Annals of Internal Medicine
SUMMARIES FOR PATIENTS
Risk Assessment and Prevention of Pressure Ulcers The full report is titled “Risk Assessment and Prevention of Pressure Ulcers: A Clinical Practice Guideline From the American College of Physicians.” It is in the 3 March 2015 issue of Annals of Internal Medicine (volume 162, pages 359-369). The authors are A. Qaseem, T.P. Mir, M. Starkey, and T.D. Denberg, for the Clinical Guidelines Committee of the American College of Physicians.
What are clinical guidelines, and what do they mean for me? The American College of Physicians (ACP) developed a clinical guideline for the assessment and prevention of pressure ulcers. Members of ACP are internists (physician specialists in the care of adults). Clinical guidelines are recommendations that provide clinicians with research-based advice to help them deliver the best possible care to patients. The ACP reviewed studies on the benefits and harms of assessing for and preventing pressure ulcers. What are pressure ulcers? Pressure ulcers, also known as “bed sores,” are wounds to the skin or the tissue under the skin. They can happen when a person spends a long time in the same position, such as in a hospital or long-term care setting. Pressure ulcers can be very painful and slow to heal, and they increase the risk for infection. They are common where skin is close to the bone, such as the back, the shoulders, the hips, and over the tailbone. Risk factors for pressure ulcers include older age, black race or Hispanic ethnicity, low body weight, mental or physical impairments, incontinence, diabetes, and malnutrition. What did the authors find? The authors reviewed research on the benefits and harms of assessing for and preventing pressure ulcers. They found that clinicians should check to see whether a patient is at risk for pressure ulcers. They also found that static mattresses (beds that help reduce pressure on the skin and body but do not move, inflate, or deflate) or overlays (a surface placed on top of a standard mattress) should be used to prevent pressure ulcers in at-risk patients. Alternating-air mattresses (air-filled beds that inflate or deflate to reduce pressure on different areas of the skin and body) or overlays do not help in preventing pressure ulcers.
Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine. Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
What does ACP recommend that patients and doctors do? 1. Clinicians should check to see whether patients are at risk for pressure ulcers. Clinicians can use their clinical judgment or risk assessment scales that are available to help determine whether someone is at risk. 2. Static mattresses or overlays can be used to prevent pressure ulcers in at-risk patients. A static mattress or overlay helps to lessen pressure on areas where pressure ulcers may occur. 3. Alternating-air mattresses or overlays should not be used instead of advanced static mattresses. Alternating-air mattresses or overlays have not been shown to be better at preventing pressure ulcers. They can also have a higher cost, with no added benefit. Questions for my doctor • Am I at risk for pressure ulcers? • Should I use a special mattress or mattress overlay at home? • What is the difference between a static mattress and an alternating-air mattress? For more information MedlinePlus: www.nlm.nih.gov/medlineplus/ency/article/007071.htm
Ann Intern Med. 2015;162:I-34. doi:10.7326/P15-9006
I-34 © 2015 American College of Physicians
Copyright © American College of Physicians 2015.
SUMMARIES FOR PATIENTS
Risk Assessment and Prevention of Pressure Ulcers The full report is titled “Risk Assessment and Prevention of Pressure Ulcers: A Clinical Practice Guideline From the American College of Physicians.” It is in the 3 March 2015 issue of Annals of Internal Medicine (volume 162, pages 359-369). The authors are A. Qaseem, T.P. Mir, M. Starkey, and T.D. Denberg, for the Clinical Guidelines Committee of the American College of Physicians.
What are clinical guidelines, and what do they mean for me? The American College of Physicians (ACP) developed a clinical guideline for the assessment and prevention of pressure ulcers. Members of ACP are internists (physician specialists in the care of adults). Clinical guidelines are recommendations that provide clinicians with research-based advice to help them deliver the best possible care to patients. The ACP reviewed studies on the benefits and harms of assessing for and preventing pressure ulcers. What are pressure ulcers? Pressure ulcers, also known as “bed sores,” are wounds to the skin or the tissue under the skin. They can happen when a person spends a long time in the same position, such as in a hospital or long-term care setting. Pressure ulcers can be very painful and slow to heal, and they increase the risk for infection. They are common where skin is close to the bone, such as the back, the shoulders, the hips, and over the tailbone. Risk factors for pressure ulcers include older age, black race or Hispanic ethnicity, low body weight, mental or physical impairments, incontinence, diabetes, and malnutrition. What did the authors find? The authors reviewed research on the benefits and harms of assessing for and preventing pressure ulcers. They found that clinicians should check to see whether a patient is at risk for pressure ulcers. They also found that static mattresses (beds that help reduce pressure on the skin and body but do not move, inflate, or deflate) or overlays (a surface placed on top of a standard mattress) should be used to prevent pressure ulcers in at-risk patients. Alternating-air mattresses (air-filled beds that inflate or deflate to reduce pressure on different areas of the skin and body) or overlays do not help in preventing pressure ulcers.
Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine. Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
What does ACP recommend that patients and doctors do? 1. Clinicians should check to see whether patients are at risk for pressure ulcers. Clinicians can use their clinical judgment or risk assessment scales that are available to help determine whether someone is at risk. 2. Static mattresses or overlays can be used to prevent pressure ulcers in at-risk patients. A static mattress or overlay helps to lessen pressure on areas where pressure ulcers may occur. 3. Alternating-air mattresses or overlays should not be used instead of advanced static mattresses. Alternating-air mattresses or overlays have not been shown to be better at preventing pressure ulcers. They can also have a higher cost, with no added benefit. Questions for my doctor • Am I at risk for pressure ulcers? • Should I use a special mattress or mattress overlay at home? • What is the difference between a static mattress and an alternating-air mattress? For more information MedlinePlus: www.nlm.nih.gov/medlineplus/ency/article/007071.htm
Ann Intern Med. 2015;162:I-34. doi:10.7326/P15-9006
I-34 © 2015 American College of Physicians
Copyright © American College of Physicians 2015.
