Preventing Pressure Ulcers By Lisa Blobstein, Communications Officer at Maimonides Geriatric Centre, Montreal . (Reprinted with permission from Long Term Care, December 2007, p. 5.) March 2008- The effects of pressure ulcers are a growing concern in long-term care. They are painful, costly and, yet, often preventable. A pressure ulcer, or bedsore, is an area of skin that breaks down when a person stays in one position for too long without shifting his or her weight. The risks for getting pressure ulcers increase if a person is bedridden, incontinent or has fragile skin that comes with older age. “Statistics show that one out of every three residents in long-term care has a pressure ulcer and 70 per cent of these painful sores could be prevented with proper education and tools,” says Fruan Tabamo, a head nurse at Maimonides Geriatric Centre in Montreal , who helped implement a pressure ulcer awareness project at the 387-bed long-term care home. Maimonides Geriatric Centre was selected as one of five pilot sites in Canada to participate in an awareness campaign on pressure ulcers in collaboration with the Canadian Association of Wound Care (CAWC). The objective was to reduce the incidence of pressure ulcers and improve the residents' quality of life. Since the Pressure Ulcer Awareness Project was introduced, the number of residents with pressure ulcers at Maimonides has dropped from 50 of 387 residents to 29—a decrease from 12.9 per cent to 7.5 per cent. In collaboration with the CAWC, Maimonides introduced many educational techniques and strategies to identify the risks for pressure ulcers and the ways to prevent them, including: • an interdisciplinary wound care committee that meets on a regular basis to discuss the situation; • using the Braden Scale Assessment upon admission and every three months to identify the residents at risk of developing pressure ulcers and prepare an interdisciplinary care plan; • heightened education for staff, companions and family members on signs and symptoms; • regular skin inspection; • standardization of dressings for wound care; and • statistical analysis on a regular basis. No matter how much is done in the area of prevention, pressure ulcers do occur in long-term care residents given the risk factors. The Maimonides Foundation recently purchased about a dozen specialized mattresses used in the treatment of residents with severe pressure sores. These mattresses promote healing by relieving pressure to the resident and providing comfort. “Sleeping on one of these mattresses is like sleeping on a cloud. These mattresses provide comfort and support in the care and treatment of our residents, when they need it most,” says Lucie Tremblay, Director of Nursing and Clinical Services. If left untreated, pressure ulcers can be very painful and potentially life-threatening. “Prevention is really the key,” says Tabamo, adding, “It takes a real team approach to go from treating pressure ulcers to preventing them. This is a long-term project.” Pressure sores are categorized by severity, from Stage I (earliest signs) to Stage IV (worst) Stage I: A reddened area on the skin that is ‘non-blanchable' (does not turn white) when pressed. This indicates that a pressure ulcer is starting to develop. Stage II: The skin blisters or forms an open sore.The area around the sore may be red and irritated. Stage III: The skin breakdown now looks like a crater where there is damage to the tissue below the skin. Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints. |