Pressure Ulcer Prevention

Families e n an d Childr

Community

Tissue Viability Service

Services

Mental Health

Secure Service s

Special

ist Ser vices

What is a Pressure Ulcer?

A pressure ulcer is an area of damage to the skin and underlying tissue. They are sometimes known as pressure sores or bed sores. They can range from red patches of skin to a large open wound. Occasionally they can be serious and cause pain, infection and damage to underlying muscle and bone. What causes pressure ulcers? The most common cause of pressure ulcers is constant pressure that is not relieved. This can be a combination of: Pressure - Pressure squeezes the tiny blood vessels in the skin which supply the skin with nutrients and oxygen. When this happens for too long the tissue of the skin and that underneath the skin is damaged and a pressure ulcer forms. Shearing - The skin and underlying tissues become stretched and tear e.g. a patient sliding down the bed or chair. Friction - A surface rubbing the skin e.g. not using a slide sheet causes the skin to rub against the sheet and may cause a pressure ulcer. Who is at risk of pressure damage? Everyone is potentially at risk of pressure damage. Some people are more at risk if they have reduced mobility, serious illness, loss of feeling, poor circulation, poor or reduced diet, weight problems, poor posture or if the correct equipment for moving and handling is either not in place or not used. By following some simple advice we can identify risk and do something about it.

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Self help measures

There are some simple steps that can be taken to prevent and treat pressure ulcers, these are known as SSKIN: Surface, Skin inspection, Keep Moving, Incontinence, Nutrition and Hydration S - Surface Special mattresses, cushions and other aids can help to reduce pressure. Other products claim to reduce pressure but may not be suitable for your needs or properly researched. It is important before obtaining any pressure relieving equipment that an assessment is carried out by a health care professional. Please note - we would advise that you do not smoke in bed due to the increased risk of fire. This applies to all mattresses whether it is your own or one that is loaned to you. S - Skin inspection and care Wash daily using warm water and pat dry, do not rub. Soap has a drying effect on the skin, so if possible, use a soap substitute. Apply a moisturising cream daily to help to maintain healthy skin. Examine skin as often as possible at least once each day. Use a mirror for areas that are hard to see or get someone else to check. Take all pressure off areas that show any signs of skin damage. Alert a health professional if you are fitted with a plaster cast and have increased pain as there maybe pressure or friction from the plaster cast. K - Keep moving Changing position regularly helps prevents the build up of pressure. If you sit for a long time, you should change position every hour. If you are in bed, you should change position every 2 - 4 hours. Do not have objects in bed with you; make sure that any tubing is not under you. Always use slide sheets or hoists to move up or down the bed. Make sure that heels are on the slide sheet and not dragged on the sheet. Do not push up with your heels as this increases friction. Page 3

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What are the signs of a pressure ulcer starting? The following symptoms could be a sign a pressure ulcer is developing. • Discoloured skin, pinkish red and/or purple bluish in colour*, which does not go pale when pressed (reddening of the skin that disappears when pressure is removed is normal and not a pressure ulcer) • Blisters, dry, cracked, or shiny areas • Skin may go darker and break down to cause an open wound • A hard swollen area of skin that may be painful to touch (* This is not always as obvious in dark skin) Places to check It is particulary important to check over areas where bones come close to the skin surface - bony prominences. Please see the diagram on page 7 for more details.

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There are things you need to tell us when we are not around • Tell us if you are not eating as much as you used to • Tell us if you think there is a problem with your cushion/mattress we provided • Tell us if you are unwell or not moving around as much as you usually do • Tell us if you have a sore bottom or heels

This leaflet has covered the main information that you need to prevent and recognise pressure ulcers. More information can be obtained by speaking to your health professional. Contact details for your health professional are Name: Telephone Number: Email: Office Base:

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Contact details for Tissue Viability Services:

Other sources of information:

The Mental Health Helpline This provides an information and listening service for Central Lancashire: 01772 643147 people in Lancashire. It is available between 7:00pm and 11:00pm Mondays to Fridays and from 12:00 Darwen Health Centre: noon until 12:00 midnight on Saturdays and Sundays. 01254 226875 Other sources of information: Freephone 0500 639000. The Mental Health Helpline provides an information and listening service for people in Lancashire. It is available between 7.00pm Customer Care and 11.00pm Mondays to Fridays and from 12.00 noon until 12.00 If you wish to pay639000. a compliment about the Trust’s midnight on Saturdays and Sundays. Freephone 0500

services, make a comment, raise a concern or complaint,

The Patient Advice and Liaison Service provides advice and please contact the Customer Care Department on information. Please contact East Lancashire PALS on: 01282 474178 or 07507 857345

01772 695315, freephone 0808 144 1010 or email [email protected]

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print, audio book or Braille.

W przypadku jakichkolwiek problemow z odczytaniem tekstu z przyjamnoscia dstarczymy Panstwu ulotke z duzym drukiem, tasme do odluchu lub tekst w jezyku Braille. Data Protection Leaflet number: XXX XXX/XXXX The Trust will endeavour to ensure that your Name of Leaflet: Seeing a Clinical Psychologist information secure and confidential at all ©in Lancashire Care NHS Darwen Foundation Trust. Copies of this leafletremains are available from: Blackburn with times. The Data Protection Act 1998 explains how All rights reserved. Not to be reproduced February inDate wholeproduced: or in part without the2009 permission personal information should be processed and this date: owner. February 2011 ofReview the copyright applies to NHS all information whetherTrust, held on paper Lancashire Care Foundation or electronically on computer systems. We must Data Protection Sceptre Point, Sceptre Way, ensure that all personal information is processed Lancashire Care NHS Foundation Trust fairly, lawfully and as transparently as possible so © Lancashire Care NHS Foundation Trust adheres to The Data Protection Act 1998. Walton Summit, Preston PR5 6AW you: The Trust will endeavour to ensure that Not to be 2009-02-18. All rights reserved. • Understand reasons for us processing your your information and without the reproduced inremains whole secure or in part personal information confidential at all times. For further Give your consent for the disclosure and use of permission of the copyright owner. Tel: 01772• 695300 information regarding data protection information where necessary please visit the Trust’s website or ask a Email: [email protected] • Gain Trust in the way we handle your member of staff for a copy of our leaflet information entitled Us”. from:Website: www.lancashirecare.nhs.uk Copies“Sharing of this Information leaflet are With available • Understand your rights regarding the right to Lancashire Care NHS Foundation Trust, request access about information we hold Review Date: Leaflet Code: Date Produced: Namethe of Leaflet: about you. Sceptre Point, 038/2013 November 2013 November 2014 Pressure Ulcer Prevention The Caldicott Guardian, who is a senior health Sceptre Way, clinician, has the role to ensure we meet Walton Summit, the highest standards for handling personal Bamber Bridge, information at the Trust.