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Research shows that most pressure ulcers are preventable.

Nursing leaders who have introduced effective prevention programs say that leadership, training, and relentless focus on making skin care a priority are all key.

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The constant pressure against the skin reduces blood flow to contact areas.Tierney, who works as an inpatient consultative wound care nurse, says of pressure ulcers, “Any nurse who has seen one is highly motivated to prevent them.” But individual motivation has yet to translate into widespread success because the prevalence of pressure ulcers in health care facilities is actually increasing, with some 2.5 million patients being treated for pressure ulcers in US acute care facilities annually.Pressure ulcer incidence rates vary considerably by clinical setting — ranging from 0.4 percent to 38 percent in acute care, from 2.2 percent to 23.9 percent in long-term care, and from 0 percent to 17 percent in home care.The basic definition of pressure ulcers — damage to the skin or underlying tissue caused by unrelieved pressure — has remained constant, but the tools and techniques of skin care have changed in recent years.This is due in part to a sharper focus on the problem by organizations such as the National Quality Forum and Centers for Medicare & Medicaid Services, both of which have recently called for greater efforts to eliminate hospital-acquired pressure ulcers.In an increasingly complex hospital environment with sicker patients yet shorter stays, it’s been important to build vigilance right into daily care processes.Bevette Griffin, RN, CWON, head of the enterostomal therapy department at OSF St.While remarkable medical advances allow health care professionals to work modern-day miracles, an ancient medical problem still threatens to harm or even kill some patients.Documented in autopsies of Egyptian mummies, pressure ulcers — commonly called bedsores — have plagued patients and their caregivers for centuries.Categorized by severity according to a scale developed and periodically updated by the Washington, DC-based National Pressure Ulcer Advisory Panel, pressure ulcers range from Stage I — the earliest sign of skin redness — through Stage IV, deep craters that damage muscle and bone, and sometimes tendons and joints, often requiring surgery.“You never forget the worst pressure ulcer you’ve ever seen,” says Kathleen Tierney, RN, BSN, CWOCN, a nurse clinician at Baystate Medical Center, a member organization of IHI’s IMPACT network.

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