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Best Practices for Assessment, Prevention, and Treatment of Pressure Ulcers

All clinicians are expected to use best practices to assess, prevent, and treat pressure ulcers to improve patient outcomes. The framework used in this chapter was applied from the best practice recommendations outlined in the 2008 Canadian Association of Wound Care (CAWC).1 Best Practice Enabler and Quick Reference Guide2 developed by wound experts and researchers.3 In addition, the Registered Nurses Association of Ontario (RNAO)4 clinical practice guidelines of prevention and management of pressure ulcers were also applied.

  1. Identify and Treat the Cause
    1. Assess and identify risk factors that may lead to pressure ulcer formation or may contribute to poor healing of existing ulcers.
    2. Minimize pressure and reduce friction and shear.
    3. Maximize nutrition and hydration.
    4. Control incontinence and moisture
  2. Address Patient Centered-Concerns
    1. Assess and Control Pain
    2. Assess and Assist with Psychosocial Needs
  3. Provide Local Wound Care
    1. Stage the Pressure Ulcer
    2. Use Principles of Preparing the Wound Bed
    3. Adjunctive Modalities or biologically active dressings
    4. Surgical Interventions for non-healing Stage III and Stage IV
  4. Provide Organizational Support
    1. Interdisciplinary team approach
    2. Educate patients, caregivers and health providers

CAWC Best Practice Enabler And Quick Reference Guide

CAWC Best Practice Enabler And Quick Reference Guide

Risk Factors of Pressure Ulcers
  1. Canadian Association of Wound Care. 2008. Best Practice Enabler. Toronto, Canada.
  2. Canadian Association of Wound Care. 2006. Quick Reference Guide. Recommendations for practice. Toronto, Canada.
  3. Keast D.H. , Parslow, N. Houghton, PE., Norton,L. and Fraser, C. (2006) Best Practice Recommendations for the Prevention and Treatment of Pressure Ulcers: Update 2006. Wound Care Canada 4(1):R19-29.
  4. Registered Nurses’ Association of Ontario (2005). Risk assessment and prevention of pressure ulcers. (Revised). Toronto, Canada: Registered Nurses’ Association of Ontario. Updated 2011.

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