Pressure Ulcers

Before we can discuss the various stages of pressure ulcers, it is important to know that while everyone is at risk there are a number of populations that are at increased risk for pressure ulcers.

The reason that these particular populations are at increased risk is that they decreased ability to communicate their needs, decreased ability to feel the need to move, or decreased ability to receive assistance in moving. .

By decreased sensation I mean the person cannot feel the sensation that something is wrong or that the person needs to move, and if they cannot move on their own the patients are likely in a setting such as a broken bone where they require assistance but can tell someone they need to move.

Many times they have multiple disease processes and the lack of heath due to the multiple disease processes means that it takes longer for the wounds to heal and the patients are at increased risk for infection in the wound sites, contributing to increased wound time and starting a nasty cycle.

The primary disease processes that I see associated with pressure ulcers are diabetes, arterial disease, dementia, broken bones (both of which I've spoken briefly about), and spinal cord injuries.  Many times spinal cord injury patients can help with their own care, as most spinal cord injury patients at least in their later stages are alert and oriented enough to understand the importance of moving and repositioning regularly, but they may require assistance.  In this nursing staff preforms an important role, and when patients develop pressure ulcers it is important to have nursing staff review the records because many times nursing staff at the home fail to note that they are documenting or not documenting that they are providing care.

Next week we'll focus on the most difficult type of pressure ulcer, the DTI.