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Pressure Ulcer Prevention and Management Policy

1. Purpose

The purpose of this policy is to establish clear guidelines for the prevention, early detection, and effective management of pressure ulcers within {{org_field_name}}. Pressure ulcers, also known as pressure sores or bedsores, can have serious health implications for service users. This policy ensures that our care staff take a proactive approach to pressure ulcer prevention, delivering high-quality care that aligns with NICE Guidelines (CG179) and Care Quality Commission (CQC) Fundamental Standards.

By implementing structured prevention strategies and evidence-based management techniques, we protect service users from unnecessary pain, infections, and complications associated with pressure ulcers.

2. Scope

This policy applies to all employees, including care workers, nurses, managers, and any external healthcare professionals involved in the care of service users. It covers:

• Risk assessment and identification of service users at risk.
• Preventative measures to reduce pressure ulcer incidence.
• Early intervention and management strategies.
• Staff training and responsibilities.
• Compliance with legal and regulatory requirements.
• Monitoring, evaluation, and continuous improvement.

3. Legal and Regulatory Framework

This policy is compliant with the following legislation and best practice guidelines:

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Regulation 12: Safe care and treatment.
• Care Quality Commission (CQC) Fundamental Standards – Ensuring service users receive person-centred care that prevents avoidable harm.
• National Institute for Health and Care Excellence (NICE) Guidelines CG179 – Prevention and management of pressure ulcers.
• Tissue Viability Society Guidelines – Standards for skin integrity and pressure area care.
• Safeguarding Adults: The Role of Health Services (Department of Health, 2011) – Ensuring the prevention of neglect-related pressure ulcers.

4. Risk Assessment and Identification

A proactive risk assessment is the foundation of our pressure ulcer prevention strategy. The following steps are undertaken for all service users:

• Initial Assessment: Every new service user undergoes a skin integrity risk assessment upon starting care services.
• Use of Standardised Tools: The Waterlow Score and Braden Scale are used to assess the risk of developing pressure ulcers.
• Regular Monitoring: Service users identified as high-risk are reassessed weekly or sooner if their condition changes.
• Documentation: All risk assessments and observations are recorded in the care plan and reviewed periodically.

5. Pressure Ulcer Prevention Strategies

Prevention is a priority, and our care team follows these measures:

• Repositioning and Mobilisation:
  • Encourage and assist service users in frequent repositioning (every 2 hours for immobile individuals).
  • Promote gentle exercises where appropriate to improve circulation.
  • Use pressure-relieving cushions, mattresses, and heel protectors where necessary.
• Skin Care and Hygiene:
  • Maintain clean and dry skin, using barrier creams as needed.
  • Avoid excess moisture (e.g., from incontinence) that can contribute to skin breakdown.
  • Check skin daily for early signs of redness, swelling, or tenderness.
• Nutritional Support:
  • Ensure service users receive a balanced diet rich in protein, vitamins, and hydration.
  • Work with dietitians where necessary for tailored nutritional plans.
• Equipment and Support Aids:
  • Provide pressure-relieving equipment, including air mattresses and pressure redistribution cushions.
  • Conduct regular equipment maintenance checks to ensure they function effectively.

6. Early Intervention and Management

If a pressure ulcer is identified, our response includes:

• Immediate Reporting:
  • Staff must immediately notify the service user’s GP, district nurse, or tissue viability nurse.
  • The incident must be documented in the service user’s care records.
• Wound Management:
  • Follow the staging system (Grade 1-4) to classify severity.
  • Implement appropriate wound dressings as recommended by healthcare professionals.
  • Ensure wound care is performed under medical supervision.
• Pain and Infection Management:
  • Monitor for signs of infection such as increased pain, swelling, or discharge.
  • Work with GPs to manage pain effectively using analgesics or topical treatments.
  • If infection is suspected, refer the service user for antibiotic treatment.
• Care Plan Adjustments:
  • Review and modify the service user’s care plan based on medical recommendations.
  • Increase repositioning frequency and ensure nutritional needs are met.

7. Staff Responsibilities and Training

All employees play a critical role in preventing and managing pressure ulcers.

• Care Workers:
  • Perform regular skin integrity checks and document observations.
  • Encourage movement and repositioning for at-risk service users.
  • Report any concerns immediately to senior staff.
• Registered Nurses (where applicable) & Senior Staff:
  • Conduct wound assessments and oversee care interventions.
  • Provide clinical guidance on treatment plans.
  • Liaise with external tissue viability specialists when necessary.
• Management Responsibilities:
  • Ensure all staff receive annual training on pressure ulcer prevention.
  • Provide the necessary resources and equipment to maintain high standards of care.
  • Monitor compliance with policies and conduct regular audits.

8. Record Keeping and Compliance

Accurate documentation is essential for tracking progress and ensuring compliance:

• All risk assessments, interventions, and observations must be recorded in service user care plans.
• Incident reports must be completed for any pressure ulcers that develop under our care.
• Regular audits will be conducted to assess the effectiveness of prevention measures.
• Service user feedback is encouraged to continuously improve care quality.

9. Monitoring, Evaluation, and Continuous Improvement

To maintain high standards of pressure ulcer care:

• Monthly audits will be conducted to evaluate risk assessments, care plans, and incident reports.
• Lessons learned from pressure ulcer incidents will be reviewed and incorporated into staff training.
• Feedback from service users and families will inform best practices.
• Annual policy reviews will ensure the policy remains up to date with national guidelines.

10. Policy Review and Updates

This policy will be reviewed annually or sooner if new guidelines or best practices emerge. Updates will be communicated to all staff, and refresher training will be provided as necessary.

11. Conclusion By implementing this Pressure Ulcer Prevention and Management Policy, {{org_field_name}} ensures a proactive and structured approach to preventing and managing pressure ulcers. Our commitment to early intervention, staff training, and continuous monitoring aligns with best practices and regulatory requirements, ensuring service users receive the highest quality care. Through vigilance and teamwork, we can minimise the incidence of pressure ulcers and improve overall well-being for those in our care.

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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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