Pressure ulcer prevention Resources

It is estimated that there are currently 944,000 older people living with dementia in the UK, and that 593,200 of those people are living with advanced symptoms. People living with advanced dementia have a significantly higher prevalence of pressure ulcers (PUs), compared to those living without dementia with similar comorbidities. The care and support required to prevent pressure ulcers in people living with dementia needs to be individualised, following a holistic and person-centred assessment of the person and their unique circumstances. An improved understanding of the increased risk and causal factors of developing pressure ulcers in high risk groups, such as people living with advanced dementia, can support practitioners to conduct a more through and person-centred risk assessment and management plan, including choosing the most appropriate products to meet a person’s needs.

Pressure injuries are sometimes considered to be due to a lack of good nursing care. However, it has been debated as to whether the development of some pressure injuries at the end of life is inevitable. More recently, the term ‘skin failure’, which occurs in dying patients, has been introduced in the wound care literature, and it is proposed that the presence of skin failure may make pressure injury inevitable. This article defines the theories around skin failure and presents the different terminologies used to describe skin damage typically found in the dying patient, such as the Kennedy ulcer and Trombley- Brennan terminal tissue injury (TB-TTI). It also discusses the importance of healthcare professionals being able to recognise that skin changes, which appear to be pressure injuries, are due to skin failure at the end of life and be able to differentiate between these and usual pressure injuries when planning and delivering care for these patients.

There has recently been an increased focus on the use of patient information leaflets as a means of communicating key information and engaging patients in preventative measures. The prevention and management of pressure ulcers depends on proactive and effective communication between nurses and other healthcare professionals and the patients themselves. This is particularly important in community settings, with the increasing responsibility placed on patients to self-manage their conditions. However, despite the use of patient information leaflets as part of the nursing process, there is little research evidence to support their use with regards to pressure ulcer prevention and, in particular, whether patients themselves engage with and understand the information. This article discusses the existing literature and knowledge around patient information leaflets, looking at it in light of a recent study around pressure ulcer prevention in Birmingham Community Healthcare NHS Trust.

Guy Alexander gives an overview on the selection of mattresses used in pressure ulcer prevention
Guy Alexander RGN, Dip N, BSc (Hons) is a Specialist Nurse - Joint Equipment Services, Hampshire County Council Social Services, North Hampshire PCT.
Article accepted for publication: January 2004

In the first of a series of articles, Sylvie Hampton discusses the role of HCA's in the management of pressure ulcer prevention
Sylvie Hampton MA, BSc (Hons), DpSN, RGN is a Tissue Viability Consultant, Eastbourne.
Article accepted for publication: November 2004