A Clinical Guide to Pressure Injury Risk Assessment & Prevention

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Pressure injuries (ulcers) are a major burden on our patients, families, caregivers, and the health care system. Clinicians must be focused on prevention programs not only for patients, but also because of the monumental cost to the health care system.

The goal of pressure injury prevention is to maintain skin integrity. Developing a comprehensive pressure injury program should be evidence-based and consist of an action plan to promote prevention.

Identifying a patient’s specific risk factors and immediate implementation of preventive measures will decrease the risk of pressure injury significantly.

This guide provides a protocol for risk assessment, monitoring, and screening for pressure injuries, as well as techniques for minimizing the mechanical stresses that can lead to skin breakdown. The importance of nutrition and hydration in maintaining skin integrity is discussed. Finally, the guide emphasizes the need for ongoing pressure injury education for nursing staff and for patients and their families.

This evidence-based framework for creating and implementing an effective pressure injury prevention program includes the following topics:

Initial risk assessment using validated assessment and screening tools

Performance characteristics of pressure redistribution and support surfaces

Ongoing training and pressure injury education for staff, patients and families

Techniques to reduce mechanical stress, such as offloading and patient repositioning

Recommendations for nutrition and hydration

Protocol for moisture control

This guide is generally written to provide practical guidance for all health care professionals in managing individuals at risk of pressure injury.