Prevention starts with understanding where, how and why pressure injuries occur.
In fact, a 2019 report revealed pressure injury is the only hospital-acquired condition that increased in incidence rates (+6%) from 2014-2017, while other hospital-acquired conditions saw a decrease.² Pressure injury prevention strategies have been shown to shorten patients’ hospital stays and reduce their readmission rates¹. It’s our goal to pursue patient-centered science that can support your commitment to proactive care and potentially improve lives.
When prevention isn’t possible: Explore pressure injury management options
Annually, more than 2.5 million people in the U.S. alone develop pressure injuries.³ Taking extra care to prevent pressure injuries shouldn’t overburden staff or inflate care costs. In fact, putting the right plan in place should ultimately help reduce costs for your facility. Discover more economic impacts of prevention (PDF, 2.6 MB)
When skin is exposed to friction and gravity, pressure injuries can develop in as little as six hours.
It’s estimated that 60,000 patients die each year as a direct result of pressure injury-related complications.
From 2013-2019 Hospital Acquired Pressure Injuries (HAPIs) have shown an upward trend, 2.5% to 3.2% in all inpatient care units and an upward trend of 5.6% to 6.4% in critical care units.⁷,⁸
Pressure injuries develop through mechanical forces – pressure, friction, and shear. These, along with moisture, set the stage for pressure injury development.
A pressure injury may affect only the epidermis, or there may be an injury to the underlying tissue (like dermis, adipose, or muscle). Pressure injuries typically develop over boney prominences or may be related to medical devices such as tubes and braces. Tissue damage occurs due to intense or prolonged exposure, or a combination of these two, to sustained tissue deformation and pressure.
Pressure alone can cause pressure injuries but they are more likely in combination with shear or friction. Shear is when two unaligned forces move one part of the body in one direction and the other in opposition at the interface of the skin and the bony surface prominence, causing damage to tissue deep within the skin. Friction occurs when two surfaces rub against one another, affecting the skin's surface.
Skin microclimate -the temperature, humidity, and airflow next to the skin's surface- and moisture play an important role in skin health and integrity. Therefore, an excess of moisture which may include sweat, urine, feces, or excessive exudate, makes the stratum corium more suspectable to damage. And when combined with the friction from linen and bed sheets, this potential damage is exacerbated.
Most Hospital Acquired Pressure Injuries occur on the sacrum followed closely by the buttocks. Immobility is the greatest risk factor for development of pressure injuries.¹⁰
Moisture associated skin damage may compromise the epidermis barrier function and predispose tissue to pressure injury.⁹
Immobility, as with sacral pressure injuries, makes the heel an area to watch closely. Consider repositioning the patient and using prophylactic dressings that can reduce pressure, friction, and shear.
Medical device related pressure injury (MDRPI) is caused by a device used for diagnostic or therapeutic purposes. Examples include respiratory devices such as tracheostomy faceplates, tubes and securement devices, endotracheal tubes; orthopedic devices such as cervical collars; urinary or fecal collection devices or compression stockings among other things. MDRPIs may be defined as those found on mucous membranes (the moist lining of the body cavities such as the tongue, oral mucosa, nasal passage) or non-mucosal locations. Injuries can also be caused by other objects found in a patients room, such as remotes, cell phones, and chargers.¹¹
Knowing how to properly assess and stage a pressure injury, as outlined by the NPIAP, is an important component in reducing patient risk.
Download a free copy of a pocket-sized staging card and a wound measuring guide to help aid in your assessment of suspected pressure injury.
To protect against friction and shear, the NPIAP recommends using a polyurethane foam dressing to protect bony prominences like the sacrum and heels.⁹
To align with these standards, Tegaderm Silicone Foam Dressing, through its breathability, management of moisture, minimization of local shear force, minimal disruption to skin upon removal, and cushioning, may help prevent skin damage.
Explore Tegaderm Silicone Foam Dressings
Get hands-on experience with Tegaderm Silicone Foam Dressings and discover how they can help to enhance your comprehensive pressure injury prevention program.
Skin integrity and management of skin conditions is critical in the prevention of pressure injuries. The NPIAP recommends a preventative skin care regimen, which includes cleansing and protecting the skin with a barrier product, to aid in prevention of pressure injuries.
NOTE: Specific indications, contraindications, warnings, precautions, and safety information exist for these products and therapies, some of which may be Rx only. Please consult a clinician and product Instruction for Use prior to application.
Unique 3M technology protects skin from stool, urine and other bodily fluids by forming a protective barrier. The waterproof protectant formula in Cavilon Advanced Skin Protectant can help manage friction and shear for up to seven days.¹²,¹³
This trusted barrier film is ideal for routine skin protection from moisture and friction. Consider use of this breathable, fast-drying barrier on heels, elbows, and tops of ears.
