Week 6 | Pressure Ulcers (16170-SP)
- Pressure Ulcer Scope
- Scope of the problem
- Prevalence: Number of patients with at least one pressure ulcer who exist in a given population at a given point in time.
- Incidence: Number of patients who were initially ulcer free who develop a pressure ulcer within a particular time period in a defined population.
- Pressure Ulcer Etiology
- Pressure Ulcer: A localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. A number of contributing or confounding factors are also associated with pressure ulcers; then significance of these factors is yet to be elucidated.
- Pressure from devices.
- Mucosal pressure ulcers: pressure ulcers found on the mucous membrane with a history of a medical device in use at the location of the ulcer.
- Causative factor is pressure which is dependent upon:
- Intensity of pressure.
- Duration of pressure.
- Tissue tolerance: the condition or integrity of the skin and supporting structures that influences the skin's ability to redistribute pressure.
- Factors affecting tissue tolerance
- Nutritional debilitation
- advanced age
- Low blood pressure
- Elevated body temperature
- Pathophysiologic theories of pressure ulcer development
- Ischemia caused by occlusion of capillaries.
- Reperfusion injury.
- Impaired lymphatic function.
- Mechanical deformation of tissue cells.
- Common pressure ulcer locations
- Heel pressure ulcers
- National Pressure Ulcer Advisory Panel Staging System: used only classify pressure ulcers based on the depth of tissue destruction.
- Suspected Deep Tissue Injury (DTI)
- Stage I
- Stage II
- Stage III
- Stage IV
- Practice classifying tissue damage.
Objectives for Learning Outcomes
At the end of this course work the learner will be able to:
- Discuss the significance of pressure ulcers as a health care problem.
- Differentiate between prevalence and incidence of pressure ulcers.
- Describe the etiology of a pressure ulcer.
- Define the NPUAP classification system for staging pressure ulcers.
Renee Anderson, MSN, RN, CWON
Certified Wound and Ostomy Care Nurse; Co‐Director, Wound Management Education Program, University of Washington School of Nursing , Seattle; Clinical Faculty, Biobehavioral Nursing & Health Systems University of Washington School of Nursing; President, Rainier Clinical Consultants, Inc., Seattle, WA