Pressure injuries (bed sores) are painful, dangerous, and often preventable. Preventing them is one of the most important things a PSW does — and it shows up often on the exam.
What Causes Them
Pressure injuries form when constant pressure cuts off blood flow to the skin, usually over a bony area. They develop fastest in clients who cannot move themselves.
High-Risk Areas
- Heels and ankles
- Tailbone (sacrum) and hips
- Shoulder blades and elbows
- Back of the head and ears
The Four Stages (Simplified)
- Stage 1: Red skin that does not turn white when pressed.
- Stage 2: Broken skin, a blister or shallow open sore.
- Stage 3: Deeper wound into the fatty tissue.
- Stage 4: Very deep, reaching muscle or bone.
How PSWs Prevent Them
- Reposition every 2 hours (or as the care plan states).
- Keep skin clean and dry — moisture damages skin.
- Use pillows to relieve pressure on bony areas.
- Check skin during care and report any redness immediately.
- Keep bedding smooth and wrinkle-free.
🔑 Key Takeaways
- Pressure injuries form over bony areas from constant pressure.
- Reposition every 2 hours to prevent them.
- Stage 1 = non-blanching redness; report it early.
- Keep skin clean, dry, and pressure-free.