A pressure ulcer, sometimes called a “bedsore,” is an injury to the skin and underlying tissue usually caused by unrelieved pressure.
Pressure ulcers can occur when you are lying in bed or sitting for long periods of time, usually on the buttocks, hips, heels, elbows or shoulders. They begin as reddened areas, but can damage skin and muscles if not treated.
By working closely with your health care team, you or your loved one may be able to reduce your risk for getting a pressure ulcer. Our nursing staff will also conduct skin assessments at regular intervals during the hospital stay to help prevent pressure ulcers.
What Causes a Pressure Ulcer?
Pressure ulcers occur when unrelieved pressure on the skin squeezes the tiny blood vessels that supply the skin with nutrients and oxygen. When the skin does not get nutrients and oxygen for too long, the tissue may die and a pressure ulcer forms.
Sliding down in a bed or chair stretches or bends blood vessels that may also lead to a pressure ulcer. Even slight rubbing or friction on the skin may damage the skin or make a minor pressure ulcer worsen.
The following increases the risk for pressure ulcers:
- Cannot change positions
- Wetness from continuous or periodic loss of bowel
- Not eating or drinking enough
- Reduced mental awareness or confusion and/or bladder control
Pressure ulcers are serious problems and can lead to pain, slower recovery from other health problems or possible complications (i.e., an infection, difficulty walking etc.).
How Can a Pressure Ulcer be Prevented?
Work with your health care team and follow the key steps below to reduce your risk for getting a pressure ulcer.
Some prevention tips may not be right for everyone. If you or your loved one is receiving hospice or palliative care, discuss pressure ulcer prevention and management with your health care team. Comfort may be more important than turning and repositioning.
- Ask questions and help plan your care
- Explain your needs, wants and concerns
- Know what is best for you and become an informed consumer of health care
- Understand what and why things are being done
- Speak to your nurse if you have had a pressure ulcer in the past
Key Steps to Pressure Ulcer Prevention
- If you are unable to move yourself in bed, someone should change your position at least every two hours.
- If you are in a chair, your position should be changed at least every hour.
- If you are able to shift your own weight, you should do so every 15 minutes while sitting.
- When shifting position or moving in your bed, don’t pull or drag yourself across the sheets. Also, don’t push or pull with your heels or elbows.
- Avoid repetitive movements, such as rubbing your foot on the sheets to scratch an itchy spot.
- Avoid doughnut-shaped cushions — they can actually cause injury to deep tissues.
- Atlantic Health System has placed special mattresses called “pressure redistribution surfaces” on all beds to protect your skin. Those in our medical centers can turn to Channel 3 on the television to learn more.
Take Care of Your Skin
- Allow a member of your health care team to inspect your skin at least once per day.
- If you notice any reddened, purple, painful or sore areas, notify your nurse as soon as possible.
- Clean your skin right away if you get urine or stool on it.
- Prevent dry skin by using creams or oils.
- Don’t rub or massage skin over reddened, purple or sore parts of your body.
Safeguard Your Skin from Moisture
- Tell your health care provider if you have a problem leaking urine or stool.
- If leaking urine or stool is a problem, use absorbent pads while in bed and briefs while out of bed that pull moisture away from your body.
- Apply a cream or ointment to protect your skin from urine and/or stool.
Improve Your Ability to Move
- Ask your nurse if you qualify for a rehabilitation program designed to help you maintain/regain independence and improve movement.
If You are Confined to Bed for Long Periods of Time
- Talk to your health care provider about getting a special mattress or overlay.
- Try to keep the head of your bed as low as possible (unless other medical conditions do not permit it).
- If you need to raise the head of the bed for certain activities, try to raise it to the lowest point possible, for as short a time as possible.
- Pillows or foam wedges may be used to keep your knees or ankles from touching each other.
- Avoid lying directly on your hip bone when lying on your side.
- Pillows may be placed under your legs from mid-calf to ankle to keep your heels off the bed. Never place pillows behind the knee.
If You are in a Chair or Wheelchair
- Talk to your health care provider about getting a chair cushion to reduce pressure while sitting.
- Remember that comfort and good posture are important.
*This information is intended as a guideline based on evidence-based research and best practices. Thanks to the Texas Medical Foundation for sharing their materials. Project of the NJHA Collaborative to Reduce the Incidence of Pressure Ulcers.