A QLD Government website
QLD Government
QSCIS
Queensland Spinal Cord Injuries Service

Key principles of pressure injury prevention

The most important aspect of preventing pressure injuries is that everyone is unique and the person’s management plan needs to be tailored to that individual. It can be a matter of trial and error to find the best solution to manage the person’s skin to suit their needs.

When to do a skin check?

Head to toe skin checks should be attended twice daily at a minimum. Additional skin checks may be required in the following circumstances:

  • after an adverse event such as a poor transfer or fall
  • during a trial of new equipment such as a mattress, shower commode or cushion
  • with new clothing
  • when a new device is being used such as a different leg bag system or compression garment
  • after an episode of incontinence
  • at times of a change in routine such as travel, starting a new activity or working longer hours

How to do a skin check?

Perform a skin check by looking at and feeling the skin.

Look

an image of a man sitting on a bed holding a hand-held mirror to check his feet

Check with a mirror, take a photograph, or have someone else check the skin. If the person is unable to use a hand-held mirror, modified mirrors can be obtained. These may be called ‘quad inspection mirror’, ‘hand held inspection’ or ‘flexible inspection mirror’. To inspect feet, an inspection mirror on a telescopic arm can be used.

Photo by: Shepherd Center

An image showing a redish imprint on ones leg caused by prolonged sitting or lying.

Know what is ‘normal’ and what is not. Any change can be an issue.

An image of a heel with redish dark pressure injury.

Check bony prominences as these are high risk areas.

An image showing pimples around a skin.

Look for pimples, bruising or scrapes.

Photo by: English Dermatology

A reddish rash around saccrum and coccyx.

If redness is present, check for blanching. Blanching indicates return of blood supply to the tissue. Return of colour from white to pink should occur within 2 seconds. If there is non-blanching erythema, a stage 1 pressure injury is present.

Photo by: 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: Osborne Park, Western Australia; 2014

An image showing a dark-skinned feet with a skin injury on the lateral medial malleoli

People with darker skin tones may not see skin changes early. It is important to feel the skin when checking.

Feel

Feel for any changes such as lumps, bumps, pimples, skin texture, soft or hard areas.

Photo by: English Dermatology

Heat or warmth to the area can indicate an underlying problem.

Manufacturing a handheld mirror

Purpose:

To assist the individual with weak or no hand grasp to hold the mirror in the position while performing skin care checks.

Materials:
  • Plastic mirror
  • Perspex or thermoplastic (splinting material)
Considerations:
  • Consider purchase of a commercially available item if the person has an appropriate funding source.
  • Requires someone with knowledge on plastics or Perspex to construct. Technology for Ageing and Disability Queensland may be able to assist with manufacture of a mirror if required.
  • Pillows could be used as an alternative low-cost option to support a mirror
Attach a perspex or thermoplastic splinting material into the middle of the plastic mirror leaving 105mm of the handle to grasp to.