SL123-Pressure Ulcer Prevention and Management Policy
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Registration Number: {{org_field_registration_no}}
Pressure Ulcer Prevention and Management Policy
1. Purpose
The purpose of this policy is to ensure that {{org_field_name}} effectively prevents, identifies, and manages pressure ulcers among service users, in compliance with CQC regulations, NHS guidelines, and best practices in supported living care. Pressure ulcers, also known as bedsores or pressure injuries, can significantly impact the health and quality of life of vulnerable individuals. As such, this policy aims to:
- Prevent the occurrence of pressure ulcers through proactive care planning.
- Identify and assess pressure ulcers at an early stage.
- Provide evidence-based treatment to prevent deterioration and complications.
- Ensure compliance with national standards and CQC fundamental standards of care.
- Support staff with training and resources to manage pressure ulcer risks effectively.
This policy emphasises a multidisciplinary approach, ensuring that staff, healthcare professionals, and service users work together to reduce the risk and impact of pressure ulcers.
2. Scope
This policy applies to:
- All staff members, including carers, nurses, and support workers.
- Service users at risk of developing pressure ulcers, ensuring their needs are met with personalised care plans.
- Families, advocates, and healthcare professionals involved in service users’ care, ensuring collaboration and shared responsibility.
- External medical professionals working in partnership with {{org_field_name}}, ensuring best practices in prevention and treatment.
By implementing this policy, {{org_field_name}} ensures that pressure ulcer prevention and management remain a high priority across all aspects of care delivery.
3. Legal and Regulatory Compliance
This policy aligns with:
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:
- Regulation 9 – Person-Centred Care (ensuring individualised prevention plans)
- Regulation 10 – Dignity and Respect (ensuring service users receive compassionate care)
- Regulation 12 – Safe Care and Treatment (ensuring evidence-based management of pressure ulcers)
- Regulation 13 – Safeguarding Service Users from Abuse and Improper Treatment (preventing neglect-related pressure ulcers)
- Regulation 17 – Good Governance (ensuring robust monitoring and review mechanisms)
- National Institute for Health and Care Excellence (NICE) Guidelines CG179 – Prevention and Management of Pressure Ulcers.
- Tissue Viability Society Best Practice Standards – Ensuring high standards in wound care.
- NHS Stop the Pressure Campaign Guidelines – Promoting national strategies for pressure ulcer prevention.
- Safeguarding Vulnerable Groups Act 2006 – Ensuring that failure to prevent pressure ulcers does not constitute neglect.
This policy ensures that {{org_field_name}} meets all legal, ethical, and professional responsibilities in pressure ulcer prevention and management.
4. Understanding Pressure Ulcers
4.1 What Are Pressure Ulcers?
Pressure ulcers are localized injuries to the skin and underlying tissue, usually over bony areas, caused by prolonged pressure, friction, or shear. Common areas include:
- Heels – Common in individuals with limited mobility.
- Sacrum (lower back) – Due to prolonged sitting or lying down.
- Hips – Especially in wheelchair users.
- Elbows – When resting arms for extended periods.
- Shoulders – For service users with reduced mobility.
- Back of the head – Particularly in individuals who are bedridden.
4.2 Risk Factors
Service users may be at high risk of developing pressure ulcers due to:
- Limited mobility or prolonged immobility – Individuals who are unable to reposition themselves.
- Incontinence – Prolonged exposure to moisture can lead to skin breakdown.
- Nutritional deficiencies – Poor diet can impair skin integrity and healing.
- Poor circulation – Conditions such as diabetes can increase risk.
- Cognitive impairments – Individuals with dementia may not recognise pain or discomfort.
- Previous history of pressure ulcers – A sign of increased susceptibility.
A structured individualised risk assessment is crucial to identifying service users who require additional support and preventative measures.
5. Prevention Strategies
5.1 Risk Assessment
- All service users must undergo a comprehensive pressure ulcer risk assessment upon admission.
- Risk assessment tools such as the Waterlow Score, Braden Scale, or Norton Scale must be used to determine risk levels.
- Regular reassessments (weekly or upon condition changes) ensure continuous monitoring and early intervention.
5.2 Repositioning and Pressure Relief
- Service users at risk must be repositioned at least every two hours.
- Pressure-relieving equipment (e.g., alternating mattresses, gel cushions) must be provided as needed.
- Encouragement of mobility exercises to reduce sustained pressure.
- Documentation of repositioning schedules through turning charts.
5.3 Skin Inspection and Monitoring
- Daily skin checks for early detection of pressure damage.
- Use of moisture barrier creams for skin protection.
- Immediate escalation to tissue viability nurses (TVNs) or medical professionals if concerns arise.
5.4 Nutrition and Hydration Support
- Regular nutrition screening to assess dietary needs.
- Provision of protein-rich meals and vitamin supplements where needed.
- Encouraging fluid intake to maintain skin hydration.
5.5 Incontinence Management
- Prompt changing of incontinence products to prevent moisture-related skin damage.
- Training staff on appropriate skin protection methods.
6. Identifying and Treating Pressure Ulcers
6.1 Classification of Pressure Ulcers
- Stage 1: Redness, non-blanchable skin changes.
- Stage 2: Partial skin loss with blisters or shallow wounds.
- Stage 3: Full-thickness skin loss with visible fat.
- Stage 4: Severe tissue damage, possibly exposing muscle or bone.
6.2 Immediate Actions Upon Detection
- Immediate escalation to senior staff.
- Photographic documentation (with consent).
- Application of dressings as per tissue viability team guidelines.
6.3 Wound Care and Treatment Plans
- Regular wound assessments and dressing changes.
- Use of pressure-relieving dressings to aid healing.
7. Staff Training and Responsibilities
7.1 Training Requirements
- All staff must receive annual pressure ulcer prevention training.
- Supervised competency assessments in repositioning and skincare.
7.2 Roles and Responsibilities
- Care Staff: Daily monitoring and basic skin care.
- Nurses & Senior Staff: Risk assessments and treatment planning.
- Registered Manager: Policy implementation and compliance audits.
8. Incident Reporting and Safeguarding
8.1 Documenting and Reporting Pressure Ulcers
- Mandatory reporting of all Stage 2+ pressure ulcers.
- Detailed documentation, including wound appearance, treatment, and progression.
8.2 Safeguarding Considerations
- Escalation of severe cases as potential neglect concerns.
- Mandatory CQC notification of avoidable severe ulcers.
9. Monitoring and Continuous Improvement
9.1 Audits and Reviews
- Monthly reviews of pressure ulcer cases.
- Annual policy updates based on emerging best practices.
9.2 Policy Updates and Quality Assurance
- Integration of new wound care technology.
- Feedback incorporation from staff and service users.
10. Related Policies
- Infection Control Policy
- Safeguarding Policy
- Incident Reporting Policy
11. Policy Review
This policy will be reviewed annually, with updates provided to all staff.
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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