Preventing pressure ulcers in emergency departments: four simple and effective nurse-led changes

Abstract

Patients can develop pressure ulcers within a few hours of entering an emergency department (ED). However, despite the critical role of EDs in reducing the incidence of pressure ulcers, few have protocols in place for prevention. This article describes the prevention emergency project (PEP), a quality improvement project undertaken in the ED at Karolinska University Hospital in Sweden to reduce the incidence of pressure ulcers. The article demonstrates how four simple nurse-led changes -early risk assessment, pressure-relieving equipment, intentional rounding, and using prophylactic dressings and incontinence pads -can reduce the incidence of pressure ulcers significantly when integrated into ED workflow.

Content Validation of an Emergency Department Skin Risk Assessment Instrument

“…Many organizations incorporate approaches to mitigate and decrease hospital-acquired PIs (HAPIs), including assessing patients within the first 24 hr of admission for PI presence or risk, frequent repositioning, use of various skin-friendly surfaces and devices, and continuous monitoring during hospitalization with a validated skin risk assessment instrument (Gamston, 2019; Weller et al, 2018). Commonly used instruments include the Braden Scale, Norton Scale, and Waterlow Scales, though these have not been fully adopted in ED settings due to their limited adaptability to the fast-paced emergency environment (Bjorklund et al, 2012; Gamston, 2019; Stanberry, Lahti, Kevin, & Delin, 2022).…”