OASIS-E M1306: Six (6) Steps to Prevent Pressure Ulcers

Any person who is in a bed or chair for 8 hours or longer is at risk for pressure ulcers. Pressure ulcers - also known as bed sores, decubitus ulcers, pressure sores and skin ulcers - often develop in patients with the following conditions: diabetes mellitus, deep venous thrombosis, s/p hip fracture, s/p hip surgery, limb paralysis, dependent edema, cancer, malnutrition, osteoporosis, Parkinson’s disease, rheumatoid arthritis, and urinary tract infections. In addition, patients with Alzheimer’s disease, congestive heart failure, chronic obstructive pulmonary disease, and c/p cerebral vascular accident are at risk for pressure ulcers.

Who's At Risk for Pressure Ulcers?

A person is at risk for pressure ulcers if s/he...

Is in a bed or chair for eight hours or more – excluding sleeping
Has urine or fecal incontinence
Has a chronic medical condition
They already have redness or pain in pressure ulcer areas: such as sacrum, trochanter, scapulae, elbow, heel, inner and outer malleolus, inner and outer knee, back of the head
Has trouble getting enough calories or fluids every day
Is already under-nourished

6 Pressure Ulcer Prevention Strategies

Change Position Every 2 Hours!
The patient should move their position no less than every 2 hours, and if chair or bedbound, perform passive or active range of motion exercises while in a chair or in bed.
Gentle, Daily Skincare!
1. Clean the skin with mild soap and warm water or a no-rinse cleanser.
2. Gently pat dry. Use skin protectant to protect skin vulnerable to excess moisture.
3. Apply lotion to dry skin.
4. Be vigilant about skincare especially if incontinent of urine or feces.
Make sure Bedding is Dry, Clean and Wrinkle-Free
1. Change bedding and clothing frequently.
2. Watch for buttons on the clothing and wrinkles in the bedding that irritate the skin.
Make Sure Patient is Adequately Hydrated!
1. If not contraindicated make sure the patient is drinking eight (8) 8-oz glasses of water a day.
Make Sure Patient Consumes Enough Calories!
1. If not contraindicated make sure the patient adds calories. Some good strategies on increasing calorie intake
2. Add butter or margarine to foods when cooking and put on foods that are already cooked.
3. Add cream sauce or melt cheese over vegetables.
4. Eat peanut butter sandwiches, or put peanut butter on vegetables or fruits, such as carrots or apples.
5. Mix whole milk or half-and-half with canned soups.
6. Add protein supplements to yogurt, milkshakes, fruit smoothies, or pudding.
7. Drink milkshakes between meals.
8. Add honey to juices.
9. Encourage the patient/caregiver to keep a log of dietary and fluid intake and position changes
Consider Pressure-Relieving Mattress and Support Surface
a. Special foam mattresses and as alternating pressure mattresses can be used to provide a soft surface. These distribute the pressure over a larger surface area, reducing the pressure on especially vulnerable parts of the body.