I. Preventing pressure ulcers through positional placement and change
1. All high-risk groups should change positions regularly to minimize the amount of time and intensity of pressure on pressure-prone areas of the body.
2. The frequency of positions should be determined by the patient's condition, skin tolerance, mobility, and the material of the support surface used.
3. When assisting the patient with position changes and moving the patient, the patient's body should be lifted to minimize friction and shear, and to avoid dragging, pulling, and tugging.
4, so that the pressure, friction and shear force to minimize, while maintaining the patient's appropriate level of activity.
5. Limit the amount of time the patient sits in a chair without a support surface.
6. Instruct the patient to sit in the wheelchair in a variety of seating positions (e.g., leaning forward, reclining, upright, etc.).
II. Pressure Reduction with Support Surfaces
A support surface is a device on which a patient can be placed to manage pressure, friction, shear, and the microenvironment, including regular beds and mattresses, various inflatable power beds and mattresses and supports, natural or synthetic sheepskin pads, electrons, pillows, wheelchairs and chairs, and cushions.
Support surfaces reduce pressure on skin contact surfaces by increasing the contact surface with the body or by changing the position and duration of contact between the support surface and the body. The ability of support surfaces to reduce and redistribute pressure makes them one of the most commonly used protective devices for the prevention of pressure ulcers.
1. The application of support surfaces can effectively reduce the incidence of pressure ulcers.
2. The use of a supportive surface still requires regular position changes and ongoing evaluation of its effectiveness in preventing pressure ulcers.
3. Use a pressure-relieving cushion in a chair or wheelchair.
4. Medical sheepskin cushions can effectively reduce the incidence of pressure ulcers.
5. Avoid ring or loop devices, water-filled gloves, and non-medical synthetic sheepskin pads.
6, localized pressure-reducing pads must be placed on the mattress, not directly on the bed frame without a mattress.
7, for all people at high risk of pressure sores, the use of high-level foam mattresses is better than ordinary hospital foam mattresses.
8, the use of buckwheat skin mattresses, static anti-pressure sore mattresses, air mattress beds can effectively prevent the occurrence of pressure sores.
Third, effective skin care to reduce the incidence of pressure ulcers
1, skin protection can reduce the incidence of pressure ulcers in the pressure parts of the use of film dressings, hydrocolloid dressings, foam aids can reduce the bedridden patient's skin to withstand the shear force, thereby preventing pressure ulcers occur.
2, for pressure ulcer high-risk groups, can consider the use of multi-layer soft silicone foam dressings in high-risk areas to strengthen the prevention of pressure ulcers.
3. Focusing on medical device-associated pressure ulcers is part of pressure ulcer prevention, and the use of hydrocolloid dressings, foam dressings, and transparent dressings can all serve to protect the skin.
4, should be concerned about adhesive dressings on the skin 'damage, silicone dressings than hydrocolloid and transparent film dressings on the skin stratum corneum less damage.
5, keep the skin moderately moist can protect the skin, is conducive to the prevention of pressure ulcers.
6, keep the skin clean is conducive to the prevention of pressure ulcers.
7, the incontinent patients timely cleaning of the skin and the use of skin protectants to prevent the patient's skin impregnation, can reduce the feeling of skin moisture, skin redness, and prevent the occurrence of pressure ulcers.
8, in addition to the bone augmentation pressure site, should also pay attention to the following parts of the skin care, such as: ladder variable pressure stockings, neck brace, oxygen catheter, transnasal catheter, radial artery catheter, tracheal intubation and its fixed stent, oxygen saturation, non-invasive masks, fecal incontinence control equipment, continuous compression devices, splints, stents, urinary catheters and other relevant parts of the skin in contact with the skin.
9. It is prohibited to rub hard against the pressurized area.
IV. Nutritional support
1. For patients at nutritional risk or at risk of pressure ulcers due to acute or chronic disease, or undergoing surgical treatment, provide a high-protein blend of oral nutritional supplements in addition to the normal diet or tube-fed nutrition.
2. Patients may require different nutritional management at different stages of their disease. According to evidence-based guidelines, patients at risk for pressure ulcers need to be provided with timely nutritional support when they are at nutritional risk or undernourished.
3. When patients are at risk for pressure ulcers and nutritional risk, they need to be seen by a dietitian, nutritional specialist care, and a physician*** to formulate a reasonable and individualized nutritional support plan, and to monitor and evaluate the effects of nutritional support. When patients are at nutritional risk, they should be reassessed regularly for their nutritional status.
4. Supplementation with appropriate nutrients such as zinc sulfate can promote the healing of pressure sores.
Extended reading
What are the risk factors for pressure ulcer development?
(1) Local factors
① Pressure factors: vertical pressure, friction, shear force of the combined effect of the pressure exceeds the normal skin capillary pressure; so that the local skin blood circulation is impaired, leading to
resulting in damage to the cuticle of the skin.
② physical and chemical factors of stimulation: sweat, urine, exudate and other substances stimulation, so that the local pH changes, the skin barrier function is destroyed.
(2) Systemic factors
① Sensory disorders change the metabolism of skin tissues.
② Systemic malnutrition: lack of muscle and fat tissue to protect the pressure area, and no cushioning of the bone conflict.
③ Insufficient perfusion of tissue blood flow causes tissue hypoxia, affecting the nutritional supply of the tissue,
skin resistance is reduced.
④ Elderly people have loose and dry skin, lack of elasticity, and thinning of subcutaneous fat atrophy.
⑤ Overweight: obesity, the blood supply of adipose tissue is relatively small, affecting the local blood circulation, activity is difficult to move the bed easily dragged.
⑥ body temperature is high or low: high body temperature, in order to cool the body surface excessive sweating, the temperature around the vulnerable area increases, the skin in the bed sheet impregnation and friction increased possibility;
body temperature is low, the body "shut down" peripheral circulation, resulting in a reduction in the blood supply to the pressure area.