So you walk the patient to the shower, make sure she’s got everything, shampoo, soap, towels… ‘Just wait for me – I’ll come and take you back to your bed,’ you call as you hurry off to your next task.

Within a minute, you hear screaming from the shower cubicle … You run in and the patient is flat on the floor, blood flowing from a large gash on her head. What just happened? She said she felt dizzy and slipped on the wet shower floor. It was probably a combination of the anaesthetic she had a couple of days ago plus pain-killing medication she had this morning!                                                                                                                                                                                                                                                                 Could this have been avoided? Of course it could have been …………..

Click the link Slips, Trips and Falls: The ‘Nurse you’re killing me’ series. 

or go to www.amazon.com, copy and paste “Slips, Trips and Falls: The ‘Nurse you’re killing me’ series. ASIN: BOOHJAAHLQ, into the search bar and enjoy!

We just have to get rid of silly nursing rituals that put patients at risk of falling, get with the times and make healthcare safer for patients and nurses.

Catherine A. Sharp

I have written this book for lawyers, expert witness nurses, legal nurse consultants and healthcare workers. If you are a nurse you may feel really annoyed at the title of the book; perhaps thinking I’m accusing you… I’m not. On the contrary I support you in your quest for the right tools and equipment to prevent pressure sores…you’ll see why as you read the book.

Lawyers, I hope this will help you to understand the aetiology of pressure sore development, how easy they are to prevent with reasonable care.

And to nurses providing reports for the Courts I have given some ‘reasonable care’ suggestions in the book.

Click on this link http://www.amazon.com/dp/B00DEXM3J6 Let me know what you think or if you are a lawyer in Australia and need a report give me a call, or send an email.

Patients often sue healthcare facilities for the development of a pressure injury so it’s a good idea to find out how to prevent them…and they are easy to prevent with the right alternating pressure air mattresses and chair cushions that relieve pressure on all parts of the body, every few minutes, throughout the 24 hours. 

Do you know what to look for in an alternating pressure air mattress? Do you know what questions to ask the companies that supply them? Not all mattresses will prevent pressure injuries believe me.

Read our book… ‘Sharp Clinical Solutions for the Prevention of Pressure Injuries’ the first of many we hope…

Click on this link.

http://www.amazon.com/Clinical-Solutions-Prevention-Pressure-ebook/dp/B00D2ZN2SW/ref=sr_1_1?ie=UTF8&qid=1370038191&sr=8-1&keywords=B00D2ZN2SW

Pressure injuries, also known as pressure ulcers, bedsores or decubitus ulcers, are appalling wounds that occur when soft tissue is ‘compressed’ between the skeleton and a surface e.g. a mattress or chair cushion, for a period of time. That time is different for every patient but tissue can begin to die in just a few minutes of unrelieved pressure.

The unrelieved pressure can destroy muscle, fat, bone and skin. Pressure injuries are extremely painful wounds that become infected and may result in limb amputation and / or death.

If incontinence caused pressure injuries / ulcers we’d see millions of babies and tiny tots with wet nappies and big pressure ulcers on their little bums, clogging up our hospitals; we don’t. Babies get nappy rash and as distressing as that might be nappy rash does not cause a big pus-filled hole to develop, down to the bone.

Where did this idea come from – that incontinence could cause pressure injuries? Well for decades now nurses have used numerical tools to assess patients’ risk of pressure injury / ulcer development. The tools contain parameters such as mobility, incontinence and nutrition. Each parameter gives a score and nurses total the scores to determine patients risk; that could be anywhere from ‘no-risk’ to ‘high-risk.’

If deemed at risk the patient may be given an alternating pressure air mattress if they are bedridden and / or a ‘turning’ regime where nurses will reposition patients every two hours, to relieve the pressure on each part of the body. They may be rolled from side to side for example.

It’s easy to understand how poor mobility / immobility can result in a pressure injury, but incontinence?? Well it can’t and let me tell you why.

Most pressure injury risk screening tools, as well as the studies that have reported on incontinence as a potential risk factor for pressure injury development, do not differentiate between ‘urinary incontinence’ and ‘faecal incontinence’ nor between the different types of, stress or functional incontinence.

Stress incontinence may occur during physical activity for example so it is clear that this type of incontinence is not a cause of pressure injury. But functional incontinence can occur in patients with decreased mobility, that physically cannot get to the toilet in time because they have suffered a stroke, or had a leg amputated, for example. So it is the decreased mobility that puts them at risk of pressure injury, not the incontinence.

Some studies show that pressure injuries developed in patients with indwelling urinary catheters…so wet skin was not the cause of the pressure injury.

Catherine A. Sharp

Founder & CEO

Expert Witness Nurse Consultants Australia

If you, or a loved one, developed a pressure injury / ulcer, the healthcare facility may tell you that it was inevitable because you were a diabetic, or you were incontinent or you were malnourished. Even worse they may tell you that it is your own fault because you didn’t move enough!!

Don’t believe them! The reason you developed a pressure injury is because of unrelieved pressure, on that part of your body where the pressure ulcer has developed, over a period of time…and that time can be a matter of minutes to hours. The time is not really known and is different for each person. However the places people get pressure injuries are well-known; the commonest being the heels and the sacrum (your bottom / base of the spine), greater trochanters (hips), the occiput (the back of the head)… but they can develop anywhere on the body.

Pressure damage starts when tissue is sandwiched between the bony skeleton and a hard surface such as a mattress, operating theatre table or chair. The blood cannot get to that tissue and it starts to die. The process can be really painful but if you are a diabetic with peripheral neuropathy (loss of sensation in your lower limbs) you may not feel the pain of pressure in your heels and huge revolting pressure injuries can develop. This is bad enough but so often diabetics end up having their legs amputated because of heel pressure injuries / ulcers.

In the next article I am going to tell you why incontinence does not cause pressure injuries!

Catherine A. Sharp

Founder & CEO

Expert Witness Nurse Consultants Australia

Did you know most pressure ulcers (also known as pressure injuries, bedsores, decubitus ulcers) are preventable!

So if you did develop a pressure ulcer anywhere on your body whilst in a healthcare facility, or being cared for by a healthcare worker at home, you may want to know why it happened, what could have been done to prevent it and what you can do about it now.

Have you got horrible scars from the pressure ulcer? Did it heal or do you still have a smelly draining wound?

Were you treated for an infection? Did you require surgery to remove dead tissue from the ulcer? Did you lose a limb?

If you, or a relative, have any questions please send me an email info@expertwitnessnurse.com.au

Anything you tell me will be treated in confidence.

Catherine A. Sharp

Founder & CEO

Expert Witness Nurse Consultants Australia