MDS Alert
18 Risk Factors That Could Make or Break Your Pressure Ulcer Prevention Efforts
Do a careful assessment to see if a resident has any of the following risk factors for skin breakdown, advises Jenny Hurlow, GNP, CWOCN, a geriatric nurse practitioner and wound care specialist in Memphis, Tenn. • Incontinence • Weight loss • Impaired ability to perform late-loss activities of daily living (ADLs), including ability to feed self • ADL decline • Impaired cognitive functioning, especially a decline • Impaired ambulation • Depression indicators • Sedatives (anti-anxiety agents), hypnotics, antipsychotics • Fluid/hydration deficit • Decrease in meal intake or poor intake • Nutritional problems • Oral health problems (could reduce intake) • Physical restraints • End-stage disease • Unstable conditions • Pain • Previously healed pressure ulcer • Certain comorbid conditions. Hurlow urges paying attention "to any comorbid condition that affects mobility, perfusion, and sensation." Research: A recently published study found that elderly nursing home patients with non-blanchable erythema (stage 1 pressure ulcers) who have hypotension, contractures, or a history of stroke require more "intensive" efforts to prevent pressure ulcers (Vanderwee K et al. Journal of Clinical Nursing. Vol. 18, No. 21, November 2009 at www.ingentaconnect.com/content/bsc/jcn/2009/00000018/00000021/art00014).
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