Pressure-induced Injuries: Risk Factors (Nursing)

00:04 Hey guys, welcome to pressure injury care.

00:08 So what am I talking about here? When you guys hear the word pressure injury,what we're talking about is a patient's bony prominences are having a lot of pressure applied, and this can result in injury.

00:21 So you may hear the terms 'pressure injury' or 'pressure ulcer', that's pretty interchangeable and you may hear these terms.

00:29 So let's take a look at this.

00:32 So when we're talking about pressure injury, there are several areas of risks.

00:36 So we're going to go through each different position and some things to look for as a nurse.

00:41 So if you take a look at this image here, see all these hot spots when the patient's in a prone position.

00:47 So take a look here, we see the patient's toes, for example.

00:51 We see right here at the hips, the bony prominences of the hips, you see the patient's elbows, even their collarbones here, especially the patient's head over here as well.

01:04 If it's making contact with a mattress, for example, this is going to cause areas of risk for pressure injury.

01:11 And again, when you look at this image, this may look a little odd here, but imagine the patient's laying in bed, and all these red hot spots are making contact with consistent pressure on the mattress.

01:24 Now let's take a look at a different position here.

01:27 Let's take a look at the supine position.

01:29 So man, these hot spots again.

01:32 This is some of the really, really common pressure injury points that you're going to see as a nurse.

01:38 So I want you to take special attention down here at the feet of the patient.

01:43 So you see where there's a hot spot with the heels.

01:46 This is a huge, huge issue and one of the first places we need to look as a nurse.

01:52 This is a really common place for a patient to get a pressure injury.

01:57 Also, we don't really have a good way to show the hot spot here, but a patient's coccyx or sacrum in the back of their tailbone is definitely a huge area of risk.

02:07 In a lot of times it goes unnoticed unless the nurses assess.

02:13 Also notice again, the patient's elbows, even the back of their shoulder blades we may not think about.

02:19 And the patient's back of their head in contact with consistent pressure on that mattress.

02:26 Now here's another way we could get pressure injuries.

02:30 Again, look at all these different hotspots.

02:33 The side of the foot, the hip bone and constant pressure with the mattress, side of the patient's head, their shoulder blade, for example, even knees to knees if the patients has constant pressure applied to these points.

02:50 Now we talked about some areas to look and to assess of where some pressure injuries may occur.

02:56 And again, you can imagine with all those hotspots we just saw, it's really important for a thorough, thorough skin and head to toe assessment as a nurse.

03:08 Now who's going to be at risk? This is a long list here but unfortunately, the list is long for the areas of the people at risk.

03:16 So immobility is a huge one, right? You can imagine, makes a lot of sense if the patient's in the bed a long time, they can't move, because of maybe an accident, a motor vehicle accident, for example.

03:29 Here's a big population, if the patient's in the intensive care unit, a lot of the times they're on meds, their consciousness is not there, and we've got them sedated so they are laying flat in that supine position for a long, long time.

03:44 So we want to make sure we assess these people.

03:47 Also, of course, if we have poor nutrition, poor hydration, this is not supporting those nice, that integumentary system to help provide those defenses.

03:58 Our elderly patient again with their poor fragile skin, that is definitely going to be a risk for friction, shearing pressure injuries.

04:07 And again, as you can see the list goes on here, right.

04:11 So one important point after all these points and I want you to take a look at too and we don't really think about a lot.

04:17 We have a lot of diabetic patients that they have because of their disease process can't feel very well.

04:25 So a lot of the times they can develop pressure injury when we're really not looking at these patients as an at risk population.