying in bed for extended period of time

 Staying in one position for extended period of time
 Sitting in a chair or wheelchair for long periods
 Skin being weak can be easily damaged

1.4 Describe how incorrect handling and moving techniques can

damage the skin.
If a resident is nursed in bed and is not turned regularly onto various sides and back this can cause
pressure sores as the individual is staying in one position for an extended period of time this leads to
the breakdown of the skin.

If the resident is kept in a wheelchair or curtain chair for too long this can also damage the skin.
Incorrect or non-use of slide sheets and hoists affect skin as moving without these can cause
pressure and damage. Residents should be moved and repositioned according to their care plan.

1.5 Identify a range of interventions that can reduce the risk of skin
breakdown and pressure sores
There are a range of interventions that can reduce the risk of skin breakdown including:

 Turning service users nursed in bed regularly.

 Alternate sides. Right, Back, Left.
 Correct use of slide sheets, hoists and manual handling.
 Regular checks on pressure sites to find a pressure sore early.
 Not keeping an individual in one chair or wheelchair for long periods.

1.6 Describe changes to an individual’s skin condition that should be

reported
Understand good practice in relation to own role when undertaking pressure area care is important.
There are many changes to an individual’s skin that should be reported including:

 Swelling
 Hard skin
 Cool or hot skin
 Redness
 Red patches that will not go away

2
Rebecca Prout Unit 22

 Dry skin
 Sore skin
 Marked areas
 Broken skin

2.1 Identify legislation and national guidelines affecting pressure area

care
 Human rights act
 National pressure ulcer advisory panel
 CQC
 Care standards act
 European pressure ulcer advisory panel
 NICE guidelines

2.2 Describe agreed ways of working relating to pressure area care

These are the policies and procedures of the company I work with and also the standards of care set
out by CQC, and the care plan.

2.3 Describe why team working is important in relation to providing

pressure area care
We should check and adhere to our workplace’s procedure. Adhere to correct moving and handling,
turning charts, agreed care plans (how often to turn individuals) always report and record.

PPE, checking of equipment. All staff should be up to date in training and agree on how to carry out
tasks, ensure all staff are working from the same clear instructions. If there is consistency there it is
less likely the resident will develop a pressure sore.

Be able to follow the agreed care plan

3.1 Describe why it is important to follow the agreed care plans

I am instructed and it is in my job description to follow the care plan and the policies and procedures
and agreed ways of working. No one will be harmed if I follow the instructions, I have a duty of care
to prevent harm to anyone I look after. Residents are assessed regularly and care plans updated.

Care plans are to ensure the resident is getting the best care for their diagnosis and that it gives
them a safe environment and quality of life. If care plans are followed it is less likely the resident can
develop a pressure sore. Care plans are agreed between the resident, staff and family which makes
the individuals best interest at the heart of the care plan. If staffs are up to date on a care plan it

3
Rebecca Prout Unit 22

means they are all working under clear instruction and not following separate routines. Correct and
consistent care decreases the individual’s chance of sores and damage to the skin.

3.3 Identify any concerns with the agreed care plan prior to
undertaking pressure area care
It is important to identify any concerns that we may have for an individual.

In my workplace we have a resident; Miss X who usually gets up in the morning into a wheelchair.
Putting Miss X into bed one night we noticed a small pressure sore starting, we informed our senior
staff and recorded it on the Handover (passing the baton) and looked at the care plan.

We had to amend the care plan as soon as possible to be kept in bed instead of up in wheelchair for
a few days, we had to amend turning times in care plan to 2 hourly from left to right and to be kept
off back as much as possible.

We also had to include not to be left in wheelchair for long periods of time.

3.4 Describe actions to take where any concerns with the agreed care
plan noted
If we have any concerns with the agreed care plan we must communicate this verbally or in writing
to senior staff and fellow colleagues immediately. We would write this in a carer communication
book but also report to the manager. The manager must then assess the individual again and discuss
the care plan with colleagues, resident and the resident’s family to ensure the individual is getting
the best possible care.

3.5 Identify the pressure area risk assessment tools which are used in
own work area
In our care home we carry out a risk assessment as the resident is being moved in. We continuously
check the skin for any breakdown when moving, handling or repositioning. We also ensure the
individual’s facilities match their needs such as mattress, if they need an air flow mattress or
ordinary mattress.

Armchairs, whether they need an armchair, curtain chair or recliner, and have an OT that will assess
wheelchair suitability. All of these precautions help prevent pressure sores.

3.6 Explain why it is important to use risk assessment tools

We must use risk assessment tools to ensure all equipment and facilities are suitable for the
resident. With the correct precautions pressure sores can be avoided. We must also do it to ensure
we are complying with all guidelines and policies and procedures.

4
Rebecca Prout Unit 22

4.1 Identify a range of aids or equipment used to relieve pressure

 Soft foam mattresses
 Air mattresses
 Pro pad cushions
 V cushions
 Pillows
 Mattress toppers
 Foot protectors
 Dressings
 Elevating pillows

4.2 Describe safe use of aids and equipment

It is important that you are up to date with the individual’s care plan to identify any risks.

The correct equipment for that individual must be used. Slide sheets and hoists should be used
correctly by 2 carers and staff should be up to date with all training.

Any electrical equipment such as airflow mattresses need to be installed by professionals and kept at
the correct pressure for that individual. Check and maintain all equipment regularly.

If any aids or equipment are not safe do not use them and remove the item out of use (where
possible) and report it.

4.3 Identify where up-to-date information and support can be

obtained about:
Materials
Policies and procedures, management or colleagues, provider of the materials, and the internet.

Equipment
Moving and handling training, guidelines, management, provider of the equipment, LOLER and the
internet.

Resources
Resources provider, management, colleagues, the internet.