Protect Patient Skin with TJC Pressure Ulcer Prevention Guidelines

Each year in the United States, more than 2.5 million people are affected by pressure injuries like skin ulcers—also known as bedsores—according to the Agency for Healthcare Research and Quality (AHRQ).

Many of these adults are at risk for pressure ulcers developing during a hospital stay while being treated for another condition. While small ulcers may heal quickly when promptly treated, severe pressure injuries can increase patients’ risk for worse outcomes, including amputation, and threaten their quality of care

Want more resources? Our Pressure Ulcers Toolkit dives deep into contributing factors for pressure injuries and assists you in improving the processes associated with pressure ulcers in your healthcare organization.

Factors That Influence Pressure Ulcer Development

In most cases, pressure ulcers develop when prolonged pressure is exerted on the skin and restricts blood flow to the tissue in those affected areas. Common factors that accelerate ulcer development include:

• Immobility: When patients are unable to move or leave a resting position due to illness, injury, or surgery can increase the chances of pressure ulcer development.
  
  
• Friction: Skin under pressure that consistently rubs against bedding or clothing can be at greater risk for injury.
  
  
• Moisture: Skin that is kept in an overly moist environment, either from sweat, water, urine, or wound drainage, may be at greater risk for ulceration and infection.
  
  
• Poor Nutrition: For patients who are malnourished, a lack of essential nutrients to repair damaged cells can weaken skin health and increase the chances of pressure damage.

Healthcare providers should recognize situations that increase the risk of pressure ulcers and take steps necessary to protect patient skin from pressure ulcers.

Ways to Limit Pressure Ulcers in Patients

Fortunately for healthcare teams, there are a variety of ways we can reduce the risk of pressure injuries in patients. Here are some of the most common preventive measures you can implement in high-risk patient care to improve skin health and limit infection.

Reposition Patients Regularly
Providers should shift patients every 1-2 hours to relieve pressure on the skin. By repositioning patients throughout the day, we can redistribute body weight and alleviate prolonged pressure on vulnerable areas like the hips, heels, and lower back. This improves blood circulation, prevents tissue damage, and reduces the risk of pressure ulcer development.

Do Frequent Skin Inspections
Performing daily skin examinations can help providers catch early signs of pressure damage such as redness, swelling, or changes in texture. With early detection, healthcare providers can quickly adjust the patient's position or apply protective dressings and medication.

Use Supportive Devices
Cushions, mattresses, foam wedges, and other devices can reduce pressure ulcer development by evenly distributing body weight and minimizing pressure on vulnerable areas. Specialized pressure-relieving cushions can also help improve circulation, which reduces the likelihood of infection and tissue damage.

Monitor Hydration & Nutrition
Keeping patients hydrated and well-nourished can support overall skin health. Proper hydration keeps skin supple and less prone to breakdown, while a balanced diet rich in protein, vitamins, and minerals strengthens skin and promotes faster healing when damage does occur.

Manage Moisture in the Environment
Excess moisture from sweat, incontinence, or wound drainage can soften the skin, making it more vulnerable to friction and pressure damage. By keeping the skin at a normal level of dryness using absorbent pads, moisture-wicking materials, and barrier creams, we can help keep patient skin stronger and less prone to injury and infection.

Educate Patients on Skin Care
By educating patients on the risks of bedsores and other pressure injuries, we can help reduce their overall risk by empowering them to take an active role in their skin health. Patients can learn how to identify signs of skin damage and practice proper hygiene while understanding the need for frequent repositioning.

Improve Your Quality of Care for High-Risk Patients

To assist your organization in reducing the development of pressure ulcers and safeguarding each patient’s quality of care, The Joint Commission issued Quick Safety Issue 70. This issue provides critical pressure ulcer prevention guidelines, covering both the early identification and evaluation of severe pressure injuries to help providers improve outcomes.