Preventing Pressure Injuries – getting the basics right!

Each year in New Zealand, approximately 55,000 people experience a pressure injury [1]. While that may not sound like many people to you, the cost to the New Zealand taxpayer is huge at over $600 million per year [1]. Pressure injuries can significantly reduce a person’s quality of life. They cause significant pain, social isolation, reduced mobility, prolong hospital admissions and in the worse cases, can even lead to death [1].

Pressure Injuries are Preventable

Despite the doom and gloom, the good news is that research shows most pressure injuries are preventable! Good quality and timely healthcare means nobody should have to go through the ordeal of developing a pressure injury. A focus on reducing pressure injuries will not only lead to cost savings for health providers and their funders but more importantly, it will enhance a person’s quality of life. This is all sounding pretty good right? It is widely acknowledged that simple steps such as safe moving and handling techniques, positioning, skin care, optimising nutrition and hydration are important ways to prevent pressure injuries [2].

In New Zealand we are fortunate to have access to highly specialist and elite equipment designed to decrease the risk of pressure injury development. However, ‘getting the basics right’ in moving and handling practice needs to be prioritised to optimise these new equipment aids. The NZ Moving and Handling Association (MHANZ promotes the awareness of safe moving and handling to those who receive care and/or work in a range of New Zealand health and residential care settings. MHANZ is firmly focused on getting the basics of moving and handling people right. For people at risk of developing pressure injuries, clinicians need to closely consider that they’re optimally trained to ensure the use of safe and effective manual handling techniques in the movement and transition of these people.

Nutrition is Key

So how do we ensure we get the nutrition basics right too? It’s not rocket science. We all know a good diet will help us to maintain independence and live life to the fullest, and it’s the same with pressure injuries. Research shows that poor nutrition has a direct correlation to impaired tissue perfusion and skin resilience. Add to that somebody who may be of older age, immobile, unable to easily access food or already malnourished and the risk of developing a pressure injury is massive [1].  Individuals with pressure injuries have higher energy and protein needs and it’s important that their micronutrient needs for vitamin C, zinc and copper are also met [3]. Supporting people to access adequate nutrition may mean the foods provided need to be fortified with protein and energy and presented in a modified texture form (pureed or minced and moist) that are easy to eat and swallow.

Early Identification and Treatment

Early identification of individuals at risk of pressure injuries and ensuring appropriate fortified meals are available, can also be key factors in ‘getting the basics right’. This could include the use of a validated nutrition risk screen. The use of this is of particular importance for individuals being admitted to a residential care facility. High-risk residents can subsequently be immediately identified and appropriate nutritional care plans can then be put in place. Regular monitoring of these nutritional care plans and incorporation of any requirements for fortified food and fluids could then, once again, reduce the risk of malnutrition and pressure injuries.

And it really is that simple. By ensuring someone is well nourished you’re already reducing the chances of a pressure injury and decreasing the cost of pressure injuries on the health care system. It’s a win win situation for everyone. So what have we got to lose by getting the basics right?

  1. KPMG, The case for investment in: A quality improvement programme to reduce pressure injuries in New Zealand, 2015.
  2. British Association for Parenteral and Enteral Nutrition. BAPEN Meets NHS Midlands and East for a Focus on Nutrition and Hydration. 2015  06/05/17]; Available from:
3. European Pressure Ulcer Advisory Panel & National Pressure Ulcer Advisory Panel, Prevention and treatment of pressure ulcers: quick reference guide, 2009, National Pressure Ulcer Advisory Panel: Washington DC.

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