Describe the anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores Skin is the largest organ of the body, covering and protecting the entire surface of the body. The total surface area of skin is around 3000 sq inches or roughly around 19, 355 sq cm depending on age, height, and body size. The skin, along with its derivatives, nails, hair, sweat glands, and sebaceous glands forms the integumentary system. Besides providing protection to the body the skin has a host of other functions to be performed like regulating body temperature, immune protection, sensations of touch, heat, cold, and pain through the sensory nerve endings, itself divided into epidermis, dermis, and subcutaneous layer or hypodermis. Each layer has it own function and own importance in maintaining the integrity of skin and thereby the whole body structure. Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over a bony area such as a heel which may have been in contact with a bed or a splint over an extended period of time. The surface of the skin can ulcerate which may become infected. Besides the heel, other areas commonly involved are the skin over the buttocks, sacrum, ankles hips and other bony sites of the body.
Identify pressure sites of the body
Heels, bottom, elbows, legs anywhere on the body.
Identify factors which might put an individual at risk of skin breakdown and pressure sores Not being able to move around, get out of bed, being incontinent, not maintaining personal hygiene. Describe how incorrect handling and moving techniques can damage the skin If you do not move a person right you may tear the skin, or bruise it Identify a range of interventions that can reduce the risk of skin breakdown and pressure sores Regularly changing position or moving helps to prevent pressure sores developing in vulnerable areas or to relieve already existing ones. In every clients risk assessment notes it must be shown how often they need to be moved it could be every 15 min. or might be every 2 hours. Risk assessment as well should be suggesting how to prevent putting pressure on existing ones or vulnerable areas. Also might be helpful: using special cushions and mattresses can also help Describe changes to an individual’s skin condition that should be reported Any redness or breaks in skin, any dis-coloration of skin any patches of skin that feel unusually spongy or tough to touch must be recorder into clients care plan and a person in charge informed. 2. 1 Identify legislation and national guidelines affecting pressure area care Clinical Guidelines for the Prevention and Treatment of Pressure Ulcers (The National Institute for Health and Clinical Excellence 2005)
The European Pressure Ulcer Advisory Panel (EPUAP) and The National Pressure Ulcer Advisory Panel (NPUAP)
The Health & Social Care Act (2008)
The Health Act (2009)
2. 2 Describe agreed ways of working relating to pressure area care These are the policies and procedures of the company I work with and also the standards of care set out by CQC, and the care plan. 2. 3 Describe why team working is important in relation to providing pressure area care To provide consistency of care. If everyone did what they thought was best without consulting others or telling them what they have done, it could cause harm to the person. Training, shadowing, reading, research etc. can improve knowledge and skills in this area. 3. 1 Describe why it is important to follow the agreed care plan So that I am doing what I am meant to be doing, not what I think I should do. And I am instructed and it is in my job description to follow the care plan and the policies and procedures and agreed ways of working. No one will be harmed if I follow the instructions, I have a duty of care to prevent harm to anyone I look after. 3. 2Ensure the agreed care plan has been checked prior to undertaking the pressure area care I will check the care plan and also check if it’s been filled in properly 3. 3 Identify any concerns with the agreed care plan prior to undertaking the pressure area care I will check what the care plan and risk assessment says and if I am unsure I will ask for assistance and help before I undertake any pressure area care, this will reduce the likely hood of any further damage or harm.
3. 4 Describe actions to take where any concerns with the agreed care plan are noted I would inform my line manager and the District Nurse, so that they can look at the problem and amend any changes that may be required 3. 5 Identify the pressure area risk assessment tools which are used in own work area These are usually carried out by the line manager and the District nurse; they complete them and are reviewed on a regular basis. They are in the care plan for all staff to see 3. 6 Explain why it is important to use risk assessment tools So that everyone is following the same practice and helping to reduce the risk of it becoming more serious, and to prevent pressure sores. 4. 1 Identify a range of aids or equipment used to relieve pressure Special mattresses, cushions, dressings, shoes pads, airflow mattresses. 4. 2 Describe safe use of aids and equipment.
Always check electrical equipment is in good working order, checked each year and serviced. 4. 3 Identify where up-to-date information and support can be obtained about: – Materials, the District Nurse, GP, internet for specialist providers – Equipment, the internet, NHS, GP, internet for specialist providers – Resources, the internet, NHS, GP
5. 1 Prepare equipment and environment in accordance with health and safety guidelines Not surprisingly, health care facilities make health and safety high priorities. [ As in other industries, the Occupational Safety and Health Administration set up guidelines and requirements to protect workers as they do their jobs within the health care industry. When health care facilities comply with these federal standards, the chances of illness and injury resulting from working in the facilities decline, in contrast to any facility in violation of the requirements