Pressure Ulcer Prevention

Pressure ulcers (also called “bed sores” or “decubitus ulcers”) are skin wounds caused by pressure from lying or sitting in one position too long. Pressure ulcers most often occur in bony areas such as the heels, elbows, or buttocks. They can be mild or severe. Millions of people get pressure ulcers each year.

Hospitalized patients are particularly at risk for developing pressure ulcers due to immobility, and compromised nutrition, trauma, and dehydration prior to their admission.

Middlesex Hospital participates in the National Database of Nursing Quality Indicators (NDNQI), which tracks hospital acquired pressure ulcers. At Middlesex, we strive to make pressure ulcers a “never event,” meaning that we do our utmost to prevent them from occurring. To do this, we have developed a protocol that involves assessing a patient’s risk on admission, and continuously during their stay. For patients who are at high risk, or come to the hospital already having a pressure ulcer, we employ a variety of interventions including pressure relief devices, frequent position changes and addressing nutrition and hydration problems.

NDNQI tracks all pressure ulcers, including the least severe “Stage 1” variety, which is classified as redness of the skin.

Here are some ways that doctors and nurses can help prevent pressure ulcers:

• Find out which patients are at greatest risk for pressure ulcers. This includes people who spend a lot of time in the bed or a chair, or people who do not eat well.
• Each day, look all over a person’s body for any skin changes or sores.
• Keep patients as clean and dry as possible. This is needed because soiled or wet skin increases the chance that a person will get pressure ulcers.
• Make sure patients eat a healthy diet and drink enough water.
• Decrease pressure on a person’s skin. Remind patients to shift position often when they are sitting or lying down. For patients who cannot move, put them in a new position at least once every two hours. If needed, give patients a special mattress that helps prevent pressure ulcers.