You have been chosen to do an in-service department on pressure ulcers for the medical unit you work in. Discuss the four stages of pressure ulcers. How can they be prevented? What are the risks of developing pressure ulcers? What do you feel is the biggest reason pressure ulcers occur in a healthcare facility? Give your rationale.

Pressure Ulcers – Stages, Development, Prevention, Risks and Causes

The pathophysiologic process leading to the development of pressure ulcers follows four stages. In the first stage, the skin area reddens, becomes warm on touch, and may appear purplish or bluish. The patient may also complain of feeling a burning or an itching sensation in the area. The affected area may develop open sores or blisters in the second stage. The skin area may be discolored, and the patient may complain of pain around the area. This stage is preceded by the development of a crater-like appearance on the skin area due to damage to the underlying skin tissues. A wound is evident at this stage. In the fourth stage, the area is severely damaged, a large wound is evident, and muscle, bone, and tendon involvement is apparent.

Pressure ulcer prevention is a priority intervention for all patients at risk of developing bedsores. Changing the patient’s sitting or lying position frequently, using cushion mattresses that relieve pressures on areas of the skin at risk of developing ulcers, and maintaining skin areas at risk of developing ulcers dry but not too dry can help prevent pressure ulcers (Yap et al., 2019). Other preventive strategies include maintaining a healthy diet to promote the patient’s immune function and adequate hydration.

The risk factors for pressure ulcers are numerous. Immobility is the leading cause of pressure ulcers. Due to immobility, sustained pressure is placed on areas of the skin, and skin areas may be exposed to urine (Yap et al., 2019). Poor nutrition and hydration, old age, sensory loss, and poor perfusion on skin areas at high risk for ulcers are other risk factors for pressure ulcers.

Pressure ulcers in healthcare are often indicative of quality compromises in the care process. The biggest reason for pressure ulcer occurrence is when patients are bedridden for a long time, consequently causing sustained pressure on areas of the skin. Application of sustained pressure on areas of the skin disrupts blood flow in the affected areas. This makes these areas vulnerable to breakage and, subsequently, ulcer development (Tesfa Mengist et al., 2022). Pressure ulcers will also develop when preventive measures such as repositioning are not applied.

References

Tesfa Mengist, S., Abebe Geletie, H., Zewudie, B. T., Mewahegn, A. A., Terefe, T. F., Tsegaye Amlak, B., Tadesse, B., GebreEyesus, F. A., Tsehay, T., Solomon, M., Chekole Temere, B., Geze Tenaw, S., & Mesfin, Y. (2022). Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in gurage zone hospitals, South Ethiopia, 2021. SAGE Open Medicine, 10, 205031212211055. https://doi.org/10.1177/20503121221105571