This National Institute for Health and Care Excellence (NICE) guideline covers risk assessment, prevention and treatment in children, young people and adults at risk of, or who have, a pressure ulcer (also known as a bedsore or pressure sore). It aims to reduce the number of pressure ulcers in people admitted to secondary or tertiary care or receiving NHS care in other settings, such as primary and community care and emergency departments.
Carry out and document an assessment of pressure ulcer risk for adults:
Offer adults who have been assessed as being at high risk of developing a pressure ulcer a skin assessment by a trained healthcare professional. The assessment should take into account any pain or discomfort reported by the patient and the skin should be checked for:
Develop and document an individualised care plan for neonates, infants, children, young people and adults who have been assessed as being at high risk of developing a pressure ulcer, taking into account:
Encourage adults who have been assessed as being at risk of developing a pressure ulcer to change their position frequently and at least every 6 hours. If they are unable to reposition themselves, offer help to do so, using appropriate equipment if needed. Document the frequency of repositioning required.
Use a high-specification foam mattress for adults who are:
Carry out and document an assessment of pressure ulcer risk for neonates, infants, children and young people:
Provide training to healthcare professionals on preventing a pressure ulcer, including:
Provide further training to healthcare professionals who have contact with anyone who has been assessed as being at high risk of developing a pressure ulcer. Training should include:
Discuss with adults with a heel pressure ulcer and if appropriate, their carers, a strategy to offload heel pressure as part of their individualised care plan.
All patients are potentially at risk of developing a pressure ulcer. However, they are more likely to occur in people who are seriously ill or have:
Also, the use of equipment such as seating or beds which are not specifically designed to provide pressure relief can cause pressure ulcers.
Pressure ulcers are often preventable and their prevention is included in domain 5 of the Department of Health's NHS Outcomes Framework 2014 to 2015. The current guideline rationalises the approaches used for the prevention and management of pressure ulcers. Its implementation will ensure practice is based on the best available evidence. It covers prevention and treatment and applies to all people in NHS care and in care funded by the NHS.
You can read the guideline on NICE's website.