In theory, this helps staff make a baseline assessment of the patient’s condition and their level of risk on admission and helps them plan their care and implement preventive or management strategies from the outset.
Structured pressure ulcer risk assessment tools are recommended in many international guidelines and completing the Waterlow score is a requirement for nurses in NHS hospitals on admitting a patient.
The negative predictive values for the Braden Scale were also higher than for both the Waterlow and the Norton Scales.
Tools to help assess a patient’s risk of developing a pressure ulcer have been in use for half a century, but do they actually result in fewer pressure ulcers, or do they take up nurses’ time which could be better spent with the patient?An updated Cochrane review gives us the current state of the evidence.The information on this page is general in nature and cannot reflect individual patient variation.It reflects Australian intensive care practice, which may differ from that in other countries.I remember sheepskin booties, creams, sorbo rings, a variety of mattresses and, for those particularly at risk, soft pink and white squares, a quirky item which was probably peculiar to Barts Hospital and had a cutesy name (‘pink fluffy’? We made sure our patients were hydrated and nourished; most of all, we didn’t leave them in one position for a long time.
A combination of careful observation and practical measures helped reduce the incidence of pressure ulcers and this is a constant, applying equally today, while pressure-relieving aids are subject to change and moving patients doesn’t look the same now as it did thirty years ago, when manual handling was the norm and lifting techniques learnt in the first days of training.Use a pressure injury risk assessment scale in conjunction with a comprehensive visual assessment to determine the patient’s risk of pressure injury and to inform the development of a prevention plan.The skin and mucosa impacted by invasive medical devices (including but not limited to nasogastric tubes, tracheal tubes, urinary catheter, faecal management devices, nasopharyngeal airway and intravascular devices) should be inspected: All patients are to be regularly assessed for pain, especially in relation to repositioning and in the presence of pressure injuries.At this time “there is no high quality risk randomised control trial evidence which identifies that undertaking a structured risk assessment reduces the incidence of pressure injury” (4).In the critical care setting however, there are a number of studies that have investigated which pressure risk assessment tool is the most appropriate to use in the intensive care unit.There was so much interest in this and we were excited to co-host with @We Nurses as tweetchat to discuss the evidence and what nurses think about this and the their current practice. Are pressure ulcer grading & risk assessment tools useful?