How to spot the warning signs a pressure injury is developing

4 minute(s) to read

Pressure injuries are almost entirely preventable, yet an estimated 4-8% of New Zealanders who receive healthcare in New Zealand will experience one, regardless of their age or mobility.

The cost is staggering in human terms (constant pain, loss of function and mobility, distress, embarrassment, septicemia and even death), as well as financially. Pressure injuries cost our health system almost $700m a year.

But the true picture is far worse. Hospitals, aged care facilities and other healthcare providers vastly under-report the incidence of pressure injuries. A KPMG report prepared in conjunction with ACC and the Ministry of Health showed in 2012/13 there were just 349 ACC claims for pressure injuries submitted. Yet every year an estimated 55,000 New Zealanders sustain a pressure injury, with 3000 people developing a pressure injury so serious that muscle, bone or tendons are exposed.

So why are only a tiny number officially reported and ACC claims lodged?

At Cubro, we want to encourage our customers to ‘pipe up about pressure injuries’ to help reduce the stigma, shame and blame that people may feel when someone in their care develops one.

“These things do happen and sometimes there is no obvious cause,” explains Cubro Wound Care Nurse Katie Cunard. “The most important thing is to look after the client and treat it so it doesn’t get any worse, rather than worry about finger pointing.”

Katie strongly believes that education is key to empowering healthcare staff to recognise risk factors early on and take appropriate action when necessary. “95 percent of pressure injuries are preventable. So it’s about identifying people’s risks and treating them appropriately,” she says.

Who is at risk?

While pressure injuries can occur to anyone, people more likely to suffer include those with spinal cord injuries, the elderly, people with poor mobility, incontinence issues or past medical history of such injuries.

“It’s not so much the length of time you spend in bed, it’s whether you’re able to move yourself. Somebody could spend long periods of time lying down or sitting but if they can shift their weight and move themselves slightly, that’s okay. It’s the ones who can’t feel their own limbs or move themselves around who are most at risk.”

Nutrition is another important aspect, and people with high or low BMIs are two major risk categories. “Just because somebody has a high BMI doesn’t mean they’re well nourished,” Katie says. “That’s one of the biggest things that I think is overlooked. ‘Oh, they’ve got a high BMI, they’ll be fine.’ But actually, they often have a low nutrient diet.”

Protein is particularly important for healing wounds, along with sufficient nutrients and body fat so that our cells can repair. “Hydration is another important aspect. If we’re not hydrated, then our skin becomes dry and it loses its elasticity and is unable to prevent pressure injuries as much.”

Warning signs

Checking for reddened skin after helping someone change their position is an important step. Any instances of non-blanchable erythema (where you push firmly on the skin and it doesn’t blanch to a lighter shade) should immediately be investigated.

“Sometimes you’re not going to see any warning signs and that’s the hardest thing,” Katie says. But having the confidence to speak up when you do notice a pressure injury developing comes back to having the right education and support in place for staff.”

Cubro has a free webinar available online called Pressure Injury and Positioning as part of our Cubro CoLabs series. In the 40 minute presentation, Katie and her colleague present lots of useful information along with videos of how to use a care bed to minimise the risk of pressure, friction and shear injuries.

“I’m always available to help answer any questions that Kiwi healthcare professionals may have,” Katie says. “It’s important to take that blame culture and stigma away. It’s unfortunate that a patient has got a pressure injury. But let’s put them at the forefront of their care and deal with it.”


We know that early detection is key to preventing and treating pressure injuries, and we're committed to creating more education, training and resources to support health professionals like you.

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