CHW123-Pressure Ulcer Prevention and Management Policy

Registration Number: {{org_field_registration_no}}

Pressure Ulcer Prevention and Management Policy

1. Purpose

The purpose of this policy is to establish clear guidelines for the prevention, identification, and management of pressure ulcers within {{org_field_name}}. This policy ensures compliance with Care Inspectorate Wales (CIW) regulations, NICE guidelines on pressure ulcer prevention and management, and the Regulation and Inspection of Social Care (Wales) Act 2016. Our objective is to reduce the incidence of pressure ulcers, enhance resident comfort, and promote optimal wound healing where necessary through evidence-based practice.

2. Scope

This policy applies to all employees at {{org_field_name}}, including nurses, healthcare assistants, care workers, and ancillary staff involved in resident care. It outlines roles and responsibilities related to pressure ulcer prevention, risk assessment, early intervention, treatment strategies, infection control, staff training, and documentation.

3. Related Policies

This policy should be read in conjunction with:

CHW11 – Safe Care and Treatment Policy: Supporting clinical safety and best practices.
CHW07 – Person-Centred Care Policy: Ensuring individualised care planning for at-risk residents.
CHW18 – Risk Management and Assessment Policy: Identifying and mitigating risks associated with pressure ulcers.
CHW17 – Infection Prevention and Control Policy: Preventing infections in wound management.
CHW27 – Staff Supervision, Training, and Development Policy: Ensuring staff receive training in pressure ulcer prevention and management.

4. Policy Statement

{{org_field_name}} is committed to delivering high-quality, evidence-based care that prioritises the prevention of pressure ulcers. We recognise the serious health implications of pressure ulcers, including pain, reduced mobility, infection risk, and diminished quality of life. This policy outlines proactive measures to prevent pressure ulcers, as well as a structured approach to their treatment if they occur.

5. Risk Assessment and Prevention Strategies

To prevent pressure ulcers, our care team follows a structured risk assessment process:

Initial and Ongoing Assessments: All residents undergo a pressure ulcer risk assessment upon admission using a recognised tool such as the Waterlow Score or Braden Scale.
Regular Reassessments: Risk assessments are reviewed weekly or whenever there is a change in a resident’s condition.
Identifying High-Risk Residents: Residents with limited mobility, incontinence, poor nutrition, diabetes, or previous pressure ulcers receive additional monitoring.
Skin Integrity Checks: Daily inspections are performed to detect early signs of skin breakdown.
Repositioning Schedules: Residents at risk are repositioned at least every two hours or as clinically indicated to relieve pressure on vulnerable areas.
Use of Pressure-Relieving Equipment: Providing specialist mattresses, cushions, and heel protectors for residents at high risk.
Hydration and Nutrition Monitoring: Ensuring adequate fluid intake and balanced nutrition to promote skin health and wound healing.

6. Early Detection and Intervention

Early identification of pressure ulcers improves treatment outcomes. Staff are trained to:

Recognise early warning signs such as redness, non-blanching skin, warmth, swelling, or broken skin.
Report and document any concerns immediately to the nurse in charge.
Implement prescribed interventions such as barrier creams, dressings, and pressure redistribution techniques.
Monitor wounds closely for signs of deterioration or infection.

7. Wound Care and Treatment Protocols

If a resident develops a pressure ulcer, the following treatment protocol is followed:

Wound Assessment: A full assessment is conducted, recording:
- Stage of the ulcer (as per NPUAP/EPUAP grading system: Stage 1-4, Unstageable, or Deep Tissue Injury).
- Size, depth, and presence of exudate or necrosis.
- Pain levels and signs of infection.
Cleaning and Dressing: Wounds are cleansed using sterile saline, and appropriate dressings are applied to maintain a moist healing environment.
Pressure Offloading: Continuous evaluation of positioning and use of airflow mattresses and pressure-relieving devices.
Pain Management: Residents experiencing discomfort are provided with appropriate analgesia and comfort measures.
Infection Control Measures: Signs of infection are closely monitored, and wound swabs are taken where necessary.
Referral to Tissue Viability Nurses (TVN): Complex wounds are escalated to specialist wound care teams for expert input.

8. Infection Control in Pressure Ulcer Management

To minimise infection risks, {{org_field_name}} follows strict infection control measures:

Aseptic Dressing Technique: All wound care is performed using sterile procedures.
Hand Hygiene Compliance: Staff follow handwashing and glove usage protocols before and after wound care.
PPE Requirements: Appropriate gloves, aprons, and masks (if required) must be worn.
Wound Care Waste Disposal: Dressings and clinical waste must be disposed of according to infection control guidelines.

9. Nutrition and Lifestyle Support

Good nutrition and hydration play a crucial role in preventing and healing pressure ulcers. Dietary support includes:

High-protein meals to support tissue repair.
Vitamin C, zinc, and iron supplementation where required.
Hydration monitoring to prevent skin dryness and improve circulation.
Involvement of dietitians and speech therapists for residents with swallowing difficulties.

10. Training and Competency of Staff

To ensure high standards of care, all care staff at {{org_field_name}} receive training in:

Pressure ulcer risk assessment and prevention techniques.
Correct repositioning and manual handling to reduce pressure points.
Wound assessment and dressing application.
Recognising infection and wound deterioration.
Person-centred care approaches to skin integrity management.

11. Documentation and Record-Keeping

Accurate documentation is essential for monitoring wound healing and regulatory compliance. Staff must:

Complete wound care charts for all residents with pressure ulcers.
Document all preventative measures taken.
Log repositioning schedules in residents’ care records.
Maintain records of referrals to external specialists.

12. Managing Pressure Ulcer Care Efficiently

To provide efficient care, {{org_field_name}} employs the following strategies:

Daily Skin Integrity Audits: Ensuring early detection and intervention.
Wound Care Schedules: Ensuring timely dressing changes and monitoring.
Effective Stock Management: Ensuring wound care products and PPE are readily available.
Regular Staff Briefings: Reinforcing best practices and addressing concerns.
Family and Resident Education: Providing guidance on prevention strategies and wound care expectations.

13. Responsibilities

Care Staff: Monitor residents’ skin, report concerns, and follow care plans.
Nursing Staff: Conduct wound assessments, implement treatment plans, and liaise with external healthcare professionals.
Registered Manager: Ensures policy compliance, staff training, and audit processes.
Tissue Viability Nurses (TVNs): Provide expert advice and oversee complex wound care cases.

14. Compliance with CIW Regulations

This policy ensures compliance with CIW expectations by:

Implementing proactive and evidence-based pressure ulcer management.
Ensuring infection prevention and control measures are in place.
Maintaining comprehensive records for regulatory inspections.
Providing staff training to uphold best practices.

15. Policy Review

This policy will be reviewed annually or updated in response to new clinical guidelines, CIW regulations, or best practice recommendations. Any amendments will be communicated to all staff to ensure continued compliance and excellence in care provision.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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