1. Prevention and treatment January 2016
Pressure ulcers
Prevention and treatment
January 2016

2. What are pressure ulcers?
Skin injuries caused by pressure
Pressure leads to reduced blood flow
Reduced blood flow causes tissue to die

3. Common causes of pressure ulcers
Intense pressure
Long-lasting pressure
Fragile skin
Friction, when skin is pulled or dragged across a surface
Shearing, when skin and tissues over a bony prominence slide against a hard surface
Moisture, especially caused by urine

4. CNAS can help prevent pressure ulcers
Never massage red or damaged skin.
Turn and reposition residents according to their care plans.
Encourage proper nutrition.
Remind wheelchair-bound residents to shift their weight frequently.
Toilet residents frequently and monitor for incontinence.
Change incontinent residents as soon as possible.
Report ANY concern about a resident’s skin to the nurse.

5. Early warning signs of pressure ulcers
An area of reddened skin that does not return to its original color
Swelling
An area of hardness or firmness
Bruises
Skin tears
Blisters
Skin discoloration
A change in skin temperature

6. Stage 1
The skin is unbroken, but may be reddened or darkened, and does not return to normal color when pressure is removed.
Keep all pressure off the affected area.
Maintain good hygiene.
Never rub the area vigorously.
Maintain any transparent protective dressing that the nurse may have applied.
Ask the resident if the area is painful, and inform the nurse.
Used with permission of the National Pressure Ulcer Advisory Panel, January 2016.

7. Stage 2
The top layer of skin is broken or there is a fluid-filled blister.
Follow steps in Stage 1.
Follow your facility’s policy on cleansing and maintaining dressing.
Watch for signs of infection.
Used with permission of the National Pressure Ulcer Advisory Panel, January 2016.

8. Stage 3
The wound is deeper, with the entire thickness of skin missing. Fat may be visible, but no muscle or bone is showing.
Follow steps in Stages 1 and 2.
Special products may be used to cleanse the wound and to remove dead tissue.
The resident may need a special low pressure mattress.
Used with permission of the National Pressure Ulcer Advisory Panel, January 2016.

9. Stage 4
The wound is deep enough to expose muscle or bone. There may be drainage or areas of dead tissue that are thick, black, and hard.
• Follow the steps in Stages 1, 2, and 3.
Keep the nurse updated on the condition of the wound.
Used with permission of the National Pressure Ulcer Advisory Panel, January 2016.