General guidelines on pevention of ulcer

RISK ASSESSMENT
1 .- Consider all potential risk patients.
2 .- Select and use a method of evaluating risk.
3 .- Identify risk factors.
4 .- Record your activities and results. Evaluate.

SPECIFIC CARE
1 .- Skin

* Examine the state of the skin daily.
* Keep the patient’s skin at all times clean and dry.
* Use soap or cleansing agents with low irritation potential.
* Wash skin with warm water, rinse and conduct a thorough drying without friction.
* Do not use on any skin alcohols (rosemary, tannin, colonies, etc.).
* Apply moisturizers, ensuring complete absorption.
* Preferably use natural linen fabrics.
* To reduce potential friction injuries may use protective dressings (polyurethane, hydrocolloid ,…)
* Do not perform massage over bony prominences.

2 .- Incontinence

* Treatment of incontinence.
* Rehabilitation of sphincters.
* Patient Care: absorbers, collectors, …

3 .- Mobilization:

* Develop a rehabilitation plan to improve mobility and patient activity.
* Perform Positioning:
* Every 2-3 hours to bedridden patients, following a scheduled rotation and individualized.
* In periods of time sitting mobilizations will be carried out if you can do it independently, teach him to move every fifteen minutes.
* Maintain body alignment, weight distribution and balance.
* Avoid direct contact of the bony each other.
* Avoid dragging. Perform the demonstrations reducing shear forces.
* On her side, it exceeds 30 degrees.
* If necessary, elevate the head of the bed as little as possible (maximum 30 °) and for the shortest time.
* Do not use floats.
* Use devices that mitigate to the maximum pressure mattresses, pillows, protections for local products.
* Only supplementary material does not substitute for the mobilization.

GENERAL CARE:

* Treat those processes that may influence the development of pressure ulcers:
* Respiratory
* Circulatory disorders
* Metabolic
* Identify and correct the different nutritional deficits (calories, protein, vitamins and minerals).
* Ensure adequate hydration status.

EDUCATION:
* Assess patient’s ability to participate in its prevention.
* Develop an education program to prevent pressure sores, which is:
* Organized, structured and understandable.
* Aimed at all levels: patients, families, carers, managers, and
* To include mechanisms for evaluating the efficiency.

TREATMENT:
Treatment of patients with pressure ulcers should include the following:

- Contemplating the patient as an integral being
- Make a special emphasis on preventive measures.
- Achieve maximum involvement of the patient and family in the planning and implementation of care
- Develop clinical practice guidelines on pressure ulcers locally with the involvement of community care, specialized care and health and social care
- Setting up a framework of scientific evidence based clinical practice
- Make decisions based on what scale cost-benefit
- Constantly evaluate clinical practice and practitioners to incorporate research activities.