1. PRESSURE ULCERS THE TIP OF THE ICEBERG PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 1

2. LOCALIZED INJURY TO THE SKIN 1.Compression of soft tissue interferes with tissue blood supply 2.Develops within 24 hours of initial pressure 3.Can take as long as a week to present themselves PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 2

3. DEATH OF TISSUE 1.The first tissue to die are nearest the bone 2. As pressure and anoxia continue thee remaining layers of tissue die 3. The skin is the last to die The damage resembles an iceberg with a smaller amount of damage visible at the surface and a large amount of damage below. PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 3

4. FAVORITE PLACES TO OCCUR 1.Bony prominences 6. Elbows. 2.Sacrum7. Ears. 3.Ischium (back part of the hips) 8. buttocks 4.Heels 5.Trachanter (hips) PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 4

5. PROBLEMS WITH PRESSURE SORES PATIENT Pain Infection death FACILITY Cost of care Increase in workload Law suits Reported to State and Federal agencies PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 5

6. PREVENTION: EARLY DETECTION 1.Risk assessment: use Braden Scale Lower the number the higher the chance of developing a pressure ulcer 2.Implement interventions to prevent pressure ulcers Pressure relief cushions, mattress  Frequent turning  Changing incontinent patients, use of barrier cream.  Do not vigorously rub patients why drying after bath.  Moisturize skin PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 6

7. TEST QUESTION FOR 0.5 CEU 1, Why is a pressure ulcer like an ice berg? _______________________. 2. Name 2 ways to prevent pressure ulcers. ---------------------------------- ___________________ 3. Name the sequence of tissue death. _____________________________________ 4. What causes a pressure ulcer ?_______________________________________ 5. Name 4 common areas for pressure areas to form. __________________________________________________________ Name ( Print)_____________________________ Date _________________ Educator Rose Marie VanDee RN, MSN NV000672 ________________________ PROCARE HOSPICE OF NEVADA RM VANDEE RN MSN 2015 7