Accreditation 2023 - Risk Assessment

Pressure Ulcer Prevention by Jennifer Niitnyen

Pressure ulcers have a significant impact on client quality of life, resulting in pain, slower recovery, and increased risk of infection. Pressure ulcers are also associated with increased length of stay, cost, and mortality. Effective pressure ulcer prevention strategies can reduce the incidence of pressure ulcers and are an indication of higher quality care and services. 

Pressure ulcer prevention strategies require an inter-disciplinary approach and support from all levels of the organization. At Pembroke Regional Hospital (PRH), ALL patients admitted will have a standardized Braden Scale Assessment completed upon admission and daily thereafter in accordance with best practice guidelines.  In addition, a head-to-toe skin assessment is also completed on admission and daily until the patient is discharged from our hospital care setting.  

Our patients that are identified at risk for skin breakdown will have particular attention given to the assessment of vulnerable areas, especially over bony prominences. The “Wound Care Screening Tool” policy provides interventions based on the patient’s risk score that are to be implemented during patient admission. The Physiotherapy team, Occupational Therapists and the Registered Dietitians are involved in the patient care plan as required and are part of the coordinated health care team. Click here for the QTip.

PRH employs the following additional strategies to follow best practice guidelines of pressure ulcer prevention and wound care:  

• We use a "Pressure Injury Awareness and Prevention Plan" that was developed as a way of involving the patient and their caregivers in preventing and treating pressure injuries. 
• The “Pressure Injury Management” policy helps guide staff when making decisions regarding what dressings are most appropriate for their client based on the type of wound they have. A chart has been created and added to this policy that provides a visual reference on the different categories of dressings available at PRH.
• PRH participates in the International Pressure Ulcer Prevalence study done through Hill Rom yearly.
• A monthly wound care audit is conducted on Medical 2A and 3B to assess for any hospital acquired pressure injuries.
• Wound care rounds are done intermittently throughout the month and any wound care referrals that have been sent are completed on the patients that remain in hospital.
• A wound care treatment plan is developed for the patient and communicated with our community partners on patient discharge from PRH.
• The “Wound Assessment and Treatment Record” provides a standardized document for the charting of wound care by nursing staff. All nursing staff are introduced to these wound care documents during nursing orientation. 

To learn more, review the “Pressure Injury Awareness and Prevention Plan”, “Braden Scale for Predicting Pressure Sore Risk” “Pressure Injury Management”, and “Wound Assessment and Treatment Record”.