Preventing pressure injuries at home: a nurse's guide for families
Pressure injuries (also called pressure sores or bed sores) can develop in a matter of hours, and some take months to heal. The good news is that most of them can be prevented. Here's what our nurses teach families and support workers.
Who is at risk?
Anyone who spends long periods sitting or lying in one position, especially people who:
- Use a wheelchair or spend most of the day in bed
- Have reduced sensation, for example after a spinal cord injury, stroke or with diabetes
- Are frail, underweight or not eating and drinking well
- Have continence issues, because moisture weakens skin
- Are recovering from surgery or illness
Where to look
Pressure injuries form over bony areas: heels, tailbone and buttocks, hips, shoulder blades, elbows, the back of the head and ears (especially under oxygen tubing or masks). Check these at least once a day, and more often for people at high risk.
Early warning signs
- Redness that doesn't fade within about 30 minutes of relieving pressure
- On darker skin, an area that looks purple, bluish or darker than the surrounding skin
- Skin that feels warmer, cooler, firmer or softer than nearby skin
- Blistering, a shiny patch or broken skin
- New pain or tingling in one spot
Five things that make the biggest difference
1. Move regularly
Change position often. In bed, a 30-degree side tilt with pillows is gentler than lying flat on one hip. In a chair, small weight shifts every 15 to 30 minutes help. The right frequency depends on the person, so ask a nurse to set a schedule.
2. Use the right equipment
Pressure-relieving mattresses, cushions and heel boots work, but only if they're the right type, set up correctly and actually used. An occupational therapist or nurse can advise. Equipment can be funded through NDIS or Support at Home.
3. Keep skin clean and dry
Wash gently, pat dry, moisturise dry skin, and change continence aids promptly. Avoid massaging red areas, which can cause more damage.
4. Eat and drink well
Skin needs protein, energy and fluids to stay strong and heal. Unplanned weight loss is a warning sign worth raising with a GP or dietitian.
5. Watch for slide and friction
Dragging someone up the bed or letting them slide down a chair tears fragile skin. Use slide sheets and lift properly.
When to call for help
Contact a nurse or GP the same day if you see broken skin, a blister, a dark or purple patch, or a wound that's getting bigger, smells, oozes or is more painful. Fever or confusion alongside a wound needs urgent medical review.
How Good Nurse helps
Our Registered Nurses do skin and pressure risk assessments, set up repositioning plans, manage complex wounds and train support workers to spot problems early. We work with NDIS participants and older people on Support at Home across Westmead, Parramatta and Western Sydney.
Worried about someone's skin? Call 1300 457 557 to speak with a nurse.
This article is general information, not personal medical advice. Always follow the advice of your own health professionals.
Talk to a nurse
Free, no-obligation chat with one of our Registered Nurses about NDIS or Support at Home care in Western Sydney.