A recent report from the Health and Disability Commission highlights the critical importance of preventing and managing pressure injuries, especially in aged care settings.

An estimated 55,000 New Zealanders are affected every year by pressure injuries. They can happen to anyone whose ability to move is limited; typically people unable to reposition themselves, unable to experience the sensation of pain and people confined to bed, a chair or a wheelchair for long periods of time.

Evidence shows most pressure injuries are preventable – early identification of people at risk and subsequent effective management needs to be a high priority for all care providers to reduce significant harm to this group of people.

There are key actions that are globally promoted to reduce the risk and impact of pressure injuries. This includes ensuring the following:

  • Surface- provide a supportive and pressure relieving surface
  • Skin Inspection – check for discolouration and pain under or around medical devices
  • Keep moving – change position often
  • Incontinence– keep skin dry and clean
  • Nutrition – eat healthily and drink plenty of fluids

Significant work is ongoing to create resources to support best-practice prevention and management in all health settings, including aged residential care. The ongoing challenge is to systematically embed this at clinical practice level to ensure harm is avoided and residents receive the best preventive care.

An excellent starting point for all health professionals, carers and people giving and receiving care is the Guiding Principles For Pressure Injury Prevention And Management In New Zealand published in 2017 by ACC, Ministry of Health, Health Quality & Safety Commission (HQSC), and the New Zealand Wound Care Society, in partnership with health sector experts.

The guide has six best-practice principles that are applicable in all healthcare settings, including aged-care facilities, as well as home care, hospitals, residential facilities, primary healthcare, and hospices.

These principles are:

People First:

People have access to care, and receive information and participate in shared decision-making about the care needed to prevent and manage pressure injuries.

Leadership:

Healthcare organisations demonstrate leadership by ensuring that they have systems and resources to prevent and manage pressure injuries.

Education and training:

Healthcare workers at all levels have access to and support for acquiring current knowledge and skills that enable them to prevent and manage pressure injuries.

Assessment:

Pressure injury risk assessments are completed as part of admission, referral and transfer processes, with reassessments when people’s health status changes. At-risk areas are checked regularly and whenever the opportunity arises.

Care Planning and Implementation:

Individualised, person-centred care plans employing evidence-based care bundles are developed, documented and implemented to reduce the risk of pressure injuries.

Collaboration and Continuity of Care:

Care support, information and resources move seamlessly with people transferring between healthcare settings.

The guide and other useful resources can be found can be found here.

Adopting guidelines and principles also requires consistent measurement if healthcare providers are to make continual improvements in the way they manage the incidence and prevalence of pressure injuries.  HQSC has prepared national guidance, which although focused on hospital settings, is valid across all care settings.  Further details can be found here.

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