NICE (2018) reports that pressure ulcers are caused when an area of skin and the tissues below are damaged as a result of being placed under pressure sufficient to impair its blood supply.
Typically, they occur in a person confined to a bed or a chair by an illness and as a result they are sometimes referred to as ‘bedsores’, or ‘pressure sores’.
Since pressure injuries are most likely to develop on people with limited mobility this makes older people particularly susceptible.
80% of patients treated for pressure injuries are aged 60 or above.
Pressure damage can further limit mobility, be extremely painful and can be difficult to heal.
They can have significant impact on a person’s quality of life if they are not monitored and treated diligently.
Pressure ulcers can cause significant pain and distress for people. They also contribute to longer stays in hospital and cost the NHS in the region of more than £1.4 million every day.
Many pressure ulcers are avoidable if simple knowledge is provided and preventative best practice is followed.
Reporting on pressure injuries
Care homes have a duty to report Grade 3 and 4 pressure sores to the CQC and their local safeguarding team.
It is common practice for a root cause analysis (RCA) team to visit and look at why the pressure damage occurred.
RCA is a methodical process that seeks to identify the root causes that led to a serious incident happening and the actions required to prevent the incident from reoccurring.
Incontinence Associated Dermatitis
Incontinence Associated Dermatitis (IAD) is often confused with pressure damage due to their similar appearance.
However the causes are quite different.
Pressure damage is caused by constant pressure against fragile skin.
IAD is caused by skin inflammation leading to the breakdown of the skins protective barrier.
IAD can be caused by faecal or urinary incontinence.
Prevention involves cleaning, moisturising and protecting the skin, as well as regular inspection to ensure early intervention if required.
Differentiating between pressure injury and IAD
If the person is not incontinent then the condition is not IAD.
However, visual assessment and clinical observation is critical to a correct diagnosis.
“Incontinence is a risk factor for pressure injuries, but IAD can also occur in the absence of any other pressure injury associated risk factors, and vice versa.”
Managing wounds in AutumnCare
Pressure damage and wounds must be monitored rigorously in order for care staff to track healing effectively.
Assessment and Treatment
AutumnCare contains a comprehensive wound care assessment which allows for recording of all wound types, including pressure damage.
Care staff can photograph the wound and add this photograph to the wound form within AutumnCare.
This allows staff to track healing visually and intervene if healing is not on track.
Monitoring pressure injuries
AutumnCare’s Dashboard allows staff to see at a glance the total number of wounds at the care home at any time.
Staff can drill down into more detail on each injury and the resident’s treatment history.