1. Pressure Ulcer Prevention: Best Practices
Student Name(s) (listed alphabetically)
Significance Statement
Key Findings
Key Practices Recommended
References
For patients who are at risk for developing pressure ulcers, using a combination of best practice preventative measures as compared to a single intervention or no interventions may decrease the formation of pressure ulcers.
P- Patients at risk for developing pressure ulcers
I- Best practice preventative measures
C- As compared to a single intervention or no interventions
O- Decrease the formation of pressure ulcers
Pressure Ulcer Risk Assessments
In the hospital setting, some nurses underestimate the risk of pressure ulcer development (p < 0.001).1
It is recommended to assess pressure ulcer risk within six hours of patient admission. 3
A risk assessment tool should be clearly understood and have categories related to pressure ulcer development. 4
Risk assessment scale should also have an age category to determine at-risk populations (p < 0.05). 2
Repositioning and Assistive Devices
A turn frequency chart is recommended to use every two hours (p < 0.05). 2
Use of heel protector boots is recommended to offload the heal, a common area of pressure ulcer development. 3
Dressings, Creams, and Nutrition
When a nonblanchable erythema stage I pressure ulcer is first assessed, a dressing should be applied to promote rapid healing before the ulcer progresses. 4
Oral nutritional supplements can be utilized to supplement nutrition (p < 0.05). 2
Utilizing multiple prevention strategies can reduce the prevalence of pressure ulcers. These strategies include:
Utilizing Pressure Ulcer Risk Assessment Scoring: Used to determine high risk patients and further interventions that are necessary. 1
Utilizing Specialty Mattresses: Used as an essential strategy in preventing pressure ulcers especially in acute care settings. 2
Repositioning, Turning, and Offloading: Used in all current practice guidelines to prevent pressure ulcers. 2
Utilizing Patient Transfer Devices: Used to reduce patient friction and shearing. 2
Increasing Nutritional Intake: Used as an added measure used to prevent tissue breakdown. 3
Placing Dressings Over at Risk Areas: Used to provide protection to prevent further breakdown. 4
Ambulating Frequently: Used to reduce the amount of pressure on one area. 4
Applying Topical Creams: Used to prevent breakdown in the incontinent patient. 4
1. Barker, A, Kamar, J, Tyndall, T, White, L, Hutchinson, A, Klopfer, N, Weller, C. (2013). Implementation of pressure ulcer prevention best practice recommendations in acute care: An observational study. International Wound Journal doi: /j X x
2. Cox, J. (2011). Predictors of pressure ulcers in adult critical care patients. American Journal of Critical Care doi: /ajcc
3. Elliott, J. (2010). Strategies to improve the prevention of pressure ulcers. Nursing Older People, 22(9):
4. Sharp, C, Burr, G, Broadbent, M, Cummins, M, Casey, H, Merriman, A. (2000). Pressure ulcer prevention and care: A survey of current practice. Journal of Quality in Clinical Practice, 20(4):150-7.
Key Methodology
Observational cohort study using surveys.1
A retrospective correlational designed study utilized data collection from hospital documentation systems and power analysis.2
Exploratory descriptive research design utilizing a 26-item questionnaire. 4
Exploratory study using nurse observation. 3