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Specific Nutritional Interventions For those at risk who have special needs that make it difficult to meet their nutritional needs with ordinary oral intake, high protein mixed oral or enteral supplementation should be provided in addition to usual diet Administer between meals to avoid interfering with normal appetite Managing Friction & Shear HOB Elevated No More Than 30 Degrees After moving from flat to elevated positioning, roll sideways to release shear forces. Use Trapeze When Indicated for Self-Care Use Lifting aids To Move Patient Protect Elbows & Heels If Being Exposed To Friction Some recent QA studies found use of silicone coated dressings or silicone skin creams can decrease incidence of ulcers, but RCT found no difference. 8/7/2012 10
Conceptual Schema for Etiologic Factors in Pressure Sore Development Intensity & Duration of Pressure Pressure Sore Development Tissue Tolerance 3 R’s Redistribution Surfaces* ◦ Reactive ◦ Active ◦ Non-powered ◦ Powered Remobilization Repositioning Mobility Activity Sensory Perception Extrinsic Factors Moisture Friction & Shear Intrinsic Factors Nutrition Aging Low arteriolar pressure Low oxygen tension INTERVENTIONS TO DIMINISH EXPOSURE TO PRESSURE *See www.npuap.org - click on Research- then on Support Surface Standards Initiative 8/7/2012 11
Page 1 and 2: The Braden Scale: Using Subscales t
Page 3 and 4: Predictive Value of Positive Result
Page 5 and 6: Risk Assessment + Consideration of
Page 7 and 8: PLANNING CARE BY RISK FACTORS Inter
Page 9: Managing Moisture Use commercial m
Page 13 and 14: Support Surfaces in Patients at Ris
Page 15 and 16: Mimura, et al (2009) In a series o
Page 17 and 18: Any particular device for heel elev
Page 19 and 20: Pressure Reduction Seating Systema
Page 21 and 22: Bottom Line Most pressure ulcers c
Page 23: Linda Laudato BSN, RN Gold STAMP Co

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