Be pressure ulcer aware - check your skin

Many people are affected by pressure ulcers which can have a devastating effect on people’s lives and their families.

It's estimated that just under half a million people in the UK will develop at least one pressure ulcer in any given year and research suggests 80-95% of all pressure ulcers are preventable. (NHS England)

As part of Worldwide Stop the Pressure Day, we caught up with Geri Reevell, Specialist Nurse Tissue Viability, to find out how to spot the signs and what we all can do to help prevent developing pressure ulcers.

You can also watch our ‘Commitment to Care’ film which talks about the Trust’s ambition to eliminate avoidable pressure ulcers and the commitment by staff to continue to build on the work already done both locally and nationally.

What is a pressure ulcer?
A pressure ulcer or ‘bed sore’ is an area of the skin and underlying tissue which is damaged. This is due to lying or sitting in one position for too long without moving or by prolonged rubbing of the skin.

Are you at risk? 
You may be at risk of developing a pressure ulcer if you suffer from:

• problems with movement
• poor circulation
• moist skin caused by incontinence, sweating or a weeping wound
• previous skin damage
• a poor diet or fluid intake 
• lack of sensitivity to pain or discomfort from conditions such as diabetes, stroke and disorders that affect nerve supply and muscle movement.

What to look for?
Pressure ulcers are most likely to develop over bony areas. The areas most at risk are the heels, bottom, base of the spine, elbows, shoulders and the back of the head.

Red or dark patches of skin which do not disappear within 1-2 hours; discomfort or pain; blistering and any numbness, soreness, swelling or hardening of the skin are all signs that a pressure ulcer may be developing.

How do you know if it's a pressure ulcer?

Redness is the first response to pressure

Press your finger over the reddened area for 5 seconds, then lift up your finger

When you take your finger off the area it should go paler or blanch. If it blanches, it is not the beginning of a pressure ulcer (or stage 1 pressure ulcer). If it stays red, it is.



What can you do to avoid pressure ulcers?

There are simple things you can do while in hospital, community care or in your own home to prevent developing a pressure ulcer:

Look for signs of damage – if you are able, check your skin regularly or ask a relative or carer. Do not continue to put pressure on reddened areas, particularly on areas at risk.

Keep moving – one of the best ways to prevent a pressure ulcer is to relieve the pressure by regularly changing your position.  This can be as simple as standing and walking on the spot for a few minutes every hour. If you are sitting, try and lift your bottom off the seat every hour.  If you are in bed, try and change your position without digging your heels into the bed as this can cause damage.  Try not to slide down the bed as this can damage your skin.

Protect your skin – wash your skin using warm water or pH neutral soap cleansers. Do not rub or massage your skin as this can cause damage.  Do not use heavily perfumed soap or talcum powder.   If you have continence problems, please inform your healthcare team.

Eat a well-balanced diet – aim to eat a balanced diet, which is rich in energy, protein (meat, fish, nuts etc), vitamins and minerals and drink at least 6-8 cups of fluid a day.  Your healthcare team may refer you to the dietician for advice if necessary.

If you suspect that you or someone you care for may have a pressure ulcer, speak to your community nursing team or other health professional.

The Trust’s Tissue Viability Teams operate across Nottinghamshire and provide specialist assessment, expert advice, education and training to health professionals in hospitals and community settings for all ages.

Referrals can be made by community nurses, GPs, practices nurses, inpatient wards/ departments or nursing or residential care homes.  Visit Nottinghamshire Healthcare for more information.