Preventing Pressure Ulcers

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What is a pressure ulcer?

Pressure ulcers are areas of skin and tissue damage that can happen when parts of the body are under continual pressure. This can be caused by lying in bed or sitting in a chair, without moving for a long period of time. They are also sometimes known as pressure sores or bed sores.

Pressure ulcers can be very painful and sore – they can also cause infections and make you ill. This leaflet explains what ward staff will do to help stop you getting a pressure ulcer while you are in hospital, and what you can do to help yourself.

What can make me at risk of developing pressure ulcers?

You might be at risk if you:

• Are not able to move around and change your position in bed or a chair.
• Are not eating enough food or drinking enough fluid.
• Have reduced bladder or bowel control.
• Are underweight or overweight, especially if you are an older person.
• Have a serious illness, have suffered a serious injury or are undergoing surgery.
• Have had a pressure ulcer in the past.
• Have a device such as a brace, cast or collar etc.
• Wear anti-embolism stockings which can squash the skin and reduce blood supply to the area.
• Have lost feeling in your body.

What parts of the body are at risk?

The early signs of a pressure ulcer are reddening or change in colour of the skin with pain and discomfort. Pressure ulcers can also develop under the devices used to treat your condition such as oxygen masks, catheters, casts, nasal cannulas etc.

If you experience pain under the devices or have a poorly fitting medical device, please inform your nurse.

Tell us if…

• You have a sore bottom or sore heels/hips or elbows
• You notice any blisters, red patches of skin, swelling or shiny areas in your skin
• You have reduced feeling in your feet or have reduced mobility
• You are not eating as much as you used to
• You have continence problems
• You are not comfortable on your mattress or cushion

 What you can do to help yourself

• If you can, sit out in a chair; try lifting your weight side-to-side to ease the pressure on your bottom. When sitting in a chair, stand up or take a short walk every 20 – 30 minutes if you can. It is better to wear shoes or slippers while you are sitting in a chair. Your Nurse may give you special footwear that helps relieve pressure to your heels.
• Change your position regularly when lying down. If you are unable to do so, get help from the Nurse. If you can, raise each of your legs and rotate your ankles regularly to keep blood circulating to the feet and legs.
• Keep your skin clean and dry. Use a suitable moisturiser to prevent dryness. Avoid using talcum powder and use soap sparingly to prevent dryness.
• Check your skin for any signs of swelling, blisters or redness and inform the Nurse if you have any concerns.
• If you are wearing anti-embolism stockings, a Nurse will take them off every day so they can look at your skin.

 Eating and drinking well

Eating a healthy diet and drinking plenty of fluids are important to help keep your skin healthy. While you are in our hospital, you will be offered three meals a day (breakfast, lunch and dinner). The times of these meals are displayed on the ward noticeboard. We have menus with a lot of variety and your Nurse can help you choose the best options for you if you need help.

You will be offered help to eat and drink if you need it. Hot drinks are available on the ward at any time. If you are hungry in between meals there are a variety of snacks available such as biscuits at coffee time, cheese and biscuits, soup, or toast and jam. Please tell your Nurse if you are hungry or thirsty as we will make sure you receive snacks and drinks that you like. We also have special ‘build up’ drinks and supplements that we may give you if you need them.

Bladder and bowel incontinence

Incontinence can be very distressing for patients. We will do as much as we can to ensure you stay comfortable. If your skin becomes wet and stays wet for some time, your skin is at risk of being damaged and getting sore. Your Nurse may use special barrier cream to stop your skin becoming sore. Please use the call bell if you need help from the nursing staff to go to the toilet.

 Other information

During your hospital stay you may also be referred to other specialists such as:

• Dieticians to assist you with a healthy balanced diet.
• Physiotherapists and Occupational Therapists to help with your mobility.
• Tissue viability Nurse Specialists who specialise in care of the skin and treating all types of wounds.

Do not be afraid to ask for help. If you wish to contact the Tissue Viability Team, speak with your nursing team who will contact them on your behalf.