Preventing Pressure Ulcers in Hospitals and Operating Rooms

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Preventing Pressure Ulcers — also known as decubitus ulcers and bed sores — is one of the most common complications of extended bed rest in surgery centres, hospitals and long-term care facilities. They occur when continuous pressure reduces blood flow to a part of the body, leading to a breakdown of the skin in that area. Rubbing and irritation from moisture can make the problem worse.

In Canada, research estimates that pressure ulcers are present in 26% of healthcare settings. That number is highest in non-acute and long-term care facilities, and lower in community care centres. Though generally not recognised as a widespread problem, lack of resources and awareness among caregivers have been cited as barriers to reducing the prevalence of pressure ulcers.

Symptoms and Severity

Pressure ulcers occur in areas of the body that rub against bedding or mobility devices such as wheelchairs. This can include the hips, buttocks, elbows, ankles, back, legs and other areas. Pressure ulcers can be identified by a characteristic redness in the early stages and, later, by the presence of blistering and open sores. The severity of a pressure ulcer is measured on a four-stage scale:

  • Stage I pressure ulcers are just starting to develop and can be corrected with simple intervention. They are typically characterised by a tender, red area on the skin that does not turn white when pressed.
  • Stage II pressure ulcers have advanced to the point of blistering or forming an open sore. The area surrounding the sore may be red as well.
  • Stage III pressure ulcers are marked by damage to subcutaneous tissue. They appear as sunken holes or craters that may be filled with pus.
  • Stage IV pressure ulcers are the most severe, and feature damage to muscle, bone, tendons and joints as well as the skin and fatty tissue.

Depending on the severity of the issue, treatment of a pressure ulcer can involve simply cleaning and treating the wound, followed by a course of antibiotics to prevent infection. In extreme cases, surgical debridement or even amputation of the affected areas may be required.

Clearly, it is preferable to avoid pressure ulcers than to attempt to correct them after the fact. The first step in preventing bedsores is to know who is at risk.

Who Is Vulnerable?

Certain patient populations are more vulnerable than others to pressure ulcers. Special consideration must be given when treating patients who:

  • Have mobility issues or are confined to a bed or a wheelchair for extended periods of time.
  • Are older or have a condition that makes their skin more fragile.
  • Suffer from malnutrition or poor hydration, which can make skin more prone to tearing.
  • Have poor circulation as a result of diabetes or vascular disease.
  • Have diminished cognitive capacity due to Alzheimer’s or a related condition.
  • Frequently suffer from urinary or bowel incontinence.

Infants are another often overlooked population when it comes to preventing pressure ulcers in operating rooms and other hospital facilities. A 2014 report published in Advances in Wound Care states that “the hospitalized neonatal and pediatric population is at significant risk for the development of acute and/or chronic wounds and other skin-related injuries.”

The Caregiver’s Role in Preventing Pressure Ulcers

Preventing pressure ulcers in hospitals is a multidisciplinary, multidimensional process that requires the participation of a wide range of professionals in a highly routinized manner. Doctors, nurses, dieticians, physical therapists and patients themselves all have a role to play in preventing ulcers.

Some recognised best practices for preventing pressure ulcers, identified by the U.S. Agency for Healthcare Research and Quality, include:

  • Performing a comprehensive risk assessment on each patient. In settings such as critical care, where patient status can change quickly, multiple risk assessments must be performed, often as frequently as once a shift.
  • Developing a care plan for reducing pressure on sensitive areas through positioning shifts and frequent cleaning.
  • Ensuring the patient has proper nutrition and changing diet as necessary to address deficiencies.
  • Monitoring the patient’s condition and altering the care plan when necessary.
  • Empowering the patient to speak up when they experience discomfort.

Ultimately, preventing pressure ulcers in operating rooms and long-term care facilities requires collaboration and communication between a diverse group of professionals. It also requires a significant investment in tools and equipment that will help these caregivers do their jobs more effectively.
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Preventing Pressure Ulcers with Gel Pads and Positioners

Though pressure ulcers are often associated with caregiver neglect, they can occur in any facility, to any patient. Add to that the fact that Canadian health care centres can be understaffed to begin with, and it’s obvious that personnel alone can’t be the only line of defence against pressure ulcers.

That’s where gel pads and positioners come in. Gel pad positioners are an essential part of pressure ulcer prevention in hospitals and other health care facilities. They perform or aide a number of key tasks associated with reducing the risks of pressure ulcers, including:

  • Facilitating safe patient repositioning while reducing the burden on support staff.
  • Relieving pressure on sensitive areas by distributing patient weight more evenly.
  • Managing moisture and humidity while providing a surface that reduces the risk of infection.

According to Patient Safety and Quality: An Evidence-Based Handbook for Nurses, “expert opinion supports the use of seat cushions” in preventing pressure ulcers.

Gel technology offers a number of advantages over conventional foam cushions and positioners, as it is hypoallergenic and easier to clean. It is also affordable and longer lasting, making it an ideal choice for any facility with a limited budget.
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Shop Gel Pads and Positioners at Meditek

Meditek carries the Relaxa line of gel pads and positioners — a superior product that has been clinically proven to reduce the risk of pressure ulcers when used in conjunction with proper positioning and wound care techniques. Our products include standard bed pads as well as arm, head and foot rests, positioning aids and specialty products for accommodating bariatric patients.

Our team provides sales and support for healthcare providers across Canada. For more information about preventing pressure ulcers with gel pads and positioners, browse our website or contact a Meditek representative in your area directly.

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