Pressure ulcers (also known as decubitus, bed sores or pressure injury1) remain a challenge for both the providers and users (patients, clients) of health care services. In many cases, with good preventative care, up to 50% of the most serious pressure ulcers could be avoided.2. Traditional models of risk assessment, such as the use of numerical scoring systems, are cumbersome and require knowledge of their use and are not always aligned to the care environment or the specific vulnerability of the population.3,4
The identification of increased risk is only the starting point of the process. Once risk has been identified, an appropriate plan of care should be put into place before the signs of Category I damage are visible at the skin surface (non-blanching erythema).1. In order to standardise both the early identification of risk and early intervention, many organisations are now developing pathways for pressure ulcer prevention. These protocols are typically based upon existing national or international guidelines, for example, NICE5 (UK) or NPUAP, EPUAP, PPPIA1 (International).
To build on these guidelines and support clinical staff in this process, the Pressure Ulcer Prevention Advisory Board have developed an algorithm using a simple framework that can be used alongside local policies and form the basis of local preventative care pathways.
The Early Identification Strategies Toolbox developed by the Pressure Ulcer Prevention Advisory Board is now available – the free download Toolbox features guidance notes, algorithm and training materials to support implementing early identification of pressure ulcer strategies.
“Early Identification of risk in a timely, manner provides a mechanism to intervene with effective prevention strategies” Pressure Ulcer Prevention Advisory Board
For more information, visit the Academy section and click on Early Identification Strategies Toolbox
1. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Western Australia; 2014.
2. Downie F, Guy H, Gilroy P et al. Are 95% of hospital-acquired pressure ulcers avoidable? Wounds UK. 2013; 9(3):16-22
3. Guy H (2012) Pressure ulcer risk assessment. Nursing Times 108(4): 16-20
4. Healthcare Improvement Scotland (2011) SSKIN Care bundle. http://tinyurl.com/nkqgtjr
5. National Institute of Health and Care Excellence. Pressure Ulcers: Prevention and Management of Pressure Ulcers NICE Clinical Guideline 179. 2014. https://www.nice.org.uk/guidance/cg179/chapter/1-recommendations Accessed October 2018
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