Abstract

This guideline makes specific recommendations to identify at-risk adults and to define early interventions for prevention of pressure ulcers. The guideline may also be used to treat Stage I pressure ulcers (nonblanchable erythema of intact skin). These guideline recommendations are not intended as the basis for care of infants and children, nor do they apply to individuals with existing Stage II or greater pressure ulcers or to individuals who are fully mobile.

Most pressure ulcers can be prevented, and those Stage I pressure ulcers that do appear need not worsen under most circumstances. However, even the most vigilant nursing care may not prevent the development and worsening of ulcers in some very high-risk individuals. In those cases, intensive therapy must be aimed at reducing risk factors (such as improving nutritional status), at preventive measures (such as frequent turning, and the use of mattress overlays), and at treatment.

Recommendations target four overall goals: (1) identifying at-risk individuals who need prevention and the specific factors placing them at risk, (2) maintaining and improving tissue tolerance to pressure in order to prevent injury, (3) protecting against the adverse effects of external mechanical forces (pressure, friction, and shear), and (4) reducing the incidence of pressure ulcers through educational programs.

Interventions include early detection maneuvers such as risk factor identification by assessing mobility, nutritional factors, continence, and level of consciousness. Treatments evaluated included those broadly conceptualized as pressure reduction and relief and strategies to maintain tissue tolerance.

Contents

• AHCPR Statement
• Guideline Development and Use
• Foreword
• Panel Members
• Acknowledgments
• Executive Summary
• 1. Overview
  • Introduction
  • Incidence and Prevalence
  • Methodology for Guideline Development
• 2. Clinical Practice Guideline
  • Introduction
  • Risk Assessment Tools and Risk Factors
  • Skin Care and Early Treatment
  • Mechanical Loading and Support Surfaces
  • Education
• 3. Algorithm
  • Activity or Mobility Deficit
• 4. Research Agenda
• Contributors
• Glossary
• Acronyms
• Availability of Guidelines
• References

Suggested citation:

Panel for the Prediction and Prevention of Pressure Ulcers in Adults. Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline, Number 3. AHCPR Publication No. 92-0047. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. May 1992.