Guest Columns

Let's change history to prevent pressure ulcers

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Martie L. Moore, RN, MAOM, CPHQ
Martie L. Moore, RN, MAOM, CPHQ

I can remember a conversation that I overheard between my mother and aunt when my grandmother was in her last few years of life. In essence, they were talking about open areas that my grandmother had on her backside.

My mother made the comment that it was just old age. Don't ask me why as a young child that has stayed with me. Maybe it was the fear of getting older and suddenly having open areas on my buttocks. Maybe it was the expression on my mother's face. She held the expression of profound sadness and even a look of despair.

Either way, I knew that what was happening to my grandmother was not a good thing for her. It certainly wasn't something I wanted for my mother. 

Fast forward many years and I am now facing my mother being the age of my grandmother.  She has the risk factors of being an older adult, she is on long-term steroids, which thins the skin further, and she is a cancer survivor. Her skin has changed due to the treatment regime she went through.

Her mobility and nutrition status is excellent so that lessens her risks. I still talk with her about the importance of protein and ascorbic acid in her diet as building blocks for skin health. She knows that she needs to shift the cheeks and make sure that there is not compression to the tissue on her buttocks.

She slathers her moisturizer on every day to help keep her skin hydrated. She also knows to keep moisture away from the skin, especially urine and other acid type bodily fluids. She knows because her skin is thin that she needs to be careful with areas that are over bones. My goal is that my mother does not repeat history.

Today, November 20, 2014, you also have the opportunity to assure that history does not repeat itself by joining me in taking action on the World Wide Pressure Ulcer Prevention Day. 

Take the following five-step program for prevention:

1. Know the individual risk factors that might put someone at risk. Modify your action plan to their individual needs.

2. Assure nutrition is designed for optimal skin health. Many elderly are malnourished and need help in assuring that they are eating the right foods that helps keep their skin health.

3. Hydrate skin by using moisturizers — dry skin has been found to be an independent risk factor for pressure ulcers.

4. Keep the skin dry and clean from fluids that can be harmful such as urine. Develop an individualized continence management plan to include cleansers that provides a pH balance.

5. Skin needs to be nourished through blood flow. Moving and decompressing areas that blood flow is being compromised is critical. Think about how you fidget after sitting or lying for a prolonged period. Assure that the same happens for them. 

Additional action items: friction, shearing and other forces cause skin damage and create more vulnerable skin.

1. Think about how not to let those things happen to the skin. Some new therapies have looked at using silk like fabrics to reduce injury through those mechanisms. 

2. Think about the type of textiles the skin is coming into contact with on a daily basis. How soft is it to touch? 

3. Think about care of the feet using the same five-step program as above. Feet often are a missed area in the prevention regime that results in injury to the skin. 

Let's change history and work together to assure that skin health is just that — healthy skin and nothing more.

Martie Moore is chief nursing officer at Medline Industries and a member of NPUAP's Corporate Advisory Council.

Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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