Treatment of Pressure Areas

Procedure

1. Assess risk on admission with a recognised tool and reassess with any change in condition.
2. Explain the care and agree a repositioning schedule with the patient.
3. Wash hands, don gloves and provide privacy.
4. Inspect all pressure points: sacrum, heels, hips, elbows, shoulders, ears, occiput and under devices.
5. Look for non-blanching redness, warmth, induration, blistering or broken skin, and grade any damage.
6. Wash and dry the skin thoroughly, especially in skin folds and after incontinence.
7. Apply a barrier product where the skin is exposed to moisture; do not massage reddened areas.
8. Reposition at least two-hourly, using pillows to offload heels and bony prominences.
9. Use a pressure-redistributing mattress or cushion where available, and keep the sheets smooth and dry.
10. Optimise nutrition, hydration and pain relief so the patient can move.
11. Document the skin assessment, the repositioning times and any deterioration, and escalate new damage.