Have you ever heard this saying expressed by wound care nurses: “Treat the whole patient, not just the hole in the patient”? This is such a true statement when treating tissue injuries, but especially true with pressure injuries. There is no way to “heal the hole” without the proper nutritional support, proper vascular flow and systemic control of other underlying problems. Health history and nutritional screening are priorities in planning our wound care interventions when we have a “hole in our patient.”
According to the National Pressure Ulcer Advisory Panel (NPUAP) Prevention and Treatment of Pressure Ulcers Quick Reference Guide, nutritional screening should be conducted for each individual at risk for or who already has a pressure ulcer:
- Upon admission to a health care setting,
- With each significant change of clinical condition, and/or
- When progress toward pressure ulcer closure is not observed.1
Nutritional screening also includes assessing the weight status of each individual to determine weight history and identify significant weight loss (≥5% in 30 days or ≥10% in 180 days), assessing the individual’s ability to eat independently and assessing the adequacy of total nutrient intake (i.e., food, fluid, oral supplements and enteral/parenteral feeds).1
The key element to tissue reconstruction is protein. If the patient’s diet is deficient in this extremely complex substance, the “whole” patient is at risk for skin breakdown and the “hole” in the patient will not likely progress to healing. For further recommendations regarding nutritional assessments and protein intake, this NPUAP quick reference guide is a valuable resource.
At Arjo, our Wound Care Clinical Consultants are able to work in collaboration with your facility to conduct a Pressure Ulcer Prevalence Analytics study to assess real-time pressure injury rates, in addition to reviewing leading indicators, such as nutritional factors, for your at-risk patients.
- National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler (Ed.). Cambridge Media: Perth, Australia; 2014.