Gently cleanse and moisturize skin with this non-irritating and pH-balanced spray. The cleanser remains on the skin — no rinsing or wiping required — and can help control odor.
Discover why Tegaderm Silicone Foam Dressings are an appropriate choice for your wound management and pressure ulcer/injury prevention programs.
This guide includes visual references on how to properly prepare and place dressings as well as how to temporarily lift dressings for skin or wound assessments.
PDF 377 KB
Learn how to select the right Tegaderm Silicone Foam Dressing for pressure redistribution* on bony prominences for patients in the prone position.
PDF 167 KB
*In-vitro data; the clinical significance is unknown
Choose 3M products that can help cleanse and protect skin from pressure injuries, including Tegaderm Silicone Foam Dressing.
PDF 1.7 MB
Explore articles that highlight the importance of skin, preventing complications, and improving patient care.
Jessica Pehrson, MSN, RN, CWS, PHN, shares tips to help reduce the risk of pressure injury for patients in the prone position.
Note: The author is an employee of 3M.
One 3M Medical Solutions Staff shares a story of her father-in-law's pressure injury-acquired amputation.
A quick review of the connection between IAD as a risk factor for pressure injury and considerations for facilities.
Deepen your clinical expertise with training opportunities and educational resources designed especially for you.
3M webinars and archived events keep you up to date with the latest product guidelines and scientifically supported standards of care.
Although significant progress has been made in recent years to prevent pressure ulcer/injury (PU/I), it was still one of only two hospital-acquired conditions that increased according to a 2019 Agency for Healthcare Research and Quality (AHRQ) report. Join Jessica Pehrson, RN, MSN, CWS, as she outlines common areas where PU/I diagnosis, treatment, and prevention often come up short despite the latest global efforts to determine root causes and expand clinical recommendations for assessment and management.
Note: The presenter is an employee of 3M.
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References
1. Health Research & Educational Trust (2016, January). Hospital Acquired Pressure Ulcers (HAPU) Change Package: 2016 Update. Chicago, IL: Health Research & Educational Trust. Accessed at www.hret-hen.org
2. Declines in Hospital-Acquired Conditions. Content last reviewed May 2019. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/data/infographics/hac-rates_2019.html.
3. AHRQ National Scorecard on Hospital-Acquired Conditions Updated Baseline Rates and Preliminary Results 2014–2017. Adrq.gov.
https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/hacreport-2019.pdf. Published January 2019. Accessed July 1, 2019.
4. Gefen A. How much time does it take to get a pressure ulcer? Integrated evidence from human, animal, and in vitro studies. Ostomy Wound Manag 2008:54(10): 26-35.
5. Gould, L. J., Bohn, G., Bryant, R., Paine, T., Couch, K., Cowan, L., ... & Simman, R. (2019). Pressure Ulcer Summit 2018: An Interdisciplinary Approach to Improve Our Understanding of the Risk of Pressure‐Induced Tissue Damage. Wound Repair and Regeneration, DOI: 10.1111/wrr.12730.
6. Cox J, Roche S, Murphy V. Pressure Injury Risk Factors in Critical Care Patients: A Descriptive Analysis. Adv Skin Wound Care. 2018 Jul;31(7):328-334.
7. VanGilder CA, Cox J, Edsberg LE, Koloms K. Pressure Injury Prevalence in Acute Care Hospitals With Unit-Specific Analysis: Results From the International Pressure Ulcer Prevalence (IPUP) Survey Database. J Wound Ostomy Continence Nurs. 2021 Nov-Dec 01;48(6):492-503.
8. Wassel CL, Delhougne G, Gayle JA, Dreyfus J, Larson B. Risk of readmissions, mortality, and hospital-acquired conditions across hospital-acquired pressure injury (HAPI) stages in a US National Hospital Discharge database. Int Wound J. 2020 Dec;17(6):1924-1934.
9. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIAP: 2019.
10. Edsberg LE, Cox J, Koloms K, VanGilder-Freese CA. Implementation of Pressure Injury Prevention Strategies in Acute Care: Results From the 2018-2019 International Pressure Injury Prevalence Survey. J Wound Ostomy Continence Nurs. 2022 May-Jun 01;49(3):211-219.
11. Gefen A, Alves P, Ciprandi G et al. Device related pressure ulcers: SECURE prevention. J Wound Care 2020; 29(Sup2a): S1–S52.
12. Brennan, Mary R.; Milne, Catherine T.; Agrell-Kann, Marie; Ekholm, Bruce P. Clinical Evaluation of a Skin Protectant for the Management of Incontinence Associated Dermatitis: An Open-Label, Nonrandomized, Prospective Study. J of Wound, Ostomy & Continence Nursing. 2017. 44(2):172-180.
13. 3M Data on File. EM-05-013924, EM-05-305812