When it comes to pressure injuries, most experts will tell you that prevention is far more manageable than the cure.

In 2005, epidemiologists reported a 68.8% mortality rate amongst elderly patients with stage 3 and 4 pressure injuries. Approximately 67% of pressure injuries occur in elderly patients over 70 years old, however, they are still quite prevalent in younger individuals. As healthcare professionals, it is our responsibility to spread awareness so that you can prevent the devastating hazards posed by these deadly sores.

Prevalence and Recurrence

Concerningly, the complication rate after pressure injury reconstruction is 58.7%. Patients who are considered to be at a higher risk for developing pressure injuries, should take preventative measures to minimize their susceptibility.

So, how can you, as the OT, lead your patients on the correct path to optimal prevention? Firstly, it’s essential to consider your patient’s current health status in order to determine their equipment needs.

Patients with a previous history of pressure injuries face a 23.1% recurrence rate. Sacral ulcers are the most likely region for recurrent injuries to appear, making up for 82.1% of returning pressure injuries. In order of most likely to recur, sacral ulcers are proceeded by ischial ulcers (20.5%), and then trochanteric ulcers (15.4%).

Preventative Medicine

Eating a balanced diet that is high in protein or amino acid supplements are also recommended for at-risk individuals.

At-risk individuals should make their nutritional status an utmost priority and maintain adequate hydration. Patients who are comatose, paralyzed, or otherwise highly immobile, should be assisted in changing their posture on a 2-4 hourly schedule. The following diagram displays typical pressure points based on various postural alignments:

Time is of the Essence

As discussed in our previous article, pressure injuries can form in under two hours. So, timely prevention is vital when it comes to these unpleasant sores. At Novis Healthcare, our priority is patient care, so we offer a variety of preventative equipment. We have everything you and your patients need – from specialized mattresses, to slide sheets, and our new Air Cell Cushions – we’ve got you covered!

References:

Agrawal, K., & Chauhan, N. (2012, May). Pressure ulcers: Back to the basics. Indian Journal of Plastic Surgery. Thieme Medical Publishers. https://doi.org/10.4103/0970-0358.101287

Dalvand, S., Ebadi, A., & Gheshlagh, R. G. (2018). Nurses’ knowledge on pressure injury prevention: A systematic review and meta-analysis based on the pressure ulcer knowledge assessment tool. Clinical, Cosmetic and Investigational Dermatology, 11, 613–620. https://doi.org/10.2147/CCID.S186381

Paker, N., Buğdaycı, D., Gökşenoğlu, G., Akbaş, D., & Korkut, T. (2018). Recurrence rate after pressure ulcer reconstruction in patients with spinal cord injury in patients under control by a plastic surgery and physical medicine and rehabilitation team. Turkish Journal of Physical Medicine and Rehabilitation, 64(4), 322–327. https://doi.org/10.5606/tftrd.2018.2175

Need help determining what equipment is best for your patient? In next week’s article, we’ll discuss all that Novis has to offer, with comprehensive explanations of each solution available. Each of our solutions are recommendations to accommodate your patient’s needs. Here at Novis, preventing pressure injuries is a priority, so we have a solution for every case!

Missed the first 2 parts of this 4 part educational series on pressure injury? If so, sign up to receive a full copy of our educational series on pressure injuries and learn more about the underlying causes of PIs, symptoms, as well as why pressures injuries can be so difficult to treat.

At Novis Healthcare, we are determined to provide 24/7 vigilant care to patients and physicians, from specialised mattresses to air cell cushions, we’ve got you covered! Stay tuned for more information on how pressure injury equipment can help you prevent the development of these incredibly painful sores.

This “Stop the Pressure” educational series, ebook, and an additional presentation, are prepared based upon the Clinical Practice Guideline for the Prevention and Management of Pressure Injury 2019.

References:
Australian Commission on Safety and Quality in Health Care. Safety and Quality Improvement Guide Standard 8: Preventing and Managing Pressure Injuries (October 2012). Sydney: ACSHQC; 2012. (June 2017).
Clinical Excellence Commission (AU). Pressure Injury Prevention Project. (Accessed June 2017)
Miles SJ, Fulbrook P, Nowick T, Franks C. Decreasing pressure injury prevalence in an Australian general hospital: A 10-year review. Wound Practice & Research: Journal of the Australian Wound Management Association 2013;21:148–56
Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards (second edition). Sydney 2017
Australian Wound Management Association. Pan Pacific Clinical Practice Guideline for the Prevention and Management of Pressure Injury 2019

Written by Kaleigh H. Wellhofer B.S. Clinical Neuroscience, B.S. Psychology

Kaleigh studied Clinical Neurosciences and Psychology at Virginia Tech, in the United States, with an additional minor in Professional & Technical Writing. She spent two years at the Carilion Research Institute, studying potential treatment options for acquired epilepsy. During that time, Kaleigh presented her research at various conferences all over the world. She then went on to volunteer as a medical outreach professional in rural areas of Cambodia, where she oversaw the development of mobile medical clinics, taught oral hygiene in local schools, and assisted doctors with patient care. Back in the States, she has worked for major pharmaceutical companies, private practices, and research establishments as both a clinical consultant and a technical writer.