![]() ![]() The pressure injury risk assessment tool used at RCH is a modified Glamorgan Pressure Injury Risk Assessment Tool. Therefore, clinicians need to use their experience, clinical judgment and knowledge to prevent tissue damage and protect the skin in conjunction with the risk screening tool. Validated risk assessment tools for children are effective for identifying those at risk and increasing awareness of potential pressure related injuries, however they cannot embody every possible circumstance. PI risk assessment tools are the key to determining if a patient is susceptible to PIs. When an assessment identifies a patient at risk of pressure injury, interventions should be implemented immediately. ![]() Prevention requires an on-going risk assessment, consideration of casual factors, implementation of prevention strategies and the selection of an appropriate use of support surfaces. A risk factor is any element that either diminishes the skins tolerance to pressure or contributes to increased exposure of the skin to excess pressure.įrom the Prevention and Treatment of Pressure Ulcers/Injuries International In the prevention of PIs, it is essential that patients at risk are identified so an individualised prevention plan can be implemented to mitigate the risks. Several factors may influence an individual’s risk of developing pressure injuries. This leads to cell obliteration and eventually tissue death. Prolonged pressure on a localised area of tissue causes the occlusion of blood flow, preventing the supply of nutrients and oxygen to the tissue, resulting in ischaemia and re-perfusion injury. The tissues’ ability to tolerate the pressure including the intensity and duration, are factors affecting PI development. The deep fascia, subcutaneous fat, skin, bone, and muscle can all be damaged by unrelieved pressure. In addition to pressure, poor blood flow, friction, shear, and tissue ischaemia can all contribute to the develop of a PI. PIs commonly occur over bony prominences, however in the paediatric population, PIs are more commonly associated with a medical device or object. Pressure injury developmentĪ pressure injury is defined as localised damage to the skin and/or underlying tissue as a result of pressure. Induration – A hardened mass or formation of the skin tissue due to increase in fibrous elements commonly associated with inflammation and marked loss of elasticity and pliability of the skin. ![]() ![]() Re-perfusion Injury- A re-perfusion injury is a response that the tissues have that results in damage to the cells when blood supply returns back to the tissue after a period of ischemia or lack of oxygen. At the Royal Children’s Hospital a modified Glamorgan Risk Assessment Scale is currently used. Risk Assessment Scale- A formal grade used to help ascertain the degree of pressure injury risk. Pressure Injury (PI) - Is a localised area of tissue destruction that develops when soft tissue is compressed between a bony prominence, as a result of pressure, shearing forces and/or friction, or a combination of these. Intrinsic Factors - Originating internal to the body. The primary objectives are to provide evidence-based guidance for the prevention, assessment and management of pressure injuries.īlanching Erythema - Reddened skin that becomes white or pale in appearance when light pressure is applied.Įxtrinsic Factors - Originating external to the body. The aim of this guideline is to increase awareness of pressure injuries amongst health care professionals at the Royal Children’s Hospital (RCH). Most pressure injuries are preventable if appropriate evidence-based measures are implemented, including comprehensive risk assessment, skin care and targeted prevention strategies. Pressure injuries are associated with increased morbidity and hospital stay, as well hospital costs. Children and neonates are at higher risk due to their relatively larger skin surface area, increased nutritional requirements and risk of nutritional deficiencies, immature skin and the use of medical devices. International data indicates that hospitalised children and neonates experience pressure injuries at a high incidence rate, up to 27% (EPUAP/NPIAP/PPPIA, 2019). ![]()
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