Transcript Pressure ulcer prevention training presentation

PRESSURE ULCER
AWARENESS TRAINING
Eliminating Avoidable Pressure
Ulcers
The Frightening Statistics
• Every year around 700,000 people are reported
as having pressure ulcers, each one costing
around £4000 in additional care costs. Around
80% of these are avoidable if preventative best
practice had been followed.
Pressure Ulcers in Coventry
and Warwickshire
• Between April 2013 and February 2014 187 pressure
ulcers were recorded in Coventry and Warwickshire.
This equates to almost £750,000 in additional care costs
• Each one of these 187 people may have suffered
unnecessarily
• Each one of these pressure ulcers could potentially have
been prevented with a great amount of knowledge and
understanding of preventative best practice
What Are We Trying To Do?
• Supported by the CCG, C&WPT, Coventry
City Council and UHCW, React to Red
Skin is designed to increase education to
help prevent avoidable pressure ulcers
• This is part of a co-ordinated effort across
the area to increase the amount of
knowledge around pressure ulcer
prevention
The Aim of Training
• This training is a basic level of training aimed at staff
who care for people who are at risk of pressure
ulcers but who are not required to classify or treat
pressure damage
• It will provide you with basic information about
prevention
• It will provide you will tools to assessment a
person’s level of risk
Introduction
• Care professionals have a key role to play
in:
– The prevention of pressure ulcers
– The education of those being cared for
– The education of others involved in the care
• Clients with impaired mobility are at a
higher risk of developing pressure ulcers
so carers need to be particularly vigilant
• Clients with mental health issues will also
present additional challenges where carers
may need to take a more proactive role
What Are Pressure Ulcers
• A pressure ulcer is a localised injury to
the skin and/or tissue usually over a
bony prominence as a result of
pressure or pressure in combination
with shear.
• An area of damage to the skin and
underlying tissues that is caused by
unrelieved pressure, friction or shear
forces
Who Is At Risk?
• The greatest risk is to those who are immobile
• Any person who is unable to change position
without help
• People unable to feel pain due to nerve damage
• Diabetics and people with arterial disease
• Elderly people in general are at greater risk
because the skin is thinner and more fragile
How Pressure Ulcers Can
Affect People’s Lives
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They can be painful
Can cause depression and anxiety
Stop people taking part in activities
Possible hospital admission due to
infection
• May cause death
Understanding Oxygen and
Blood Flow
• The human body needs oxygen to survive
• Oxygen is carried in the blood supply
• The blood supply also carries
carbohydrates and amino acids
• It removes carbon dioxide
• All of this is needed for healthy
metabolism
Oxygen Deprivation and the
Skin
• Skin deprived of oxygen will begin to die if
the blood supply is cut off for more than a
few hours
The Skin
Physical Causes of Pressure
Ulcers
Other Causes
• Level of mobility – level of consciousness,
terminal illness
• Extremes of age
• Nutrition and hydration status
• Moisture to the skin
• Sensory – neuropathy, MS,CVA
• History of pressure ulcers
Where Do Pressure Ulcers
Develop?
Medication and Pressure
Ulcers
• Some medication can inadvertently
increase the risk of a pressure ulcer if it
reduces sensitivity to pain or pressure
• Care plans should be clearly noted with
details of sedatives or other medication
being given in order that correct pressure
area care is undertaken
What is NOT a Pressure
Ulcer?
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•
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•
•
Burn
Skin tear
Cut
Graze
Bruise
Corn
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•
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Leg ulcers
Diabetic foot ulcers
Surgical wounds
Bruise
Incontinence
Five Simple Steps
S – SURFACE
S – SKIN INSPECTION
K – KEEP MOVING
I – INCONTIENCE
N – NUTRITION AND HYDRATION
Surface
• Pressure mattresses and cushions are used by
people at risk of or who have pressure ulcers – cut
foam, memory foam, air alternating (not cushions)
• Check covers for damage
• Remove slide sheets and hoist slings
• Reposition on mattresses
• If there is a problem consult the instruction booklet
and/or call the engineer
Skin Inspection
• Vulnerable areas – bony prominence
• Discolouration, blisters, changes in skin
temperature, swelling (boggy feel),
discomfort (pain, itching, loss of sensation)
• Document what is found even if skin is
normal
• Report any concerns through the PUT
form
Blanching Skin
Non-Blanching Skin
Keep Moving
• Assist those who cannot reposition/move
themselves
• Reposition people on mattresses
• Limit chair sitting – 2 hours maximum
• Encourage regular, gentle movements
• 30 Degree Tilt
Incontinence and Moisture
• Ensure people are clean and dry
• Limit the use of vigorous movements when
washing and drying
• If soiled wash using a soap substitute
• Apply barrier cream/spray if prescribed
• Report any concerns
Nutrition and Hydration
• Ensure people are eating and drinking
• Monitor intake of food and fluid where
possible
• Check mouths for any problems such as
thrush, ill fitting dentures
• Ensure supplements are offered where
prescribed
Four Steps of Prevention
Care Homes
• Step 1- Training
– Simple advice and knowledge that can
improve the outcomes for the people you are
caring for
– Will be recorded on your employment history
(certificates are available)
– Demonstrates a commitment and willingness
to prevent pressure ulcers with simple
techniques
Care Homes
• Step 2 – Policy
– Agree what is your ‘Policy on Pressure Ulcer
prevention’?
– Publish your policy for relatives to see
– Put it on your website
– Gain React to Red Skin Accreditation
– Tell the commissioners about your proactivity
in this area
Care Homes
• Step 3 – Using The New Tools
• We have produced some tools to make
your jobs easier when it comes to
pressure ulcer prevention
– Patient information leaflets
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Posters
Workbooks
Pressure Ulcer Trigger checklists
Safety Cross
Care Homes
• Step 4 – Keep It Going
– Pressure Ulcer Prevention needs to become part of
your day to day lives
– Get used to using the tools to help record the work
that you are doing
– Publish your pressure ulcer prevention policy on your
website
– Get your organisation accredited by React To Red
Skin
– Keep a log of how many days ‘Pressure Ulcer Free’
you are in your area and communicate it regularly to
staff using the Safety Cross
Roles and Responsibilities
• Communication is the key
• Report concerns
– Deterioration
– Declining to use prescribed equipment
– Breakdown of equipment
– Increase in risks to unacceptable levels
– 48 of red, non-blanching sking
5 Simple Steps
• Incontinence – keep people dry and clean
• Sore Skin – early skin inspection means early
detection
• Unwell – feeling ill can lead to other
complications
• Reduced Mobility – those who can move less
are more at risk
• Food and Drink – make sure people have a
good diet with plenty of fluids
Mental Illness and Pressure
Ulcers
• Clients suffering from mental illness are at
risk of developing pressure ulcers if their
illness affects their motivation
• Care professionals should remain vigilant
of both client groups with mental
illnesses/impairments as well as physical
ones
Summary
• The care professional has an important part
to play in reducing the risks of people
developing pressure ulcers
• A good understanding of how pressure ulcers
develop and client groups at risk means that
care professionals are better equipped to:
• Reduce the risks
• Provide a better standard of care
Conclusion
• Only by really working together can we
stop pressure ulcers, and stop suffering
• We are all responsible for our client's
wellbeing
• Please help us to prevent pressure ulcer
occurring in the first place
PRESSURE ULCER
AWARENESS TRAINING
Eliminating Avoidable Pressure
Ulcers