Prevent Skin Issues While in the Hospital

Most often when someone goes to the hospital you probably think they are going to get fixed up, healed up, and get out of the hospital good as new.  In some cases, that does happen.  Sometimes though it doesn’t.  There is something called a Hospital Acquired Pressure Injury.  It is a term Hospitals use for when a person develops a pressure ulcer during their stay.  Hospitals are aware it happens and there are multiple reasons for it.  Most of the time it is because the person stayed in one position too long, the skin lost its blood supply due to the pressure, and the skin started to break down.  This can cause the skin to become soft or even break open, exposing the tissue and muscle underneath it.  If it is bad enough sometimes even bones can be exposed.  Getting a pressure sore to heal is not easy.  It can require a lot a time and effort to have it close back up, if it ever does.  Some pressure ulcers can takes months or even years to heal. 

So what can you do to prevent a Hospital Acquired Pressure Injury?

1. Before the person is taken to the hospital complete a skin assessment on them.  Check to make sure there are not any open areas or if there are any areas that might be of concern.
2.  When the person is first admitted communicate to the hospital staff that the person you support might be at risk for developing a pressure injury.  Especially if someone can’t communicate or advocate for themselves during a hospital stay or if they are unable to turn and re-position themselves.
3. Even though you may have communicated it at the beginning of the hospital stay, don’t hesitate to remind the hospital and nursing staff that this person will need help to re-position themselves.  Ask if the hospital staff can assist them with a walk around the unit or sitting up in a chair, anything to help relieve pressure and get their blood flowing to all areas of the body.
4. Ask if the hospital staff have completed a skin assessment and follow up to ensure that personal hygiene is attended to appropriate and quickly.  Remember: if the person is unable to advocate for themselves you need to advocate for them.  Sometimes it can be difficult to speak up but you are just looking out for the person you support. 
5. If a pressure injury starts to develop ask for a consult from the hospital wound nurse or physician right away.   A stage 1 pressure injury is easier to heal than a Stage 2.
6. After the person is discharged, complete another skin assessment as soon as possible once they arrive at home.  Check to make sure there are no soft, reddened, or open areas on the skin.  If you notice something, contact the physician as soon as possible.  He or she may want to see the person or refer them to a wound care clinic.

If you have any questions about skin care, either at the community home or while someone is in the hospital, don’t hesitate to call you HCQU.  We may be able to provide resources or materials to help you advocate for the person.