Pressure Ulcers in Adults: Prediction and Prevention

Front Cover
DIANE Publishing, 1994 - 73 pages
Find out if you are at risk for pressure ulcers or bedsores, and learn what you can do to safeguard against them. Makes specific recommendations to identify at-risk adults, lists factors placing them at risk, and gives tips on the treatment of Stage I pressure ulcers.

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Page ix - The legislation also established within AHCPR the Office of the Forum for Quality and Effectiveness in Health Care (the Forum).
Page 8 - Full-thickness skin loss involving damage to, or necrosis of, subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue...
Page 41 - World Rehabilitation Fund, International Exchange of Information in Rehabilitation; [1981]. 63 leaves. (World Rehabilitation Fund monograph; no. 11). Norton D. Calculating the risk: reflections on the Norton Scale. Decubitus 1989 Aug;2(3):24-31. Published erratum appears in Decubitus 1989 Nov;2(4):10. Norton D, McLaren R, Exton-Smith AN. An investigation of geriatric nursing problems in hospital. London: Churchill Livingstone; 1975. 238 p. Original work published in 1962. Okamoto GA, Lamers JV, Shurtleff...
Page ii - Guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical conditions.
Page 8 - Full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue. Stage IV...
Page v - ... recommended four overall goals: (1) identifying at-risk persons who need preventative measures and the specific factors placing them at risk; (2) maintaining and improving tissue tolerance to pressure in order to prevent injury; (3) protecting against the adverse effects of external mechanical forces (ie, pressure, friction, and shear...
Page 16 - Potential problem: Requires moderate to maximum assistance in moving. Complete lifting without sliding against sheets is impossible. Frequently slides down in bed or chair, requiring frequent repositioning with maximum assistance. Spasticity, contractures, or agitation leads to almost constant friction.
Page 24 - Clinically, shear is exerted on the body when the head of the bed is elevated. In this position, the skin and superficial fascia remain fixed against the bed linens while the deep fascia and skeleton slide down toward the foot of the bed. Shear forces are also generated when individuals sitting in a chair slide down in the chair. As a result of shear, blood vessels in the sacral area are likely to become twisted and distorted and tissue may become ischemic and necrotic (Reichel, 1958).
Page 26 - Uninterrupted sitting by at-risk individuals in chairs or wheelchairs should be avoided. If consistent with overall patient management goals, the individual should be repositioned, shifting the points under pressure, at least every hour or be put back to bed. Individuals who are able to move should be taught to shift weight every 15 minutes. For individuals who sit in wheelchairs or on other sitting surfaces, the use of a pressure-reducing device such as those made of foam, gel, air, or a combination...

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