CONCLUSION
Pressure injuries are a life-threatening problem among vulnerable individuals, including those who are bed- or chair-bound and those who are critically ill. Nearly all pressure injuries are considered preventable, and this requires a full commitment by the healthcare facility and individual clinicians so that a pressure injury will not occur.
There are many factors that contribute to the formation of a pressure injury, including comorbidities, incontinence, poor nutrition, and advanced age, but the most significant risk factor is immobility. Patients who are dependent on others for repositioning are at greatest risk of developing a pressure injury, for nonhealing of a pressure injury should it occur, and for the recurrence of a pressure injury.
Pressure injuries can be prevented through both an “outside” approach (which includes minimizing pressure through regular repositioning, using a support surface, and managing incontinence) and an “inside” approach (which includes managing nutrition and hydration to support health and healing).
Treating a pressure injury that has developed involves these same activities, together with treating the wound itself, frequently reassessing the wound, and reducing the factors that inhibit wound healing. Pressure reduction measures are the most important. Further strategies for pressure injury treatment include cleansing the wound, managing wound infections, debriding the pressure injury of devitalized or necrotic tissue, and utilizing appropriate dressings. By carrying out these strategies, clinicians provide the wound with the environment it needs to heal.
Finally, healthcare professionals, patients, and caregivers must be vigilant about monitoring for pressure injury recurrence. Failing to protect the development of pressure injuries or to care for existing pressure injuries puts all patients and the healthcare system in jeopardy for what is often a costly but avoidable complication.
RESOURCES
Braden-Q Scale (for pediatric population)
Frequently asked questions about maggot debridement therapy
Pressure Injury Prevention in Hospitals Training Program (AHRQ)
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NOTE: Complete URLs for references retrieved from online sources are provided in the PDF of this course.
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