Reducing a Patient’s Risk for Pressure Injuries

There is no single preventive for pressure injuries. Give priority to pressure relief. Reduce other risks to help maintain a healthy flow of nutrients to the patient’s skin.

Relieve pressure

Relieving pressure is the single most important factor in preventing and treating pressure injuries.

You can relieve pressure and restore the skin’s blood supply by repositioning the patient and using special devices. Post a schedule to remind you to reposition the patient — from side to back or from stomach to side. Make minor position changes even more frequently. Specially designed pillows, beds, or mattresses can also help reduce pressure.

In a bed

• Use pillows under calves to elevate the legs from above the knees to the ankles.

• Alter the angles of arms and legs.

In a wheelchair

• Be sure the wheelchair is the proper size for the patient to give optimal support. For example, if the seat it too narrow, it will put extra pressure on the hips.

• Cushion the back and buttocks with pillows or wheelchair cushions, and pad the footrest.

• Use a special wheelchair cushion that is designed to distribute weight evenly and relieve pressure points.

• Have special cushions tested and adjusted at the proper times as recommended by the manufacturer. This will allow the pressure relief to remain effective. 

Reduce shear and friction

Prevent skin breakdown by reducing friction and shear. Patients are less likely to slide down in bed if they’re supported by pillows and the head of the bed isn’t raised too high. During bed or wheelchair transfers, lift—don’t drag—the patient. If you can’t do this alone, get help. And be sure to use assistive devices, whenever possible.

In a bed

• Use draw-sheets or transfer boards to move patients.

• Clean and smooth the bed surface.

• Lift the head of the bed no more than 30°.

• Raise the foot of the bed slightly.

In a wheelchair

• Support the patient’s back with a pillow.

• Use a foot extension.